Hypertension: the silent killer

October 8, 2012

Mark L. Friedman, MD, FACEP, FACP

Have you ever wondered why the doctor takes your blood pressure and what it all means? Your blood pressure gives your doctor valuable information about the state of your cardiovascular system which is vital to keeping you healthy.

What is hypertension?

If your blood pressure is too low (known as hypotension), you may feel dizzy and even pass out. If it's too high (known as hypertension) over a long period of time it can put undue stress on your heart and blood vessels and ultimately result in a heart attack or a stroke.

Hypertension is not a new disease, however our ability to treat and control it is relatively new. Today, 108 million Americans have hypertension. Of that group, 82 million people do not have their hypertension under control. Some of these people do not even know they are hypertensive, while others choose to ignore this dangerous, silent, and even painless (until it's too late) condition. A disturbing third group is receiving treatment inadequate to control the disease.

 

Understanding the numbers behind your health

After getting your blood pressure taken you’ll see or be told two different numbers. Systolic pressure (the first number) is the pressure during cardiac contraction. Diastolic pressure (the second) is the pressure measured when your heart is at rest, in between beats (contractions).

When is your blood pressure too high? In short, that number is different for everyone.  Blood pressure varies depending on your age, physical state (at exercise or rest), and even your position (standing versus lying down). But we do know that there is a direct relationship between blood pressure and life expectancy.

 

Let's go through a few examples

The lower your blood pressure (down to about 100/60 — below which it would be hard to stand up), the longer your life. If your blood pressure is 200/110, it’s too high. If you have blood pressure that high and are experiencing chest pain, a headache, shortness of breath or blood in the urine, take an ambulance to the ER immediately. You are experiencing a hypertensive crisis! 

But what about a blood pressure of 140/90, previously regarded as the "cutoff" for the diagnosis of hypertension? Doctors are beginning to realize that even much of the middle ground, between this number and 120/70 (so-called "normal" or "ideal" blood pressure) results in cardiovascular damage over long periods of time.

 

So what should you do?

Have your blood pressure measured periodically and record the numbers to see trends. Avoid salt and salty foods (ex., pickles, chips — check food labels). Make sure to keep your weight within the normal range. Talk to your doctor about treatment when needed and the effectiveness of treatment once it begins.



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Originally published Oct 8, 2012 12:30:59 PM.