All About Hypertension Bloood Pressure

Your physicians will dictate two numbers, systolic/diastolic. Listen carefully to the dictation. If a person comes in with dizziness, fainting spells, feeling lightheaded upon arising, the physician most likely will speak of hypotension, or low blood pressure. This is often called orthostatic hypotension.

It will be clinic preference whether you use BP or Blood Pressure. The same is true for your other vital sign readings. The preference is to NOT use the ¿mm Hg¿ (mm of mercury) in the reading, unless you asked to transcribe mmHg.

High blood pressure is defined as having a systolic blood pressure of 140mm Hg or higher (top number) and/or diastolic pressure (bottom number of 90mmHg or higher for most people. When the systolic pressure is 140 mm Hg or higher, but the diastolic pressure remains below 90 mm Hg, the condition is known as isolated systolic hypertension. The study found that isolated systolic hypertension is the dominant form of uncontrolled high blood pressure in people over the age of 50. Among the study participants, over 80 percent of individuals in this age group who have hypertension have uncontrolled isolated systolic hypertension. Among those over the age of 60 the number is even higher.

Medical transcriptionists: A mnemonic for remembering systolic vs. diastolic readings (and which is which): To Die would be a very, very low blood pressure reading. So, diastolic is the LOW reading of the two figures, i.e. the 70 in 110/70.



For many years physicians have concentrated on treating hypertension or high blood pressure by trying to lower the diastolic pressure. Diastolic pressure is the lower number in a blood pressure reading. Now, in one of the largest studies to date, researchers have found that most middle age and older individuals with high blood pressure have a form of the disease in which the systolic pressure (the top number) is too high.

According to Nathan D. Wang Ph.D., director of the Heart Disease Prevention Program, University of California, Irvine, "The higher the systolic pressure, the greater the risk of death and disability from heart disease."

Physicians have traditionally focused on treating high blood pressure by trying to lower the diastolic pressure to keep it at 90 or slightly lower. Nathan Wong noted that many physicians are satisfied when the minimum goal of 140 systolic and 90 diastolic is reached. However, he feels the minimum goal is not the optimal goal. "The optimal goal is systolic pressure below 120 and diastolic below 80."

Additionally this large study indicated a poor level of awareness, treatment, and control of high blood pressure in all age groups. The study showed that about 48 percent of individuals with high blood pressure are not being treated for the condition, while 29 percent are inadequately treated.



High blood pressure is the leading cause of many life threatening or disabling diseases including, stroke, kidney failure, and heart attack. People who have diabetes, especially uncontrolled diabetes are more prone to high blood pressure. Adequate treatment of hypertension can reduce health risks, improve quality and quantity of life and reduce overall costs of healthcare. An acute stroke and subsequent rehabilitation can rack up thousands of dollars in medical costs. The emotional costs to both patient and loved ones are equally high.

• Medication:
  There are many very effective medications available for physicians in treating hypertension. The physician will monitor blood work and effects to find the right medication or the right combination of medications. It is very important for patients to take medications as prescribed by their physician. Skipping or forgetting doses of these medications can cause serious problems.
• Diet:
  Losing weight and following a low fat diet has been shown to help decrease high blood pressure. The DASH diet below has been shown to be a very effective treatment for lowering blood pressure and reducing the risk of heart disease.
• Exercise
  Exercise in conjunction with proper diet can also be very effective in the treatment of high blood pressure. Exercise can help reduce stress and enhance weight loss efforts.

Be sure to have your blood pressure checked at each and every visit to your doctor and ask for the results. If it is high or if only the top number is high be sure to ask about ways you can help lower your blood pressure.





You may be surprised if your doctor says you have high blood pressure (HBP) because it does not cause symptoms and you can have it even though you feel fine. However, HBP is a serious condition that can lead to stroke, heart disease, kidney failure, and other health problems. The good news is that there are simple ways to control it.



As blood flows from the heart out to the blood vessels, it creates pressure against the blood vessel walls. Your blood pressure reading is a measure of this pressure. When that reading goes above a certain point, it is called high blood pressure. Hypertension is another name for HBP. As many as 50 million Americans may have HBP. Among people age 65 and older, about 40 percent of Whites and 50 percent of Blacks have HBP.



To test blood pressure, a doctor or nurse places a cuff around your arm above the elbow, pumps air into the cuff, and then reads the measurements as the air is let out. The test is painless and takes only a few minutes.

Your blood pressure measurement may be taken several times. You may be asked to stand one time and sit another. If your blood pressure is high the first day, the doctor will want measurements from different days before deciding whether you really have high blood pressure. These steps are needed because blood pressure changes so quickly. In addition, it is affected by many things, including the normal feelings of worry during a visit to the doctor.

Because HBP is so common, everyone should have his or her blood pressure tested once a year. Blood pressure readings are given in two numbers. Although the average blood pressure reading for adults is 120/80, a slightly higher or lower reading (for either number) may not be a problem. If blood pressure goes above 140/90, however, some form of treatment-diet or drugs-may be needed. Lower blood pressure readings (for example, 110/70) are thought to be safe for most people.



Often in older adults the first number (the upper or systolic number) is high while the second (the lower or diastolic) number is normal. This condition is called isolated systolic hypertension, and it also should be treated. Studies prove that lowering the systolic number cuts down on strokes and heart attacks in people age 60 and over.



Some cases of HBP are caused by other illnesses. This kind of HBP is called secondary hypertension, and it is often cured once the original medical problem is cured. Most HBP, however, is essential or primary hypertension. This kind cannot be cured but can be kept under control by regular, ongoing treatment. Doctors think that many things combine to cause HBP. Being overweight, drinking too much alcohol, and eating too much salt are risk factors because they raise your risk of having HBP. They do not cause it directly.

Blood pressure goes up in all people during periods of stress or exercise. However, avoiding stress will not prevent high blood pressure. You can have HBP even though you are usually a calm, relaxed person. How Is High Blood Pressure Treated?

If you have mild HBP, your doctor may suggest that you lose weight and keep it off, eat less salt, cut down on alcohol, and get more exercise. You may bring your blood pressure down simply by following this advice. Even if medicine is needed, these daily habits may help it work better.

Some people think that when their blood pressure comes down, they no longer need treatment. If your doctor has prescribed medicine, you may have to take it for the rest of your life. Later on, though, you may be able to take less of it.



There is now good evidence that HBP can be prevented in many people. The keys to prevention are:

• Keeping your weight moderate
• Cutting down on salt
• Exercising regularly
• If you drink, having no more than two drinks a day

1. HBP may not make you feel sick, but it is serious and should be treated by a doctor.
2. You can bring down your blood pressure with changes in diet and daily habits and by taking medicines if necessary
3. Losing weight, cutting down on salt and alcohol, and getting regular exercise may be helpful, but only as suggested by your doctor. Do not assume these are substitutes for medicine unless your doctor says they are
4. If one day’s dose of medicine is missed, do not double-up the next day. Instead, call your doctor for advice
5. Take your medicine at the same time each day, for example, in the morning or evening after brushing teeth-to help set a regular, easy-to-remember routine

Research has shown that diet affects the development of high blood pressure, or hypertension (the medical term). Recently, a study found that a particular eating plan can lower elevated blood pressure.

This fact sheet tells what high blood pressure is and how you can follow the eating plan. It offers tips on how to start and stay on the plan, as well as a week of menus and recipes for some of the dishes.

The eating plan is meant for those with elevated blood pressure. It also is a heart-healthy plan that you can share with your family.



Even slight elevations of blood pressure above the optimal level of less than 120/80 mm Hg are unhealthy. The higher the blood pressure above normal, the greater the health risk.

In the past, researchers had tested various single nutrients, such as calcium and magnesium, to find clues about what affects blood pressure.

Then, scientists supported by the National Heart, Lung, and Blood Institute (NHLBI) tested nutrients as they occur together in food. The results were dramatic. The clinical study, called "DASH" for Dietary Approaches to Stop Hypertension, found that elevated blood pressures can be reduced with an eating plan low in saturated fat, total fat, and cholesterol, and rich in fruits, vegetables, and lowfat dairy foods. The plan is rich in magnesium, potassium, and calcium, as well as protein and fiber.

DASH involved 459 adults with systolic blood pressures of less than 160 mm Hg and diastolic pressures of 80-95 mm Hg. About half of the participants were women and 60 percent were African Americans.

• A plan similar in nutrients to what many Americans consume
• A plan similar to what Americans consume but higher in fruits and vegetables
• A "combination" plan--the DASH diet--lower in saturated fat, total fat, and cholesterol, and rich in fruits, vegetables, and lowfat dairy foods

All three plans used about 3,000 milligrams of sodium daily--about 20 percent below the U.S. average for adults. None of the plans was vegetarian or used specialty foods.

Results showed that both the fruit/vegetable and combination plans reduced blood pressure, but the combination plan had the greatest effect. The DASH eating plan reduced blood pressure by an average of about 6 mm Hg for systolic and 3 mm Hg for diastolic. It worked even better for those with high blood pressure--the systolic dropped on average about 11 mm Hg and the diastolic about 6 mm Hg. Further, the reductions came fast--within 2 weeks of starting the eating plan.



Following this diet gives the servings and food groups for the DASH eating plan. The number of servings you need may vary, depending on your caloric need.

You should be aware that the DASH plan has more daily servings of fruits, vegetables, and grains than you may be used to eating. This makes it high in fiber, which can cause bloating and diarrhea. To get used to the new eating plan, gradually increase your servings of fruits, vegetables, and grains.