Under Pressure: The Wear and Tear of Hypertension
Some people say they can actually feel their blood pressure rising when they are stressed or upset. Most wish the signs were as obvious. That’s because while the symptoms of hypertension (high blood pressure) are often subtle, its total effect on your body can be the opposite.
“Uncontrolled, long-standing hypertension can lead to heart disease, including heart attacks and congestive heart failure, as well as kidney disease, strokes and complications within the eye,” explains Brad Granger, MD, Medical Associates of Lancaster (a Lancaster General Medical Group internal medicine practice).
Marc Weiner, MD, Hypertension & Kidney Specialists, elaborates, “Over time the wear and tear causes damage to your organs. Your arteries may also start to thicken or develop little tears in the lining that can cause ruptures when the pressure is too high for too long.”
Hypertension is a serious health concern that affects one in four American adults. Many ignore the problem because they think it won’t hurt them. Other people mistakenly think that if they feel healthy, they can’t have hypertension.
For most people, normal blood pressure readings are less than 140 mmHg systolic (top number) and less than 90 mmHg diastolic
(bottom number) (see “Blood Pressure Defined” for more information). If either number is higher on a regular basis, you have hypertension.
“Everyone is at risk for developing hypertension,” says Dr. Weiner. “But if you wait until you have symptoms to start taking action, it’s already damaging your organs. So be proactive.”
The exact cause of hypertension varies from person to person. Often doctors don’t know why it develops. But they do know that sleep apnea, thyroid disease, chronic kidney disease and specific medications can cause hypertension.
Doctors have also identified contributing risk factors that include:
- Obesity
- High sodium intake
- Inactivity
- Cigarette smoking
- Advanced age
- Family history
If your blood pressure readings are consistently above 120/80, but below 140/90, you may have prehypertension (borderline high blood pressure), which some doctors view as a potential warning sign of hypertension. Dr. Granger recommends patients with this condition try lifestyle changes first. “We are particularly aggressive in treating these patients if they have known heart disease or risk factors for heart disease. It is often helpful for patients to measure their blood pressure at home with a home blood pressure monitor,” he says.
Dr. Weiner explains that the key lifestyle modifications he recommends are:
- Eating healthier
- Losing weight
- Quitting smoking
- Exercising
One diet plan has proven especially successful in helping patients reduce their blood pressure. The DASH diet (Dietary Approaches to Stop Hypertension) takes into consideration the impact different food nutrients have on blood pressure. Studies show that a diet high in fruits and vegetables and low in fat and cholesterol can sometimes significantly reduce a person’s blood pressure. Other studies indicate that consuming less than 2.4 grams of sodium a day can help lower blood pressure.
“Patients with borderline or mild hypertension are often able to bring their blood pressure into the normal range with lifestyle changes alone,” Dr. Granger says. “Weight loss of even 5-10 pounds can sometimes bring about a significant reduction in blood pressure.”
However, sometimes lifestyle changes aren’t enough to bring blood pressure under control. In these cases, doctors may prescribe a medication such as a diuretic, beta-blocker or ACE inhibitor to help manage it.
Even if you feel healthy, get your blood pressure checked by your doctor regularly. Lancaster General also has automatic blood pressure machines at Lancaster General Hospital and the Lancaster General Health Campus. Although not as accurate as your doctor’s readings, these machines can be helpful between visits.
Blood Pressure Defined
Blood pressure is the force of blood pushing against the walls of your arteries.
A blood pressure measurement includes two numbers.
The higher number (top), or systolic pressure, refers to the pressure inside the artery when the heart contracts and pumps blood.
The lower number (bottom), or diastolic pressure, refers to the pressure inside the artery when the heart is at rest and is filling with blood.
Both numbers are recorded as “mmHg” (millimeters of mercury), which shows how high the pressure of the blood raises the mercury column in the dial.
Return to Generally Speaking Fall 2004 Issue