High blood pressure, also known as hypertension, is commonly referred to as “the silent killer.” This common chronic illness often does not produce early symptoms. Yet, the effects of high blood pressure on the body can lead to significant medical problems.
High blood pressure is defined as a blood pressure in excess of 140/90 in an adult. When this is present on three separate readings at rest, it qualifies for treatment as a chronic illness. Blood pressure is measured usually in the upper arm using a pressure cuff and stethoscope. Digital devices for blood pressure measurement are also manufactured for use in doctor’s offices and at home. Blood pressure should be measured at rest in a seated position for maximum accuracy.
Risk factors for high blood pressure include a family history of high blood pressure, being overweight, smoking, drinking alcohol, a sedentary lifestyle and a high sodium (salt) diet.
High blood pressure rarely produces symptoms early in its course. For this reason, many people are not aware that they have the condition. It is recommended that all adults have their blood pressure measured at least yearly. People with other chronic illnesses such as heart or kidney disease or diabetes should be monitored more frequently.
The effects of high blood pressure accumulate over time. High blood pressure is one of the leading risk factors (along with smoking, diabetes mellitus, high cholesterol and family history) for heart disease and stroke. High blood pressure is also the second leading cause (behind diabetes) for acquired kidney failure in the United States.
Elevated blood pressure can have adverse effects on vision and can also affect circulation to the legs, also known as peripheral vascular disease. Peripheral vascular disease is a major risk factor for amputation.
The treatment of high blood pressure begins with lifestyle modification, including weight loss, regular aerobic activity (like walking briskly for 30 minutes daily) and a reduction in dietary salt intake. People with high blood pressure should not consume more than 2,000 milligrams of sodium daily (compared with the 9,000 milligrams daily consumed by most Americans). Stopping tobacco use and reducing alcohol use is also important, because both can raise blood pressure.
There are many medications for the treatment of high blood pressure. The individual selection of a blood pressure medication is determined by the patient and doctor after consideration of factors such as age, gender, coexisting medical problems and potential medication side effects. Medications may need to be adjusted from time to time.
Routine monitoring of people with high blood pressure includes not only blood pressure monitoring but also lab testing to screen for kidney or heart problems as well as monitoring the effects of any medications.
Dr. Matthew A. Clark is a board-certified physician in internal medicine and pediatrics practicing at the Ute Mountain Ute Health Center in Towaoc.