Blood Pressure

Blood Pressure WHAT IS BLOOD PRESSURE Blood pressure is the force of blood against the walls of arteries. Blood pressure is recorded as two numbers—the systolic pressure (as the heart beats) over the diastolic pressure (as the heart relaxes between beats). The measurement is written one above or before the other. The systolic number is on top (or first) and the diastolic number is on the bottom (or second). For example, a blood pressure measurement of 120/80 mm Hg (millimeters of mercury) is expressed verbally as “120 over 80”. Optimal blood pressure is less than 120 mm Hg systolic and less than 80 mm Hg diastolic. CATEGORIES FOR BLOOD PRESSURE LEVELS IN ADULTS* (Ages 18 Years and Older) Blood Pressure Level (mm Hg) Systolic Less than 120 120-139 High Blood Pressure 140-159 Greater than 160 Category Normal Prehypertension Diastolic Less than 80 80-89 Stage 1 Stage 2 * 90-99 Greater than 100 For those not taking medicine for high blood pressure and not having a short-term serious illness. These categories are from the National High Blood Pressure Education Program. ** Optimal blood pressure with respect to heart disease risk is below 120/80 mm Hg. However, unusually low readings should be evaluated for clinical significance. WHAT IS "WHITE COAT" HYPERTENSION? If your doctor suspects white-coat hypertension, you may be asked to monitor your blood pressure at home or to wear a device called an “ambulatory blood pressure monitor.” This device is usually worn for 24 hours and can take blood pressure readings every 30 minutes. You can find out if you have high blood pressure by having your blood pressure checked regularly. Most doctors diagnose a person with high blood pressure on the basis of two or more readings taken on several occasions. A consistent blood pressure reading of 140/90 mm Hg or higher is considered high blood pressure, another term for hypertension. Created by: FM Approved (WCD) 06/2007 Page 1 of 4 WHAT CAUSES HIGH BLOOD PRESSURE? In most cases the cause is not known. In a small number of people it may be due to kidney disease. The causes of high blood pressure vary. Causes may include narrowing of the arteries, a greater-than-normal volume of blood, or the heart beating faster or more forcefully than it should. Any of these conditions increase the pressure of the blood against the artery walls. High blood pressure might also be caused by another medical problem. There are factors that may increase a person’s chance of developing the disease, including: ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ ♥ Family members with a history of the disease African-American Age (older than 35) Birth control pills Overweight High sodium intake Inactive lifestyle Excessive alcohol intake Smoking Regardless of race, age, or gender, anyone can develop high blood pressure. Many Americans tend to develop high blood pressure as they get older but this is not a healthy part of aging. About 60% of those age 60 and over have high blood pressure. Once it develops, it usually lasts a lifetime so don’t stop your medicine just because you are feeling well. Although high blood pressure usually cannot be cured, in most cases it can be prevented or controlled. TREATMENT OF HIGH BLOOD PRESSURE It is important to take steps to keep your blood pressure under control. The treatment goal is blood pressure below 140/90 mm Hg, and lower for people with other conditions, such as diabetes and kidney disease. New evidence suggests that blood pressure as low as 120/90 mm Hg may be helpful in all patients. Adopting healthy lifestyle habits is an effective first step in preventing and controlling high blood pressure. If lifestyle changes alone are not effective in keeping your pressure controlled, it may be necessary to add blood pressure medications. HEALTHIER EATING WITH DASH (DIETARY APPROACHES TO STOP HYPERTENSION) The DASH Eating Plan The DASH plan shown below is based on 2,000 calories a day. The number of daily servings in a food group may vary from those listed, depending on your caloric needs. Created by: FM Approved (WCD) 06/2007 Page 2 of 4 Food Group Daily Servings (except as noted) Serving Sizes Grains & grain products 7-8 1 slice bread, 1 cup ready-to-eat cereal*, ½ cup cooked rice, pasta, or cereal Vegetables 4-5 1 cup raw leafy vegetables, ½ cup cooked vegetables, 6 oz vegetable juice Fruits 4-5 1 med fruit, ½ cup dried fruit, ¼ cup fresh, frozen, or canned fruit, 6 oz fruit juice Lowfat or fat-free dairy foods 2-3 8 ounces mlk, 1 cup yogurt, 1 ounce cheese Lean meats, pultry, and fish 2 or fewer 3 ounces cooked lean meats, skinles poultry, or fish Nuts, seeds, and dry beans 4-5 per week 1/3 cup or 1 oz nuts, 1 tablespoon or 1 oz seeds, 1 cup cooked dry beans Fats and oils** 2-3 1 teaspoon soft margarine,, 1 tablespoon lowfat mayonnaise, 2 tablespoons light salad dressing, 1 teaspoon vegetable oil Sweets 5 per week 1 tablespoon sugar, 1 tablespoon jelly or jam, 1 oz jelly beans, 8 oz lemonade  Serving sizes vary between cereals. Check the product’s nutrition label.  Fat content changes serving counts for fats and oils: For example, 1 tablespoon of regular salad dresing equals 1 serving; 1 tablespoon of lowfat dressing equals 1 serving; 1 tablespoon of a fat free dressing equals 0 servings. SYMPTOMS OF HIGH BLOOD PRESSURE High blood pressure (hypertension ) is a disease. Usually there are no obvious symptoms, and—if left untreated—high blood pressure, over a long period of time, can cause permanent damage to the body, such as heart attack, kidney failure, blindness, heart failure, and stroke. It is important to have your blood pressure checked on a regular basis by your health care provider. Stroke High blood pressure is the most important risk factor for stroke. Very high pressure can cause a break in a weakened blood vessel, which then bleeds in the brain. This can cause a stroke. If a blood clot blocks one of the narrowed arteries, it can also cause a stroke. Impaired Vision High Blood pressure can eventually cause blood vessels in the eye to burst or bleed. Vision may become blurred or otherwise impaired and can result in blindness. Arteries As people get older, arteries throughout the body “harden”, especially those in the heart, brain, and kidneys. High blood pressure is associated with these “stiffer” arteries. This, in turn, causes the heart and kidneys to work harder. Created by: FM Approved (WCD) 06/2007 Page 3 of 4 Kidney Damage The kidneys act as filters to rid the body of wastes. Over time, high blood presure can narrow and thicken the blood vessels of the kidneys. The kidneys filter less fluid, and waste builds up in the blood. The kidneys may fail altogether. When this happens, medical treatment (dialysis) or a kidney transplant may be needed. Heart Attack High blood pressure is a major risk factor for heart attack. The arteries bring oxygencarrying blood to the heart muscle. If the heart cannot get enough oxygen, chest pain, also known as “angina,” can occur. If the blood is blocked, a heart attack results. Congestive Heart Failure High blood pressure is the number one risk factor for congestie heart failure (CHF). CHF is a serious condition in which the heart muscle is weakend and unable to pump enough blood to supply the body’s needs. Avoid certain medications than can raise blood pressure. These include “non-steroidal” pain relievers like Advil (ibuprofen) or Aleve (naproxen), birth control pills, prednisone, decongestants (like Sudafed or pseudoephedrine), and some diet pills. Talk to your physician who prescribed them about other alternatives. LIFESTYLE For suggestions on how to avoid hypertension, see the “Prevention” section of: www.nhlbi.nih.gov, where you can find helpful tips regarding: ♥ ♥ ♥ ♥ ♥ ♥ Following a healthy eating pattern Reducing salt and sodium in your diet Maintaining a healthy weight—being physically active Limiting alcohol intake Quitting smoking Other factors affecting blood pressure Created by: FM Approved (WCD) 06/2007 Page 4 of 4