What Are High Blood Pressure and Prehypertension

What Are High Blood Pressure and Prehypertension: Blood pressure is the force of blood against the walls of arteries.

Blood pressure rises and falls throughout the day. When blood pressure stays elevated over time, it’s called high blood pressure. The medical term for high blood pressure is hypertension.

High blood pressure is dangerous because it makes the heart work too hard and contributes to atherosclerosis (hardening of the arteries).

It increases the risk of heart disease and stroke, which are the first- and third-leading causes of death among Americans.

High blood pressure also can result in other conditions, such as congestive heart failure, kidney disease, and blindness.

Risk Factors For Heart Disease

Risk factors are conditions or behaviors that increase your chances of developing a disease. When you have more than one risk factor for heart disease, your risk of developing heart disease greatly multiplies. So if you have high blood pressure, you need to take action.

RELATED: Improving Cardiovascular Health For Americans

Fortunately, you can control most heart disease risk factors.

Risk factors you can control: 

  • High blood pressure
  • Abnormal cholesterol
  • Tobacco use
  • Diabetes
  • Overweight
  • Physical inactivity

Risk factors beyond your control:

  • Age (55 or older for men; 65 or older for women)
  • Family history of early heart disease (having a father or brother diagnosed with heart disease before age 55 or having a mother or sister diagnosed before age 65)

A blood pressure level of 140/90 mmHg or higher is considered high. About two-thirds of people over age 65 have high blood pressure. If your blood pressure is between 120/80 mmHg and 139/89 mmHg, then you have prehypertension. This means that you don’t have high blood pressure now but are likely to develop it in the future unless you adopt healthy lifestyle changes.

People who do not have high blood pressure at age 55 face a 90 percent chance of developing it during their lifetimes. So high blood pressure is a condition that most people will have at some point in their lives.

Both numbers in a blood pressure test are important, but for people who are age 50 or older, systolic pressure gives the most accurate diagnosis of high blood pressure. Systolic pressure is the top number in a blood pressure reading. It is high if it is 140 mmHg or above.

How Can You Prevent or Control High Blood Pressure?

If you have high blood pressure, you and your health care provider need to work together as a team to reduce it. The two of you need to agree on your blood pressure goal. Together, you should come up with a plan and timetable for reaching your goal.

Blood pressure is usually measured in millimeters of mercury (mmHg) and is recorded as two numbers—systolic pressure (as the heart beats) “over” diastolic pressure (as the heart relaxes between beats)—for example, 130/80 mmHg.

Ask your doctor to write down for you your blood pressure numbers and your blood pressure goal level. Monitoring your blood pressure at home between visits to your doctor can be helpful. You also may want to bring a family member with you when you visit your doctor.

Having a family member who knows that you have high blood pressure and who understands what you need to do to lower your blood pressure often makes it easier to make the changes that will help you reach your goal.

Find Your Target Weight

Being overweight or obese increases your risk of developing high blood pressure. In fact, your blood pressure rises as your body weight increases. Losing even 10 pounds can lower your blood pressure—and losing weight has the biggest effect on those who are overweight and already have hypertension.

Overweight and obesity are also risk factors for heart disease. And being overweight or obese increases your chances of developing high blood cholesterol and diabetes—two more risk factors for heart disease.

Two key measures are used to determine if someone is overweight or obese. These are body mass index, or BMI, and waist circumference. BMI is a measure of your weight relative to your height. It gives an approximation of total body fat—and that’s what increases the risk of diseases that are related to being overweight.

But BMI alone does not determine risk. For example, in someone who is very muscular or who has swelling from fluid retention (called edema), BMI may overestimate body fat. BMI may underestimate body fat in older persons or those losing muscle.

That’s why waist measurement is often checked as well. Another reason is that too much body fat in the stomach area also increases disease risk. A waist measurement of more than 35 inches in women and more than 40 inches in men is considered high. Read Complete Guide Here

Measuring High Blood Pressure

Posture

Posture affects blood pressure, with a general tendency for it to decrease when a person moves from the lying position to the sitting or standing positions. Some patients may have postural hypotension, especially those who are taking certain antihypertensive drugs and elderly people. When this is likely, blood pressure should also be measured when the patient is standing.

Arm support

If the arm in which blood pressure is being measured is unsupported as tends to happen when the patient is sitting or standing the patient is performing isometric exercise, which increases blood pressure by as much as 10%. The arm therefore must be supported during measurement of blood pressure, especially when the patient is in the standing position.

This is achieved best in practice by the observer holding the patient’s arm at the elbow.

Instructions For Measuring High Blood Pressure

Arm position

The forearm should be at the level of the heart—that is, the mid-sternum. Measurement in an arm lower than the level of the heart leads to an overestimation of systolic and diastolic pressures, while measurement in an arm above the level of the heart leads to underestimation.

Such inaccuracy can be as much as 10 mm Hg, especially when the patient is in the sitting or standing position, when the arm is likely to be below heart level by the side. Arm position is important for self measurement of blood pressure with devices for wrist measurement.

Many of these devices inherently are inaccurate, but measurement is even less accurate if the wrist is not held at the level of the heart during measurement.

Which arm?

Arterial disease can cause differences in blood pressure between arms, but because blood pressure varies from beat to beat, any differences may simply reflect blood pressure variability or measurement errors, or both.

Bilateral measurement should be made at the first consultation; if differences 20 mm Hg for systolic or 10 mm Hg for diastolic blood pressure are present on consecutive readings, the patient should be referred to a cardiovascular centre for further evaluation with simultaneous bilateral measurement and the exclusion of arterial disease.


Cuff and bladder

The cuff is an inelastic cloth that encircles the arm and encloses an inflatable rubber bladder. The cuff is secured around the arm most often by means of Velcro on the adjoining surfaces of the cuff, occasionally by wrapping a tapering end into the encircling cuff, and rarely by hooks.

Velcro surfaces must be effective; when they lose their grip, the cuff should be discarded. The bladder should be removable from the cuff for washing. Measuring High Blood Pressure PDF