by Curtis Hamburg MD FACC

Hypertension

It has been called “the most common primary diagnosis in America” and “one of the major risk factors for heart disease and stroke.” Hypertension, also known as high blood pressure, can afflict anyone. For patients, knowing the facts about this condition can mean the difference between life and death. 

IN THE United States alone, some 70 million adults—that’s one out of every three—are affected by high blood pressure.  According to the Centers for Disease Control and Prevention (CDC), about one out of five people who have the condition are not aware of it, and millions who are aware of their condition are not being treated.  All told, about 31 million of those who have high blood pressure—that’s less than half—are adequately controlling it.

The goal of Heartwell physicians is to give each patient personalized care along with a thorough evaluation and diagnosis, followed by the most advanced available solutions.  An important part of reaching that goal involves answering all of a patients questions about hypertension—from risk factors to treatment options. The following are eight questions that patients typically ask about hypertension, along with readily understandable answers.

What is hypertension?

Hypertension is a condition in which the pressure of the blood against the artery walls is high. Hypertension is serious.  A person who has high blood pressure is four times  more likely to die from stroke and three times more likely to die from heart disease. Uncontrolled high blood pressure can lead to weakening and enlargement of blood vessels called aneurysms as well as torn blood vessels in the eyes, which can lead to vision problems and even blindness. Research shows that high blood pressure can also speed up the process of aging of the brain, causing memory loss and comprehension problems. Uncontrolled high blood pressure can lead to stroke, heart attack and kidney failure.

I’m not a type-A, stressed-out workaholic. So I can’t have hypertension, right?

The fact is, many people who have hypertension show no outward signs or symptoms, so it’s best not to create a stereotype. Granted, you might hear of some who experience dizzy spells, headaches, or frequent nosebleeds. But those symptoms usually indicate a more advanced stage of hypertension. For many patients, the only “sign” they’ll get is an abnormally high blood pressure reading at the time of their physical checkup. The patient with high blood pressure is often type A.

Who is most at risk for hypertension?

While anyone can get high blood pressure and at any age—indeed, about two million children and teenagers in the United States have it—the risk increases with age. Also, research shows that African-Americans are more affected by hypertension than other races, and often they are affected at an earlier age. However, a more important factor than age or race (which are beyond the patient’s control) is lifestyle (which the patient can do something about). High-risk candidates for hypertension include those who are overweight, not physically active, drink too much alcohol, or take in too much sodium (salt).

How can I get checked for hypertension?

A blood pressure reading is part of a routine physical checkup.

 

It is recommended that you have your blood pressure checked at least every two years, and even more frequently if you have already been diagnosed with cardiovascular disease. One word of caution: Do not rely on heart-pressure machines that are found in stores. Although they may be free of charge, their readings may not always be accurate.

How can I prepare for my checkup?

Before you go to your physician, write down any information that pertains to your heart. For example, is there heart disease in your family? (If so, who had it, and when?) Do you take medications? (If so, list them.) Be prepared to talk openly with your doctor about your diet and exercise regimen—or lack thereof. Also, write down any questions you would like to ask your physician. And it’s always a good idea to bring someone along. Four ears are better than two, especially when you’re trying to remember what recommendations were given you.

How can I lower my risk of getting hypertension?

There is no better way to lower the risk of hypertension than to make adjustments to your lifestyle. Adopt a healthy diet, get out and exercise, limit alcohol intake, and cut out smoking altogether. In addition, a key component addressing hypertension is to get regular physical checkups. The earlier high blood pressure is diagnosed, the sooner you can get out of the danger zone.

Speaking of diet, is salt really bad for me?

At times you will read headlines such as the one published in the New York Times on June 2, 2012: “Salt, We misjudged You.” Then there was the Scientific American article whose headline declared, “It’s Time to End the War On Salt.” The latter article makes the point that “the correlation between salt intake and poor health has remained tenuous.” One study cited in the article found that “intensive interventions” had only “minimal reductions in blood pressure during long-term trials.”

At the same time, it cannot be ignored that too much salt causes the body to retain fluid, and that causes increased blood pressure. The Scientific American article acknowledges that “part of the problem is that individuals vary in how they respond to salt,” and that some are more vulnerable to its negative effects. It seems reasonable, then, to take a balanced approach. Limit intake of salt, but do not think that you can cure hypertension by that measure alone.

What should I know about medication?

Medications are prescribed when lifestyle changes are insufficient to address high blood pressure. Which medication to use—or whether to use any at all—will depend on the severity of your condition. Your physician will also consider how new medications might interact with others you are already taking. Common medicines that are used to treat hypertension include beta blockers (to reduce the stress on your heart and to open up blood vessels), and angiotensin II receptor blockers (which help relax blood vessels) angiotension converting enzyme inhibitors and calcium blockers.