High Blood Pressure
Hypertension is the medical term for high blood pressure (currently defined as 140/90 mmHg or higher), the world's leading attributable cause of death. It is a common cardiovascular disorder in which blood pressure remains abnormally elevated for a sustained period of time. About 70 million American adults have hypertension, which means about one in three people is affected.
Many people with hypertension do not have symptoms and feel no negative effects. If high blood pressure is not treated, however, over time it can significantly increase the risk of heart attack, stroke, heart failure, kidney disease and death.
Risk factors for hypertension include the following:
- Age, the risk increases significantly after 45 for men and after 65 for women
- Family history of hypertension
- Race, in particular African Americans are at increased risk
- Obesity, which causes the body to use more blood
- Sedentary lifestyle, which raises the heart rate and promotes obesity
- Smoking, which damages the lining of the artery walls
- Too much sodium consumption, which causes the body to retain fluid
- Too little potassium, causing an overabundance of sodium
- Alcohol abuse, more than two drinks per day
- Chronic stress, which can have lasting effects on blood pressure
Symptoms of Hypertension
Hypertension is largely a condition with no symptoms. Only when blood pressure reaches exceedingly high levels (known as hypertensive crisis) may symptoms appear, including severe headache, anxiety, shortness of breath and nosebleeds.
Because hypertension is a silent disease, it is important to have your blood pressure checked regularly and to take steps to maintain your blood pressure within the normal range. These include maintaining a healthy weight, exercising regularly, eating a healthy diet, avoiding sodium, limiting alcohol consumption, controlling stress and abstaining from smoking.
In addition to lifestyle modification, your doctor may recommend medication to lower your blood pressure. The type of medication prescribed depends on the stage of high blood pressure and whether or not you have other medical problems. Many different classes of drugs for hypertension are available; common types include diuretics (also known as water pills) to lower the blood volume and beta blockers to widen blood vessels and ease the heart’s workload. Different drugs are often used in combination to control blood pressure.
Treatment-resistant hypertension is defined as blood pressure that remains high despite treatment with three or more antihypertensive medications. It is an especially dangerous chronic disease because of its association with increased cardiovascular risk, including stroke and heart attack, as well as heart failure and kidney disease.
Patients with treatment-resistant hypertension are strongly advised to make behavioral and dietary changes. If these treatments are ineffective, additional measures, including investigational interventional therapies such as renal denervation, may be recommended.
At Houston Methodist, a multidisciplinary team works with the hypertensive patient to ensure the best possible course of treatment.