Health Concerns - Hypertension
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What is Hypertension?

Hypertension or high blood pressure is a persistent elevation of blood pressure above normal levels. This disease affects approximately 50 million adults in the United States and nearly 75% are inadequately controlled. Many are unaware that they have the disease. Hypertension is often referred to as the “silent killer” because there are few early warning signs of the disease until damage is done to vital organs of the body. If left uncontrolled, high blood pressure can lead to stroke, kidney damage, blindness, heart attack, heart failure and even death.

How is Hypertension measured?
Blood pressure (BP) is obtained by measuring the pressure that is produced when blood is pumped through arteries. Your health care provider measures it with a device called a sphygmomanometer (blood pressure cuff) and a stethoscope. The blood pressure is reported in units of millimeters of mercury (mm Hg) of systolic blood pressure over diastolic blood pressure. Systolic blood pressure is the force of blood being pushed through the arteries as the heart is pumping and the diastolic blood pressure is the force of blood being pushed through arteries as the heart is filling. Optimal blood pressure is defined as a systolic BP < 120 mm Hg and a diastolic BP < 80 mm Hg. Hypertension is defined in stages as determined by the elevation of systolic or diastolic blood pressure. See below(1).

Classification of Blood Pressure

Category Systolic BP (mm Hg) Diastolic BP (mm Hg)
Optimal < 120 and < 80
Normal < 130 and < 85
High Normal 130-139 or 85-89
Stage 1 140-159 or 90-99
Stage 2 160-179 or 100-109
Stage 3 > 180 or > 110

What are the Risk Factors for Hypertension?
There are several factors that can increase the risk for developing hypertension. These include obesity, smoking, African-American heritage, age > 60 years, sex (male and postmenopausal women), smoking and family history of hypertension. Eliminating some of these risk factors (i.e. obesity or smoking) along with modification of dietary and lifestyle habits may help prevent high blood pressure from developing or decrease the need for medication if hypertension exists.

Smoking. One of the largest contributors to high blood pressure or overall cardiovascular disease is tobacco use. Cigarette smoking can cause a significant rise in blood pressure. If high blood pressure requires medication, the full benefit of the therapy may not be seen if tobacco use continues.

Weight Control. Weight reduction is also an important factor in preventing or controlling hypertension. A weight loss of 10 pounds has been shown to reduce blood pressure. Caution is suggested when considering the use of diet pills because some of these agents have the side effect of increasing blood pressure. It is best to consult your pharmacist or physician for advice. Increasing physical activity is a good way to help with weight loss and can also help reduce blood pressure. A 30-45 minute moderate workout (e.g. brisk walking) on most days of the week can lower blood pressure. Start slowly and steadily to build endurance. Those with a history of heart disease or other health problems should check with their physicians prior to starting an exercise program. Certain dietary considerations can also be important in preventing or controlling high blood pressure.

Other Dietary Issues. Alcohol should be consumed only in moderation. A moderate intake of daily sodium is also recommended. Not onlyshould table salt be considered, but many processed foods are also very high in sodium content. Check product labels to get this information. A healthy diet that is low in saturated fats and has adequate potassium, calcium and magnesium content can contribute to preventing and controlling high blood pressure.

How is Hypertension treated medically?
Despite best efforts to reduce risk factors, medication to treat hypertension may still be necessary. There are many different classes of medications that are used to treat high blood pressure.

Choosing a medication to treat high blood pressure often depends on other diseases or allergies a person may have. One medication may be beneficial in treating two diseases or it may be better tolerated in certain diseases. Understanding the side effects of the medication chosen for you is very important. Minor side effects can be an annoyance but not hinder daily life, and some may interfere with daily activities. Some side effects can be more severe and may require that the drug be stopped. Speak with your pharmacist or physician regarding side effects of medications prescribed for you. It may also be important to note that many patients feel dizzy after beginning treatment for hypertension. Never discontinue your medication without talking to your doctor.

What effect does Menopause have on Hypertenstion?
Postmenopausal women are at increased risk for developing hypertension. Many postmenopausal women take hormone replacement therapy. Hormone replacement therapy has not been shown to significantly increase blood pressure. There are several medications that can be used in treating postmenopausal women with hypertension.

In summary, if treatment is necessary for elevated blood pressure, it is important to follow your doctor's recommendations for diet, exercise and your medications. Attend all scheduled doctor visits and tell your physician about side effects and other medications you are taking. There are many treatment options for high blood pressure. If one medication is not right for you, another may be prescribed by your doctor.

*Please copy and print this article to discuss with your physician

1 - National Institutes of Health: The Sixth Report of the JOINT NATIONAL COMMITTEE on the Prevention, Detection, Evaluation and Treatment of High Blood Pressure. Nov. 1997. NIH publication. 98-4080.

The information provided by MenopauseRx, Inc. is not intended to replace the medical advice of your doctor or health-care provider. Please consult your health-care provider for advice about a specific medical condition.