Arteries are vessels that carry blood to all body tissues. As the heart beats, the force of the blood being pumped through the body against the walls of the arteries is known as blood pressure. When the heart contracts, the pressure generated against the blood vessel walls is called systole (sis’-toe-lee) and the pressure is known as systolic. When the heart relaxes, it’s called diastole (dye- as’ t-lee) and the pressure is diastolic. The systolic pressure is higher and is shown as the number on the top. Blood pressure is measured in millimeters of mercury, and normal is about 120/80. When these numbers are elevated over a period of time, it is recognized as high blood pressure or hypertension. Untreated hypertension can cause damage to the kidneys, heart, eyes, and nervous system. It is called “the silent killer.”

The guidelines have changed over the years. Even though many people have normal blood pressure, they do not have ideal blood pressure. Formerly, elevated blood pressure was at or higher than 140/90, but later that was changed to 130/85, and the newer guidelines classify normal blood pressure as below 120/80. Over that it is called pre-hypertension, and those people are now told to alter their life style to lower blood pressure.

Again, there now is much discussion regarding blood pressure numbers. The newest guidelines change nothing if you’re under 60. But if you’re 60 or over, the numbers have increased. The American Heart Association and many other prestigious organizations don’t always agree on the numbers, but are working together to decide which is the best solution. The results of this research will be released later this year. Follow your physician’s guidance, as your health provider knows your individual case.

Many factors are associated with high blood pressure including genetics, age, race, stress, high cholesterol, high triglycerides, obesity, smoking, diabetes, high salt diet, excessive consumption of alcohol, and a sedentary lifestyle. Regular blood pressure checks are very important, because high blood pressure can develop over many years with no noticeable symptoms. When hypertension is severe, symptoms may appear. Warning signs can include nosebleeds, racing or irregular heartbeat, headaches and dizziness.

Although hypertension is mostly a problem as one ages, it is possible to have this condition even if you are young. Your blood pressure can vary tremendously under different conditions, some of which are stress, weight, time of day, altitude, climate and even the time of year. The cause of high blood pressure is unknown in 90 percent of cases, and this type is called essential hypertension. When a disease such as kidney or thyroid disease or another physical problem is causing the rise in blood pressure, it is called secondary hypertension

Sixty years ago, the medications or the knowledge to control high blood pressure didn’t exist, but today they do. Because of this, many Americans are not only extending their lifespan, but are raising the quality of their lives as well. Because of new drugs, early detection and treatment of hypertension, medical and surgical advances and healthier life styles, death from heart disease is decreasing. The downside is, high blood pressure is insidious. Most of the time we don’t know we have it because it may give no symptoms. That is one important reason to see your physician for checkups on a regular basis.

It is important to get accurate blood pressure readings. Ideally, the patient should be measured sitting in a sturdy chair at a table so that the arm is resting at heart level, relaxed with both feet on the floor, in a quiet room at a comfortable temperature. Using the left arm for consistency, there should be no bulk on the arm or clothing that is too tight. The cuff should be placed one inch above the bend in the elbow and be snug but not tight, with no air in it. Finally, there should be one finger’s width of room between the arm and the cuff. The cuff should fit comfortably, as a blood pressure cuff that is too small will result in an overestimation of blood pressure, and one that is too large, in an underestimation. If a second reading is needed, wait at least 10 minutes. Caffeine taken less than 30 minutes prior to measurement can raise the reading, as well as stimulant drugs such as nasal decongestants.

For some people, lifestyle changes aren’t completely effective in lowering the blood pressure to a desirable reading, so medications are prescribed. Some drugs decrease excess fluid and sodium while others relax constricted blood vessels. Still others prevent blood vessels from constricting and narrowing. These medicines must be ongoing, and if treatment is stopped, blood pressure may rise again. Most of the newer medications need only be taken once daily, as their action lasts 24 hours. In addition to giving a constant blood level of the drug, this regimen is convenient, enabling better patient compliance.

Medications are not the only answer. In addition to controlling your high blood pressure with drugs, you can also help yourself by modifying your lifestyle.
This can be done by:
• Not smoking
• Losing weight if necessary
• Controlling stress
• Eating a low-fat, low-sodium diet
• Exercising regularly
I cannot say enough about the value of exercise. The older one becomes, the more regular exercise is needed. It is not only good for the heart, but it helps prevent bone loss and fractures, reduces the risk of many diseases associated with aging, increases muscle strength and improves balance and coordination, reducing the likelihood of falling. Exercise can promote good sleep, improved appetite and wellness in general.

If you are prescribed an antihypertensive drug, it is important to take your medicine about the same time daily, and do not stop it without consulting your doctor. For any questions regarding your medication or help with readings, ask your pharmacist.