Category: Cardiovascular / Pulmonary Vascular Diseases
### Summary Hypertension, or high blood pressure, is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease. Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. ### What It Is Blood pressure is measured in millimeters of mercury (mm Hg). It has two numbers: - **Systolic pressure (top number):** The pressure in your arteries when your heart beats. - **Diastolic pressure (bottom number):** The pressure in your arteries when your heart rests between beats. High blood pressure is generally defined as blood pressure above 130/80 mm Hg. ### How It Affects The Body Uncontrolled high blood pressure can lead to: - **Heart attack or stroke:** High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications. - **Aneurysm:** Increased blood pressure can cause your blood vessels to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening. - **Heart failure:** To pump blood against the higher pressure in your vessels, the heart has to work harder. This causes the heart's pumping chamber to thicken (left ventricular hypertrophy). Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body's needs, which can lead to heart failure. - **Weakened and narrowed blood vessels in your kidneys:** This can prevent these organs from functioning normally. - **Thickened, narrowed or torn blood vessels in the eyes:** This can result in vision loss. - **Metabolic syndrome:** This syndrome is a cluster of disorders of your body's metabolism, including increased waist size, high triglycerides, low high-density lipoprotein (HDL) cholesterol (the "good" cholesterol), high blood pressure and high insulin levels. ### Who Is At Risk - **Age:** The risk of high blood pressure increases as you age. - **Race:** High blood pressure is particularly common among people of African heritage, often developing at an earlier age than it does in whites. - **Family history:** High blood pressure tends to run in families. - **Being overweight or obese:** The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues. - **Not being physically active:** People who are inactive tend to have higher heart rates. - **Using tobacco:** Not only does smoking or chewing tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls. - **Too much salt (sodium) in your diet:** Too much sodium in your diet can cause your body to retain fluid, which increases blood pressure. - **Too little potassium in your diet:** Potassium helps balance the amount of sodium in your cells. - **Drinking too much alcohol:** Over time, heavy drinking can damage your heart. - **Stress:** High levels of stress can lead to a temporary increase in blood pressure. ### ⚠️ Emergency Signs Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. However, a **hypertensive crisis** (systolic over 180 and/or diastolic over 120) requires emergency care. Symptoms may include: - Severe headache - Shortness of breath - Nosebleed - Severe anxiety ### When To See A Doctor You'll likely have your blood pressure taken as part of a routine doctor's appointment. Ask your doctor for a blood pressure reading at least every two years starting at age 18. If you're age 40 or older, or you're 18 to 39 with a high risk of high blood pressure, ask your doctor for a blood pressure reading every year. ### Diagnosis Blood pressure is measured with an inflatable arm cuff and a pressure-measuring gauge. - **Normal:** Less than 120/80 mm Hg - **Elevated:** Systolic between 120-129 and diastolic less than 80 - **Stage 1 Hypertension:** Systolic between 130-139 or diastolic between 80-89 - **Stage 2 Hypertension:** Systolic at least 140 or diastolic at least 90 - **Hypertensive Crisis:** Systolic over 180 and/or diastolic over 120 ### Treatment Options - **Lifestyle changes:** Eating a heart-healthy diet with less salt, getting regular physical activity, maintaining a healthy weight or losing weight if you're overweight or obese, and limiting the amount of alcohol you drink. - **Medications:** - **Thiazide diuretics:** Diuretics, sometimes called water pills, are medications that help your kidneys eliminate sodium and water from the body. - **Beta blockers:** These medications reduce the workload on your heart and open your blood vessels, causing your heart to beat slower and with less force. - **Angiotensin-converting enzyme (ACE) inhibitors:** These medications help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels. - **Angiotensin II receptor blockers (ARBs):** These medications help relax blood vessels by blocking the action, not the formation, of a natural chemical that narrows blood vessels. - **Calcium channel blockers:** These medications help relax the muscles of your blood vessels. ### Prevention - Eat a healthy diet. - Maintain a healthy weight. - Get regular exercise. - Don't smoke. - Limit alcohol. - Manage stress.
Estimated at 15-50 cases per million adults worldwide, with variations based on etiology (Source: European Respiratory Journal, 2018).
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