Washington Regional Cardiovascular Clinic Understanding high blood pressure

At most visits with a health care provider, your blood pressure will be measured. That’s because this simple screening is the best way to check for high blood pressure, also known as hypertension or HTN, a potentially serious medical condition.

“High blood pressure means the force of blood flowing through the blood vessels is consistently higher than normal,” says Anthony Klappa, MD, a cardiologist at the Washington Regional Cardiovascular Clinic, part of Washington Regional’s Walker Heart Institute. “Over time, this damages the blood vessels and can cause serious, even life-threatening health problems.”

And while high blood pressure can lead to heart disease, stroke, kidney disease, vision loss, sexual dysfunction and peripheral artery disease, it rarely offers any warning signs in its early stages. “People often associate high blood pressure with symptoms like facial flushing, sweating or nervousness, but unless a person has severely elevated blood pressure, there are no symptoms,” Klappa says. “Many people with high blood pressure don’t even know they have it. That’s why it’s important to take regular blood pressure measurements.”

Know your numbers

Blood pressure is measured in millimeters of mercury (mmHg) and is recorded as two numbers, a top (systolic) number “over” a bottom (diastolic) number.

Systolic blood pressure, which is given as the first number, indicates how much pressure your blood is exerting against your artery walls each time your heart beats. Diastolic blood pressure, the second number, indicates how much pressure your blood is exerting against your artery walls while your heart is resting between beats.

“Typically, a blood pressure reading less than 120/80 mmHg is considered normal,” Klappa says. “A systolic reading of 130 or more, however, is considered hypertensive and should be discussed with a health care provider.”

Klappa recommends keeping these numbers handy for reference: Healthy Blood Pressure: 120 over 80 Elevated Blood Pressure: 120-129 over 80

Hypertension Stage 1: 130-139 over

80-89

Hypertension Stage 2: 140-179 over

90-119

Hypertensive crisis: 180 over 120 or

higher (either number)

Even a small increase in blood pressure numbers can cause significant damage, Klappa says, pointing to studies with people aged 40 to 89 that show the risk of death from ischemic heart disease and stroke doubles with every 20 mmHg increase in systolic measurement or 10 mmHg increase in diastolic measurement.

Make a habit of measuring bp

In addition to having your blood pressure checked at visits with your health care provider, it is a good idea to measure it regularly — even daily — with a home blood pressure monitor. Klappa recommends an automatic, cuff-style, upper-arm monitor. “Choose a monitor that comes with a cuff that fits properly around your upper arm,” he says. “Bring your monitor to your next appointment to make sure you are using it correctly and getting the same results as the clinic equipment. Then, bring it in at least once a year to make sure the readings remain accurate.”

It’s a good idea to write down your blood pressure readings to keep a record you can take to your next appointment. Some blood pressure monitors automatically store your readings, and some even allow you to upload your readings to a secure website using your personalized profile.

What to do if you have high blood pressure

If you have hypertension, talk with your health care provider about ways to lower your blood pressure. “Managing your blood pressure usually begins with making some lifestyle changes,” Klappa says. “Increasing your activity level, improving your sleep pattern, stopping any tobacco use, making healthy food choices — these all can help.” Reducing dietary sodium and boosting your potassium intake are also recommended, as is limiting alcohol.

If lifestyle modifications alone aren’t enough to effectively manage hypertension, several types of medications are available to help keep blood pressure under control. It is important to take these medications at the same time every day, exactly as prescribed, and to continue taking blood pressure readings regularly.

If you ever have a blood pressure reading in the hypertensive crisis range — 180/120 or higher — wait a few minutes and take another reading. If the second reading is still high, call your health care provider. Hypertensive crisis can often be resolved by making changes to your medication. However, a blood pressure reading of 180/120 or higher can sometimes indicate a medical emergency. Call 911 if you have a blood pressure reading at 180/120 or higher along with any of these symptoms:

• Chest pain

• Shortness of breath

• Back pain

• Numbness/weakness

• Change in vision

• Difficulty speaking

“Most cases of high blood pressure can be well managed,” Klappa says. “Making lifestyle changes and taking medications, if necessary, can reduce your risk of serious illness and help you maintain your quality of life.”

For more information or to make an appointment at Washington Regional’s Cardiovascular Clinic, visit www.wregional.com/heart.

Anthony Klappa, MD