HYPERTENSION

What is high blood pressure?

High blood pressure (hbp) or hypertension means high pressure (tension) in the arteries. Arteries are vessels that carry blood from the pumping heart to all the tissues and organs of the body. High blood pressure does not mean excessive emotional tension, although emotional tension and stress can temporarily increase blood pressure. Normal blood pressure is below 120/80; blood pressure between 120/80 and 139/89 is called "pre–hypertension", and a blood pressure of 140/90 or above is considered high.

The top number, the systolic blood pressure, corresponds to the pressure in the arteries as the heart contracts and pumps blood forward into the arteries. The bottom number, the diastolic pressure, represents the pressure in the arteries as the heart relaxes after the contraction. The diastolic pressure reflects the lowest pressure to which the arteries are exposed.

An elevation of the systolic and/or diastolic blood pressure increases the risk of developing heart (cardiac) disease, kidney(renal) disease, hardening of the arteries (atherosclerosis or arteriosclerosis), eye damage, and stroke (brain damage). These complications of hypertension are often referred to as end–organ damage because damage to these organs is the end result of chronic (long duration) high blood pressure. For that reason, the diagnosis of high blood pressure is important so efforts can be made to normalize blood pressure and prevent complications.

It was previously thought that rises in diastolic blood pressure were a more important risk factor than systolic elevations, but it is now known that in people 50 years or older systolic hypertension represents a greater risk.

Self-care

Lifestyle changes can help you control and prevent high blood pressure — even if you're taking blood pressure medication. Here's what you can do:

1.Eat healthy foods. Try the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains and low-fat dairy foods. Get plenty of potassium, which can help prevent and control high blood pressure. Eat less saturated fat and total fat. Limit the amount of sodium in your diet. Although 2,400 milligrams (mg) of sodium a day is the current limit for otherwise healthy adults, limiting sodium intake to 1,500 mg a day will have a more dramatic effect on your blood pressure.

2.Maintain a healthy weight. If you're overweight, losing even 5 pounds can lower your blood pressure.

3.Increase physical activity. Regular physical activity can help lower your blood pressure and keep your weight under control. Strive for at least 30 minutes of physical activity a day.

4.Limit alcohol. Even if you're healthy, alcohol can raise your blood pressure. If you choose to drink alcohol, do so in moderation — up to one drink a day for women, two drinks a day for men.
5.Don't smoke. Tobacco injures blood vessel walls and speeds up the process of hardening of the arteries. If you smoke, ask your doctor to help you quit.

6.Manage stress. Reduce stress as much as possible. Practice healthy coping techniques, such as muscle relaxation and deep breathing. Getting plenty of sleep can help, too.

7.Practice slow, deep breathing. Do it on your own or try device-guided paced breathing. In various clinical trials, regular use of Resperate — an over-the-counter device approved by the Food and Drug Administration to analyze breathing patterns and help guide inhalation and exhalation — significantly lowered blood pressure.

Lifestyle modification

In some patients, particularly those whose blood pressure is moderately elevated, life style modifications alone may achieve treatment goals. Patients who require pharmacological therapy may reduce the number and doses of medications through life style modification. The following modifications in diet and physical activity should be discussed with a doctor or health care provider.

Weight loss. Overweight patients can reduce blood pressure by losing weight. Gradual weight loss through modified calorie intake and increased physical activity is a good approach. A goal of losing 10-15 pounds is reasonable for many patients.

Physical activity. Regular, moderate aerobic exercise can modestly decrease blood pressure and has many other beneficial effects. A program of gradually increased activity is most prudent, such as taking a brisk, 20-30 minute walk, 3-5 times a week. All persons with chest pain (angina) and known or suspected heart disease should talk to their doctor before beginning a exercise program

Salt (sodium chloride) restriction. Excessive salt intake can contribute to hypertension in some people. Even modest restriction of salt may decrease blood pressure. Generally, many doctors advise those with high blood pressure to avoid salty food and to limit daily sodium intake to no more than approximately 2.4 grams. (Doctors use the words "salt" and "sodium" interchangeably.)

Limited alcohol consumption. Moderate alcohol intake (one or two glasses of an alcoholic beverage a day) does not appear to cause hypertension; however, chronic heavy alcohol use elevates blood pressure. This is the most common reversible cause of high blood pressure. Therefore, hypertension patients who drink alcohol excessively should discuss this issue with their health care provider and reduce their consumption of alcohol.