High Blood Pressure
High blood pressure is also called Hypertension or HBP. It is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.
Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.
You can have high blood pressure (hypertension) for years without any symptoms. Even without symptoms, damage to blood vessels and your heart continues and can be detected. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.
High blood pressure generally develops over many years, and it affects nearly everyone eventually. Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it.
When is one supposed to see a doctor?
You will likely have your blood pressure taken as part of a routine doctor’s appointment. It is advisable that you should ask your doctor for a blood pressure reading at least every two years starting at age 18. If you’re age 40 or older, or you’re 18 to 39 with a high risk of high blood pressure, ask your doctor for a blood pressure reading every year.
Blood pressure generally should be checked in both arms to determine if there’s a difference. It’s important to use an appropriate-sized arm cuff.
Your doctor will likely recommend more frequent readings if you’ve already been diagnosed with high blood pressure or have other risk factors for cardiovascular disease. Children age 3 and older will usually have blood pressure measured as a part of their yearly checkups.
f you don’t regularly see your doctor, you may be able to get a free blood pressure screening at a health resource fair or other locations in your community. You can also find machines in some stores that will measure your blood pressure for free.
Public blood pressure machines, such as those found in pharmacies, may provide helpful information about your blood pressure, but they may have some limitations.
The accuracy of these machines depends on several factors, such as the correct cuff size and proper use of the machines. Ask your doctor for advice on using public blood pressure machines.
Types of High Blood Pressure
There are two types of high blood pressure. Primary or Essential High Blood Pressure and Secondary High Blood Pressure. Both types are discussed as follows:
1. Primary (Essential) hypertension
Essential hypertension is high blood pressure that doesn’t have a known secondary cause. It’s also referred to as primary hypertension.
Blood pressure is the force of blood against your artery walls as your heart pumps blood through your body. Hypertension occurs when the force of the blood is stronger than it should be normally.
Most cases of high blood pressure are classified as essential hypertension. The other kind of hypertension is secondary hypertension. Secondary hypertension is high blood pressure that has an identifiable cause, such as kidney disease.
For most adults, there’s no identifiable cause of high blood pressure. This type of high blood pressure, called primary (essential) hypertension, tends to develop gradually over many years.
Primary (Essential) Hypertension Risks
Genetic factors are thought to play a role in essential hypertension. The following factors may increase your risk of developing essential hypertension:
- Minimal physical activity
- Being overweight
Symptoms of Primary High Blood Pressure
Most people won’t notice any symptoms of essential hypertension. They usually discover that their blood pressure is high during a regular medical checkup. Essential hypertension can begin at any age. It most often occurs first during middle age.
2. Secondary hypertension
Secondary hypertension (secondary high blood pressure) is high blood pressure that’s caused by another medical condition. Secondary hypertension can be caused by conditions that affect your kidneys, arteries, heart or endocrine system. Secondary hypertension can also occur during pregnancy.
Secondary hypertension differs from the usual type of high blood pressure (primary hypertension or essential hypertension), which is often referred to simply as high blood pressure. Primary hypertension has no clear cause and is thought to be linked to genetics, poor diet, lack of exercise and obesity.
Proper treatment of secondary hypertension can often control both the underlying condition and the high blood pressure, which reduces the risk of serious complications — including heart disease, kidney failure, and strokes.
Symptoms of Secondary HBP
Like primary hypertension, secondary hypertension usually has no specific signs or symptoms, even if your blood pressure has reached dangerously high levels.
If you’ve been diagnosed with high blood pressure, having any of these signs may mean your condition is secondary hypertension:
- High blood pressure that doesn’t respond to blood pressure medications (resistant hypertension)
- Very high blood pressure — systolic blood pressure over 180 millimeters of mercury (mm Hg) or diastolic blood pressure over 120 mm Hg
- High blood pressure that no longer responds to medication that previously controlled your blood pressure
- Sudden-onset high blood pressure before age 30 or after age 55
- No family history of high blood pressure
- No obesity
Causes os Secondary HBP
A number of conditions can cause secondary hypertension. Several kidney diseases may cause secondary hypertension, including:
- Diabetes complications (diabetic nephropathy). Diabetes can damage your kidneys’ filtering system, which can lead to high blood pressure.
- Polycystic kidney disease. In this inherited condition, cysts in your kidneys prevent the kidneys from working normally and can raise blood pressure.
- Glomerular disease. Your kidneys filter waste and sodium using microscopic-sized filters called glomeruli that can sometimes become swollen. If the swollen glomeruli can’t work normally, you may develop high blood pressure.
- Renovascular hypertension. This type of hypertension is caused by narrowing (stenosis) of one or both arteries leading to your kidneys. Renovascular hypertension is often caused by the same type of fatty plaques that can damage your coronary arteries (atherosclerosis) or a separate condition in which the muscle and fibrous tissues of the renal artery wall thicken and harden into rings (fibromuscular dysplasia). This condition can cause irreversible kidney damage.
Medical conditions affecting hormone levels may also cause secondary hypertension. These conditions may include:
- Cushing syndrome. In this condition, corticosteroid medications may cause secondary hypertension, or hypertension may be caused by a pituitary tumor or other factors that cause the adrenal glands to produce too much of the hormone cortisol.
- Aldosteronism. In this condition, a tumor in one or both of the adrenal glands, increased growth of normal cells in one or both of the adrenal glands or other factors cause the adrenal glands to release an excessive amount of the hormone aldosterone. This makes your kidneys retain salt and water and lose too much potassium, which raises blood pressure.
- Pheochromocytoma. This rare tumor, usually found in an adrenal gland, increases the production of the hormones adrenaline and noradrenaline, which can lead to long-term high blood pressure or short-term spikes in blood pressure.
- Thyroid problems. When the thyroid gland doesn’t produce enough thyroid hormone (hypothyroidism) or produces too much thyroid hormone (hyperthyroidism), high blood pressure can result.
- Hyperparathyroidism. The parathyroid glands regulate levels of calcium and phosphorus in your body. If the glands secrete too much parathyroid hormone, the amount of calcium in your blood rises — which triggers a rise in blood pressure.
Other possible causes of secondary hypertension include:
- Coarctation of the aorta. With this defect that’s generally present at birth, the body’s main artery (aorta) is narrowed (coarctation). This forces the heart to pump harder to get blood through the aorta and to the rest of your body. This, in turn, raises blood pressure — particularly in your arms.
- Sleep apnea. In this condition, often marked by severe snoring, breathing repeatedly stops and starts during sleep, causing you to not get enough oxygen.
Not getting enough oxygen may damage the lining of the blood vessel walls, which may make your blood vessels less effective in regulating your blood pressure. In addition, sleep apnea causes part of the nervous system to be overactive and release certain chemicals that increase blood pressure.
- Obesity. As you gain weight, the amount of blood circulating through your body increases. This puts added pressure on your artery walls, increasing your blood pressure.
Excess weight often is associated with an increase in heart rate and a reduction in the capacity of your blood vessels to transport blood. In addition, fat deposits can release chemicals that raise blood pressure. All of these factors can cause hypertension.
- Pregnancy. Pregnancy can make existing high blood pressure worse or may cause high blood pressure to develop (pregnancy-induced hypertension or preeclampsia).
- Medications and supplements. Various prescription medications — such as pain relievers, birth control pills, antidepressants and drugs used after organ transplants — can cause or aggravate high blood pressure in some people.
Over-the-counter decongestants and certain herbal supplements, including ginseng, licorice, and ephedra (ma-huang), may have the same effect. Many illegal drugs, such as cocaine and methamphetamine, also increase blood pressure.
Secondary Hypertension Risk Factor
The greatest risk factor for having secondary hypertension is having a medical condition that can cause high blood pressure, such as kidney, artery, heart or endocrine system problems.
Secondary Hypertension Complications
Secondary hypertension can worsen the underlying medical condition you have that’s causing your high blood pressure. If you don’t receive treatment, secondary hypertension can also be associated with other medical conditions, such as:
- Damage to your arteries. This can result in hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications.
- Aneurysm. Increased blood pressure can cause your blood vessels to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening.
- Heart failure. To pump blood against the higher pressure in your vessels, your heart muscle thickens. Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body’s needs, which can lead to heart failure.
- Weakened and narrowed blood vessels in your kidneys. This can prevent these organs from functioning normally.
- Thickened, narrowed or torn blood vessels in the eyes. This can result in vision loss.
- Metabolic syndrome. This syndrome is a cluster of disorders of your body’s metabolism — including increased waist circumference, high triglycerides, low high-density lipoprotein (HDL) cholesterol (the “good” cholesterol), high blood pressure and high insulin levels.
If you have high blood pressure, you’re more likely to have other components of metabolic syndrome. The more components you have, the greater your risk of developing diabetes, heart disease or stroke.
- The trouble with memory or understanding. Uncontrolled high blood pressure also may affect your ability to think, remember and learn. The trouble with memory or understanding concepts is more common in people who have high blood pressure.
High Blood Pressure Symptoms
One of the most dangerous aspects of hypertension is that you may not know that you have it. In fact, nearly one-third of people who have high blood pressure don’t know it.
The only way to know if your blood pressure is high is through regular checkups. This is especially important if you have a close relative who has high blood pressure.
If your blood pressure is extremely high, there may be certain symptoms to look out for, including:
- Severe headache
- Fatigue or confusion
- Vision problems
- Chest pain
- Difficulty breathing
- Irregular heartbeat
- Blood in the urine
- Pounding in your chest, neck, or ears
If you have any of these symptoms, see a doctor immediately. You could be having a hypertensive crisis that could lead to a heart attack or stroke.
Myth: People with high blood pressure will experience symptoms, like nervousness, sweating, difficulty sleeping or facial flushing.
Truth: High blood pressure is a largely symptomless “silent killer.” If you ignore your blood pressure because you think a certain symptom or sign will alert you to the problem, you are taking a dangerous chance with your life.
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