Hypertension is a condition in which an individual’s blood pressure is higher than 120 mmHg and the diastolic is above 80 mmHg averaged over time.  Blood pressure is the force that a person’s blood exerts against the wall of their blood vessels. This pressure depends on the resistance of the blood vessels, in particular, how hard the heart has to work.  In patients 60 years or older who do not have diabetes or chronic kidney disease, the goal blood pressure level is now <150/90 mm Hg. In patients 18 to 59 years of age without major comorbidities, and in patients 60 years or older who have diabetes, chronic kidney disease (CKD), or both conditions, the new goal blood pressure level is <140/90 mm Hg.

There are different stages of hypertension:

Normotensive blood pressure: No risk for hypertension (measured as less than 120 mmHg systolic or less than 80 mmHg diastolic)

Prehypertensive blood pressure: At risk for developing hypertension (measured as 120-139 mmHg systolic or 80-89 mmHg diastolic)

Stage 1 hypertension: High blood pressure that may be treated with lifestyle changes or medication (measured as 140-159 mmHg systolic or 90-99 mmHg diastolic)

Stage 2 hypertension: High blood pressure that may require one or two medications (counted as greater than 160 mmHg systolic or higher than 100 mmHg diastolic)

Having hypertension is a primary risk factor for cardiovascular disease, including stroke, heart attack, kidney failure, heart failure, and aneurysm. Among Arkansas Medicare patients, the average rate of hypertension is 55.6%, which is approximately equal to the national average of 55.4%. Lifestyle changes and modifications can help to control and manage high blood pressure. Examples of lifestyle changes include: Eating a heart-healthy diet with less salt, getting regular physical activity, maintaining a healthy weight or losing weight, limiting alcohol, not smoking, and getting 7 to 9 hours of sleep daily. However, sometimes lifestyle changes are not enough to treat high blood pressure, and there are several options in medications to safely lower blood pressure. The medications that would be beneficial to treat high blood pressure are:

Fluid pills will expel the excessive sodium in the body.

Beta-blockers, which will slow down the heartbeat.

Angiotensin-converting enzyme (ACE) inhibitors, will help to relax and narrow blood vessels.

Alpha-blockers will cause the blood to flow freely by keeping the nerves from tightening the blood vessels.

Calcium channel blockers, which will relax the blood cells.

Unfortunately, high blood pressure usually has no warning signs or symptoms; that is why it is called the “silent killer” as many don’t know that they have it. You can have high blood pressure for years without any symptoms. A few people with high blood pressure may have headaches, shortness of breath, and nosebleeds. Measuring your blood pressure is the only way to know whether you have it. For the most reliable blood pressure measurement, the American Heart Association recommends using a monitor with a cuff around your upper arm, when available.

The takeaway message is to regularly see your Primary Care Provider and to keep your doctor appointments including your annual wellness examinations, as high blood pressure can go undiagnosed for years leading to more serious conditions. When you treat your doctor like a health partner, they will be better equipped to provide medical intervention early, before you experience any negative or lasting impacts to your health.

Dimple Barolia, MD, is accepting patients at White River Health Internal Medicine. To schedule an appointment, call 870-262-1530. 

Posted January 30, 2023