High Blood Pressure (HBP) (also known as hypertension) is a chronic medical condition in which the pressure of blood in the arteries gets elevated. When your heart beats, it pumps blood into your body to provide the energy and oxygen it needs. As the blood flows, it pushes against the sides of the blood vessels; this pressure is known as blood pressure. If your blood pressure is higher than normal, it puts an extra burden on your arteries (and your heart), which may lead to heart attack and stroke.
How to Measure Your Blood Pressure?
A sphygmomanometer (blood pressure meter) is a medical instrument used by Health Care Professionals (HCPs) to measure your blood pressure. A sphygmomanometer consists of:
- An inflatable cuff to restrict blood flow is placed on your upper arm. It provides a measure of the pressure in the brachial artery, the main artery in the upper arm.
- A mercury or mechanical manometer to measure the pressure. It measures blood pressure in two numbers:
1. an Upper number of High Blood Pressure:
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- This number measures the pressure when your heart beats. It is known as Systolic blood pressure (SBP).
2. Lower Number of High Blood Pressure:
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- This number measures the pressure in your arteries between beats. It is known as Diastolic blood pressure (DBP).
- In the case of a manual sphygmomanometer- a stethoscope is used to determine the pressure of blood flow.
According to the Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of it (JNC 7), blood pressure falls into four categories for adults who are 18 years and older:
Risk Factors of High Blood Pressure
1. Ethnicity:
According to a study, High Blood Pressure (HBP) is more common and severe in African Americans and develops at an earlier age as compared to Whites and Mexican Americans. Among African Americans, women are more prone to High Blood Pressure (HBP) as compared to men.
2. Family History:
high blood pressure (HBP) runs in genes. If your parents, siblings, or close blood relatives have it, then you are at a greater risk of having HBP.
Lifestyle Factors
1. Alcohol:
- Recent research suggests that heavy drinking is associated with high blood pressure (HBP). More than three drinks per day can increase your risk of high blood pressure (HBP) along with high cholesterol levels. For people who consume alcohol, moderate consumption is recommended, i.e. for men, no more than two drinks per day, and for women, no more than one drink per day
2. Age:
- The prevalence of hypertension increases with advancing age due to the following reasons:
- Changes in hormone levels
- The efficiency of the heart decreases with age
- Changes in the walls of arteries and other blood vessels
3. Higher intake of sodium in diet:
- Sodium is a commonly used food preservative. If you eat a lot of packaged, processed, or restaurant foods, you are likely to consume higher than recommended amounts of daily sodium intake. Consuming a higher amount of sodium in the body results in fluid retention, which increases blood pressure
4. Lack of vitamin D:
- Vitamin D is known to be vital for good health, growth, and strong bones. According to a study, vitamin D also acts as an anti-hypertensive agent. It antagonizes the effect of an enzyme renin (present in the kidneys), which accelerates the synthesis of a hormone known as angiotensin. Since angiotensin increases blood volume and blood pressure, inhibiting its effect has a favorable impact on lowering the blood pressure
5. Physical inactivity:
- According to a study, approximately 35 percent of coronary heart disease mortality in the US is due to physical inactivity. If you are physically inactive, then you are at a greater risk of having a higher heart rate. At an elevated heart rate, the workload on your heart increases, which puts extra pressure on the arteries and hence raises your blood pressure
6. Smoking:
- Cigarette contains a harmful substance, known as nicotine, which can damage the lining of your artery walls. Thus, smoking leads to the narrowing of the arteries and an increase in blood pressure
Medical Conditions
1. Insomnia:
- Sleep is the natural process that calms and relaxes your body after a long hectic day. If you are sleeping for less than six hours a day or waking up more than two to three times at night, it raises your risk of high blood pressure. Lack of sleep elevates your stress hormones, which in turn may raise your heart rate. (To know more click here)
2. Pre-hypertension:
- If your blood pressure levels are higher than normal, i.e. systolic pressure between 120-139 mmHg and diastolic pressure between 80-89 mmHg, then you are at a risk for developing high blood pressure. Basically, pre-hypertension helps both patients and clinicians to intervene on time and prevent or delay its development of it.
Systolic blood pressure (Upper number):
- It is the pressure in your blood vessels when your heart beats; Diastolic blood pressure (Lower number): It is the pressure in your blood vessels when your heart rests between beats.
Overweight/Obesity
People who are overweight or obese i.e. body mass index (BMI) ≥30kg/m2, have higher blood volume as more blood is required to supply oxygen and nutrients to the tissues. To cope with the body’s demands, the arteries have to pump more blood, which increases the pressure on their walls and results in high blood pressure.
Prevention of High Blood Pressure
High Blood Pressure (HBP), i.e. blood pressure >140/90 mmHg, affects nearly one-third of American adults aged 18 or older, which is approximately 67 million people in the US. It is a life-threatening disease and if left untreated can lead to heart disease, kidney failure, stroke, and blindness.
Since high blood pressure is a silent disease and shows no signs and symptoms, you need to visit your physician regularly to check your blood pressure levels as a preventive measure. You can also use a home monitoring device to check your blood pressure on a regular basis.
Be Alert: Pre-hypertension
According to the Seventh Report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure (JNC 7), a new term known as pre-hypertension has been introduced for people whose systolic blood pressure ranges between 120–139 mmHg and/or diastolic between 80–89 mmHg.
Table 3.1
Systolic blood pressure (Upper number): It is the pressure in your blood vessels when your heart beats; Diastolic blood pressure (Lower number): It is the pressure in your blood vessels when your heart rests between beats.
Pre-hypertension is a warning sign for the risk of High Blood Pressure (HBP) in individuals. After this diagnosis, you can take some steps to prevent or lower the risk of high blood pressure (hypertension), which include:
- Be physically active
- Have healthy eating habits
- Limit your alcohol intake
- Maintain healthy weight
- Manage your stress levels
- Say no to smoking
- Sleep well
Be Physically Active High Blood Pressure
Regular physical activity is one of the important measures to prevent or control high blood pressure. It reduces your risk of heart disease, high cholesterol, diabetes, stroke, colon cancer, and other medical problems.
Brisk walking, bicycling, weight lifting, dancing, raking leaves, car washing, house cleaning, and gardening are excellent sources of moderate-level activity. You can always begin by doing 30 minutes of exercise in your daily routine. Often you may find it hard to fit regular exercise into your busy lifestyle. Therefore you can follow these simple steps to maintain a healthy lifestyle:
- Take a 10-minute walk during your lunch break
- Don’t sit after a meal. Keep moving or take a brisk walk
- Park your car far so that you can walk more
- Perform stretching exercises while listening to some music
- Use stairs instead of an elevator
- Consult your doctor before you start with any moderate-level activity, especially:
- If you have any family history of heart disease at an early age
- If you are 50 years or older
- If you had a heart attack or any other heart problem
Maintain a Healthy Weight
If you are overweight or obese, then you are at a higher risk of having high blood pressure along with high blood cholesterol and diabetes. According to a study conducted on a large proportion of overweight persons, 10 lbs (4.5 kg) of weight loss reduces or prevents it in individuals. To shed the extra pounds, you can combine the DASH eating plan with regular activity, which prevents or reduces high blood pressure.
Treatment Guidelines for High Blood Pressure (HBP)
It is associated with a greater risk of heart attack, stroke, and kidney disease. To reduce these risks associated with high blood pressure, JNC7 (the Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure) has provided a new classification of blood pressure for adults 18 years or older.
New Classification of Blood Pressure for Adults
Systolic blood pressure (Upper number): It is the pressure in your blood vessels when your heart beats; Diastolic blood pressure (Lower number): It is the pressure in your blood vessels when your heart rests between beats.
According to the revised classification by JNC7:
1. Pre-hypertension is a warning sign:
- A new term known as pre-hypertension has been introduced for people whose systolic blood pressure ranges between 120–139 mmHg and/or diastolic between 80–89 mmHg. It is a warning sign for people who are at a higher risk of developing high blood pressure in the future
2. SBP is a major risk factor for Cardiovascular Diseases (CVDs):
- JNC7 states that with advancing age, systolic blood pressure of more than 140 mmHg is an important risk factor for CVDs as compared to diastolic pressure. For people older than 50 years of age, systolic hypertension (elevated systolic blood pressure >140 mmHg) is the most common form of hypertension
