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Did you know that high blood pressure, also known as hypertension, is one of the most common conditions in the United States? According to the American Heart Association, more than 100 million Americans have high blood pressure.
As a clinician, I see patients every day with this condition. However, it rarely causes symptoms. Very often, diseases that do not cause symptoms are not taken as seriously as they should be.
In this article, I’ll review what high blood pressure is, why it’s so dangerous, and what you can do to effectively manage it.
What is high blood pressure?
In order to understand why high blood pressure is a major problem, it is first vital to know what blood pressure actually means. For this, I like to use the metaphor of water running through the pipes of your house. This is similar to your own body but instead of pipes, you have blood vessels, and instead of water, you have blood.
Blood vessels are the transportation system of your body, like the pipes that transport water to all the sinks and showers of your house. Blood takes small particles all around the body to deliver oxygen and nutrients to tissues. Blood is carried around the body through blood vessels that go through every organ from your heart and brain to your liver and kidneys. Without blood running through these organs, the organs would not have the important oxygen and nutrients they need to function.
Blood pressure is the force with which the blood flows through the vessels. There is an ideal pressure with which the blood should flow through the vessels. This allows for proper and timely delivery of oxygen and nutrients without damage. The pressure is specifically the force with which the blood hits the walls of the vessels. If this force is too high, the walls of the vessels could be damaged.
Blood pressure explained using an analogy
High blood pressure can be thought of as a rushing river rapid whose water is slamming into a rock. With high blood pressure, the blood could be slamming into the walls of the blood vessels with great force.
Low blood pressure is the opposite end of the spectrum – like a slow-moving stream that is drying up. The blood may not properly get to its destination. A solution to a slow-moving stream is rain, and so too, one potential solution for low blood pressure is to drink more water as low blood pressure is common with dehydration.
Hypertension by the numbers
Blood pressure is read as the top number/bottom number.
What do these numbers represent? The top number is the systolic pressure in your heart and blood vessel system when the heart is pumping. The bottom number is the diastolic pressure when the heart is filling.
When the heart is pumping, blood is injected into the blood vessels and the pressure will be higher. When the heart is filling between beats, the system is at rest and the pressure will be lower.
What is considered “normal” blood pressure?
As you can imagine, blood pressure guidelines are always being updated. Recently, these guidelines were changed by the American Heart Association. 120/80 is what we consider “normal” blood pressure. This is measured in millimeters of mercury.
For the top number, between 120 and 130 is the caution stage (the yellow light on a traffic light as I tell my patients). Over 130 is considered early-stage high blood pressure (stage I), and over 140 is concerning (stage 2).
For the lower number, between 80-90 being the caution stage and over 90 is considered high blood pressure.
Why is high blood pressure so dangerous?
What happens when water continuously hits a rock in a river at high speed? The surface of the rock begins to erode from the continuous pounding over time. The structures in your body also change over time from high blood pressure.
Many months to years of blood slamming into blood vessel walls at high pressure is not good for the health of the vessel walls. They become stiffer due to the erosion of the elastic tissues and could potentially break in the wrong place, such as the brain which causes a stroke. Hardening of the blood vessels could also impact the efficiency of blood delivery to the tissues.
Blood runs not only through the blood vessels but also through the heart. The effects of high blood pressure on the heart are not good, especially if high blood pressure has been present for a long time. To protect itself against the effects of blood slamming into its walls at high speed from high blood pressure, the heart thickens its walls. The problem with thicker heart walls is that they take up space and hence, there is less room for the blood to enter and leave the heart. This can cause negative effects such as issues with heart contraction and irregular heart rhythms.
Why do so many people have high blood pressure?
As I mentioned, high blood pressure is very common in the United States. Why? One of the big driving factors is the average American lifestyle. Poor diet and a sedentary lifestyle increase the risk of high blood pressure as does the obesity that generally comes with it. A diet high in salt and excess alcohol and caffeine consumption are risk factors for the disease.
Everyone should be screened for high blood pressure. This is one of the many reasons that a yearly wellness physical with your physician is so important. You should be screened by a physician at least once yearly for high blood pressure and possibly even more often if you’re at higher risk.
How to treat and manage hypertension
The good news is that high blood pressure is treatable and the dangerous end results of high blood pressure are preventable. High blood pressure can be treated with a variety of lifestyle modifications from limiting salt in the diet, eliminating alcohol and caffeine, and weight loss (if you’re overweight or obese).
Unfortunately, not all high blood pressure can be treated with lifestyle modifications alone. There are several types of prescription medication available to lower blood pressure. Sometimes, the medication is only needed for a few months until the lifestyle modification changes kick in. However, oftentimes, blood pressure medication is needed lifelong.
In the end, I hope I made it clear the high blood pressure is a dangerous, yet very treatable condition. Remember to speak to your physician to see where you stand on the blood pressure scale and if any interventions are necessary. There is no one size fits all approach as treatment is always tailored to the individual;
Do you or someone you know have high blood pressure? What are they doing to manage it? Share your thoughts in the comments below.