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UNIVERSITY STUDENT HEALTH SERVICES ● Fact Sheet HYPERTENSION Secondary hypertension is much more rare. In these cases, a direct cause for high blood pressure can be identified. Causes include kidney disease, hormonal abnormalities, tumors of the adrenal gland, medications (such as birth control pills and decongestants), and pregnancy. WHAT IS BLOOD PRESSURE & WHY IS IT IMPORTANT? Blood pressure readings reflect the force of blood pushing against the walls of the arteries that transport blood from the heart to all the body’s organs and tissues. WHO GETS HYPERTENSION? Blood pressure is recorded using two numbers: The upper number (systolic pressure) is the highest pressure when the heart is contracting to pump blood out to the body. The bottom number (diastolic pressure) measures the pressure when the heart is resting between beats and filling up with blood. Anyone with the risk factors mentioned earlier is at risk for developing hypertension. The more risk factors you have, the higher your probability of developing high blood pressure. One out of every four adult Americans has high blood pressure, and more than 50% of Americans over age 65 are hypertensive. High blood pressure also develops earlier and is more severe in African Americans. Systolic blood pressure increases with age. Diastolic blood pressure increases until age 50 and then declines. Both numbers do not have to be elevated in order to have high blood pressure. In people over 50, systolic blood pressure is more important to control than diastolic blood pressure. WHAT ARE THE SYMPTOMS? Hypertension is known as a “silent” disease because it often has no warning signs or symptoms. That is why it is important to have your blood pressure checked on a regular basis. Hypertension is the medical term used to describe the condition in which blood pressure remains persistently elevated. Untreated hypertension can become a serious condition over time because it can lead to life-threatening complications, such as heart disease, kidney disease, and stroke. Frequently, symptoms do not develop until organs begin to suffer, leading to heart disease, kidney disease, and stroke. Symptoms may include chest pain, irregular heartbeats, shortness of breath, fatigue, headache, and changes in vision. HOW IS HYPERTENSION DIAGNOSED? WHAT CAUSES HYPERTENSION? Normal fluctuations in blood pressure are normal. Therefore, two blood pressure readings of 140/90 or above on two different days are required before diagnosing someone with hypertension. In the vast majority of cases, no specific cause of hypertension is found. This type of high blood pressure is known as primary or essential hypertension. Risk factors for essential hypertension include a family history of the disease, smoking, obesity, high cholesterol, and diabetes. Other risk factors include excess salt intake, too much alcohol use (more than one to two drinks per day), and lack of physical activity. Once hypertension is diagnosed, your health care provider will check baseline bloodwork and a urine sample to rule out other causes or complications of high blood pressure. In addition, a baseline electrocardiogram (a painless test that measures the electrical activity of your heart) is also recommended. *CLASSIFICATION OF BLOOD PRESSURE FOR ADULTS Blood Pressure Classifications Normal **Prehypertension SBP (mmHg) DBP (mmHg) < 120 120-139 and or < 80 80-89 Stage 1 Hypertension 140-159 or 90-99 Stage 2 Hypertension ≥ 160 or ≥ 100 * If systolic and diastolic blood pressures fall into different categories, the higher category is used to classify blood pressure. ** Prehypertension doubles the risk of progression to hypertension compared to those with normal blood pressure. WHAT ARE THE COMPLICATIONS OF HYPERTENSION? If blood pressure is elevated all the time, the constant abnormal force of blood pushing against the arterial walls damages the blood vessels and can lead to several conditions: ■ Arteriosclerosis Elevated blood pressure makes the arteries thick and stiff while also promoting the build-up of cholesterol and fats inside the blood vessels. This can cause a blockage of blood flow in the arteries, leading to problems like a heart attack or stroke. ■ Chest pain (angina) and heart attack When arteries become damaged by high blood pressure, they are unable to carry enough blood back to the heart. A decreased blood supply means a decreased oxygen supply. When the heart does not get enough oxygen, you can develop chest pain, called angina. If heart muscle dies because of a complete lack of oxygen, it is called a heart attack or myocardial infarction. ■ Enlarged heart When the heart has to work harder to pump blood against a higher pressure, the heart muscles will start to enlarge. Over time, the thickened muscles stretch and become weaker, decreasing the heart’s ability to pump blood out to the body. When this condition becomes severe, fluid can start backing up into the lungs, causing increasing shortness of breath and cough. ■ Stroke Elevated blood pressure harms all the arteries, including those leading to the brain. If a clot blocks the artery and the brain does not get enough oxygen, a thrombotic stroke can occur. A hemorrhagic or bleeding stroke can occur when very high blood pressure causes a weakened artery to break. ■ Kidney damage Kidneys are particularly prone to damage from high blood pressure because they are primarily made up of blood vessels that filter waste products out of the body. Over time, an elevated blood pressure can narrow and thicken the blood vessels in the kidneys. As kidney function drops, waste products build up in the blood and cause a variety of complications. Eventually, the kidneys can fail completely, requiring dialysis (mechanical filtering) or transplant. WHAT CAN BE DONE TO PREVENT AND TREAT HYPERTENSION? Individuals whose blood pressure falls between normal and high readings (from 120/80 to 139/89) have prehypertension. Prehypertension is not considered an actual disease. However, individuals with prehypertension are at high risk of progressing to hypertension; therefore, it is important for these patients to start implementing healthy lifestyle habits early to prevent the development of hypertension. In addition, lifestyle changes should continue to be part of the treatment plan for those patients already taking medication(s) for hypertension. ■ Maintain a healthy weight. Being overweight can increase your risk of developing hypertension by two to six times. Even relatively small amounts of weight loss can make a huge difference in helping to decrease or prevent high blood pressure. Remember that the healthiest and longest-lasting weight loss is very slow – 1/2 to 2 pounds per week. This can be accomplished by decreasing your intake by 500 calories/day (3,500 calories in 1 week = 1 pound). ■ Be physically active. Physically active people have a 20-50% lower risk of getting hypertension. Additionally, aerobic activity for at least 30 minutes four or five times a week helps raise HDL (good cholesterol) and helps to lower total cholesterol. It is important to see a health care provider prior to starting a vigorous exercise program if you have elevated blood pressure, pains or pressure in the chest or shoulder areas, dizziness or faintness, breathlessness following a mild workout, or if you are middleaged or older. ■ Stop smoking. Smoking causes injury to the walls of the blood vessels, thereby accelerating hardening of the arteries (arteriosclerosis) already caused by hypertension. Nicotine also increases blood pressure by causing your arteries to constrict and your heart to beat faster. ■ Eat foods low in salt or sodium. Although African Americans and the elderly tend to be more affected by high sodium foods, it makes sense for everyone to limit their salt consumption. All Americans should eat no more than 6 grams of salt per day (which equals 2,400 milligrams of sodium or one teaspoon of table salt). However, most Americans eat 4,000-6,000 milligrams of sodium per day! 75% of this sodium intake comes from processed foods. In addition to the usual salty foods that come to mind, other foods with high sodium content include canned vegetables, canned soups, pre-packaged microwave meals, V8, Gatorade, and other sports drinks. ■ Adopt a healthy diet. The DASH (Dietary Approaches to Stop Hypertension) diet is rich in fruits, vegetables, and low-fat dairy products (with a reduced content of saturated and total fat). This diet is also rich in potassium and calcium. Research has shown that potassium helps to prevent and control high blood pressure. Many fruits, vegetables, fish, and dairy products are rich sources of potassium (eg, bananas, spinach, sweet potatoes, green beans, milk). ■ Limit alcohol consumption. You should drink no more than one drink per day. A “drink” is defined as: 1.5 ounces of 80-proof liquor or 1 ounce of 100-proof liquor 5 ounces of wine 12 ounces of beer (regular or light) While there is some information to suggest that alcohol may promote a longer life by lowering blood pressure and preventing the build-up of fats in the arteries, remember that these benefits are associated with moderate alcohol consumption only. Increased alcohol use will lead to weight gain from its high caloric content. In addition, chronic or excessive alcohol use can lead to diseases of the liver and pancreas, as well as increased risk of cancers. Given these and other risks, we recommend against increasing your alcohol intake or starting to drink if you don’t already do so. ■ Other suggestions In addition to the above-mentioned steps which are PROVEN to help prevent and treat hypertension, there are other factors that MAY be helpful. These include eating foods rich in calcium, magnesium, and fish oils; decreasing caffeine intake; cooking with garlic and onions; and engaging in methods of stress management such as yoga, meditation, or progressive relaxation. ■ Medications If hypertension cannot be controlled with the above lifestyle changes, medication may be necessary. Talk to your medical provider about which medication is appropriate for you. RECOMMENDED WEBSITES: ■ www.familydoctor.org ■ www.nhlbi.nih.gov ________________________________________________________________ Published by VCU Division of Student Affairs and Enrollment Services University Student Health Services: (804) 828-8828 - Monroe Park Campus; (804) 828-9220 - MCV Campus Wellness Resource Center: (804) 828-9355 - 815 S. Cathedral Place Reviewed 7/11