Hypertension

What is hypertension?

Hypertension (hye-per-TEN-shun) is also known as high blood pressure. It occurs when the blood pressing on the inside of your arteries (blood vessels) is higher than normal. Hypertension may damage your arteries. This may make you more likely to have a stroke, heart attack, kidney problems, or heart disease. High blood pressure can cause serious health problems, even if you do not feel sick. Hypertension is often called "the silent killer" because you may not have symptoms.

What may increase my risk of having hypertension?

High blood pressure can be treated with medicine and lifestyle changes. Many things may increase your risk of having high blood pressure. Some examples include:

• Smoking.
  
  
• Having diabetes (dye-ah-BEE-teez).
  
  
• Having a family history of heart disease.
  
  
• Having high cholesterol (koh-LES-ter-ol).
  
  
• Being over 60 years old.
  
  
• Being a male.
  
  
• Being a female who has been through menopause (the change of life).

What is blood pressure?

• Blood pressure is a measurement of the pressures put on the blood vessel walls of your body. There are two parts to a blood pressure measurement. The systolic (sis-TOL-ik) pressure is the top or the first number in a blood pressure reading. The diastolic (dye-ah-STOL-ik) pressure is the bottom or second number in the reading. Here is an example: 120/80, 120 is the systolic number and 80 is the diastolic number. The systolic number is the strongest pressure felt by the blood vessel walls. It happens when the heart is squeezing out blood. The diastolic number is the pressure put on blood vessel walls when your heart is at rest. When saying a blood pressure, use the word "over" to replace the slash. For example, the above blood pressure would be "120 over 80."
  
  
• High blood pressure is when the systolic number is higher than 140 or when the diastolic number is higher than 90. Only one of these numbers needs to be high to have high blood pressure. For example: 118/98, the systolic number (118) is normal, but the diastolic number (98) is high. For the blood pressure of 180/70, the systolic number (180) is high, but the diastolic number (70) is not. A good systolic number is less than 120. For some people, a number between 90 and 100 is normal. A good diastolic number is usually lower than 80 mm Hg. Your caregiver can tell you what is normal for you.

What are the types of hypertension?

• Prehypertension: A blood pressure that is very close to the numbers for hypertension is called prehypertension. A systolic pressure between 120 and 139, or a diastolic pressure between 80 and 89 is considered prehypertensive. Having prehypertension makes you more likely to develop an even higher blood pressure in the future. If you are prehypertensive, your caregiver may suggest lifestyle changes. If you have kidney disease or diabetes, you may need medicine to treat your prehypertension.
  
  
• Primary hypertension: Also known as essential (ee-SEN-shal) or idiopathic (id-ee-oh-PATH-ik) hypertension. This is the most common type of hypertension and occurs in about 90 percent of people. The cause of primary hypertension is not known.
  
  
• Secondary hypertension: Is usually caused by a medical condition or a medicine. Some examples include:
  
  
  • Kidney disease.
    
    
  • Sleep apnea (when breathing stops for short periods during sleep).
    
    
  • Stress.
    
    
  • Medicines such as aspirin, ibuprofen (eye-bu-PROH-fen), and pseudoephedrine (soo-doh-ee-FED-rin). This medicine is found in some cold medicines.
  
  
• Isolated systolic hypertension: This happens when your systolic number (top number) is over 160 mm Hg.
  
  
• White coat hypertension: High blood pressure that only happens when you get nervous or stressed because you are in a doctor's office.

What are the signs and symptoms of hypertension?

You may not have any symptoms unless you have another illness, such as kidney disease. You may have one or more of the following signs and symptoms of hypertension:

• Blurred vision or a headache.
  
  
• Sleepiness or confusion.
  
  
• Nosebleeds or coughing up blood.
  
  
• Numbness or tingling in your hands or feet.
  
  
• Shortness of breath.

What may be done to help lower my blood pressure?

• Tests will be done to learn why your blood pressure is high. Medicine may be needed to lower your blood pressure. If another illness is causing your high blood pressure, that illness will need to be treated.
  
  
• Quit smoking, and lose weight if you are overweight. Exercise three or more times a week if your caregiver says it is OK. Eat healthy foods low in fat and salt. Also eat foods that are high in fiber (roughage), such as vegetables, whole grains, or fruits. Decrease the amount of caffeine that you eat or drink. Learn to control your stress, such as using relaxation tapes or biofeedback.
  
  
• Alcohol causes blood pressure to rise in some people. If you drink alcohol, do not drink more than two drinks a day. One drink is a can of beer (12 ounces) or four ounces (one-half of a cup) of wine. It is also the same as one jigger (one and one-half ounces) of hard liquor, such as whiskey.

Where can I go for more information?

You may feel scared, confused, and anxious because of your high blood pressure. Hypertension can usually be treated with medicine. Call or write the following organizations for more information about hypertension.

• American Heart Association National Center
  7272 Greenville Avenue
  Dallas, TX 75231-4596
  Phone: 1-800-242-8721
  Web Address: http://www.americanheart.org
  

• National Heart, Lung and Blood Institute
  Health Information Center
  P.O. Box 30105
  Bethesda, MD 20824-0105
  Phone: 1-301-592-8573
  Web Address: http://www.nhlbi.nih.gov/health/infoctr/index.htm
  

Care Agreement

You have the right to help plan your care. To help with this plan, you must learn about your health condition and how it may be treated. You can then discuss treatment options with your caregivers. Work with them to decide what care may be used to treat you. You always have the right to refuse treatment.