High blood pressure

Overview

Also known as hypertension, high blood pressure (HBP) is the extra force of blood pushing against the inside of the blood vessels as the heart pumps, causing the heart to work harder. The size and elasticity of the artery walls also affect blood pressure. Each time the heart beats (contracts and relaxes), pressure is created inside the arteries. Hypertension can cause heart disease or heart failure, stroke, kidney failure and other health problems. Pulmonary hypertension occurs when pressure in the pulmonary circulation becomes abnormally elevated. Constriction, or stiffening, of the pulmonary arteries that supply blood to the lungs causes pulmonary hypertension. It then becomes more difficult for the heart to pump blood forward through the lungs. Symptoms of pulmonary hypertension range in severity and can include shortness of breath with everyday activities, fatigue, dizziness and fainting spells.

Causes

Causes of HBP include such factors as aging, obesity, heredity, stress and hardening of the arteries.

Symptoms

HBP can have no symptoms, or in other cases it may cause severe headaches, dizziness, confusion, vision problems, chest pain and breathing difficulties.

Risk factors

If you have total cholesterol levels of 200 mg/dL or higher, low levels of "good" cholesterol (HDL) or high levels of "bad" cholesterol (LDL), you are at risk for hypertension and heart disease. Since hypertension is usually a sign that you may get heart disease, many of the risk factors for high blood pressure are the same as those for heart disease. Nearly one-third of all Americans have high blood pressure, but it is particularly prevalent in:

  • People who have diabetes, gout or kidney disease
  • African Americans (particularly those living in the southeastern U.S.)
  • People in their early to middle adult years: men in this age group have higher blood pressure more often than women in this age group
  • People in their middle to later adult years: women in this age group have higher blood pressure more often than men in this age group; more women after menopause have high blood pressure than men of the same age
  • Middle-aged and elderly people: more than half of all Americans age 60 and older have high blood pressure
  • People with a family history of high blood pressure
  • Those under heavy stress
  • Obese people
  • Smokers
  • Heavy drinkers of alcohol
  • Women who are taking oral contraceptives
  • People with eating habits that include high sodium intake and fatty foods
  • People who are sedentary (not very active) Users of recreational drugs such as cocaine and amphetamines

Diagnosis

Blood pressure is measured with a blood pressure cuff and stethoscope by a nurse or other healthcare provider. You also can take your own blood pressure with an electronic blood pressure monitor available at most pharmacies. However, a single elevated blood pressure measurement doesn’t necessarily mean you have a problem. Your healthcare provider will want to see multiple blood pressure measurements over several days or weeks before making a diagnosis of high blood pressure and starting treatment. Our renowned cardiologists and healthcare professionals provide a full spectrum of state-of-the-art noninvasive cardiac testing procedures, including stress testing, echocardiograms, electrocardiograms, Holter monitoring, tilt-table tests and cardiac CT scans that help diagnose symptoms of cardiovascular disease, to which high blood pressure can be a contributing factor. Stress testing — A stress test can evaluate the heart during exercise and is often more revealing than a test conducted at rest. A stress test can help diagnose coronary artery disease (CAD), hypertension, valvular disease and arrhythmias. It also can evaluate cardiovascular physical fitness and measure the heart's response to medical or interventional treatments. There are several types of stress tests: Nuclear stress test — During a nuclear stress test, a small amount of injected radioactive substance is used to create a nuclear image that shows how well blood flows into the heart muscle, both at rest and during activity. Exercise stress test — Using continuous electrocardiographic monitoring while exercising on a treadmill, this test examines the heart’s activity. Stress echocardiogram — A stress echocardiogram takes ultrasound images after a patient exercises. Echocardiogram (echo) — An echocardiogram uses ultrasound (sound waves) to examine the heart’s chambers and valve function. It is sometimes used with a stress test to provide additional information needed to diagnose CAD, HBP, valve disease, arrhythmias and other conditions. Audio and visual recording of the waves rebounding from the heart walls and valves indicate the size, shape, texture and function of these structures. The speed and direction of the blood flow also can be evaluated.

Nonsurgical treatment

Our staff of experienced cardiologists and cardiac healthcare professionals offers a multifaceted approach to hypertension. In addition to blood pressure and cholesterol medications, the major factor in management of high blood pressure is lifestyle choices. High blood pressure can be controlled by:

  • Monitoring of blood pressure and cholesterol
  • Taking prescribed medications exactly as ordered by your healthcare provider
  • Stress management
  • Smoking cessation
  • Maintaining a healthy weight, or losing weight if overweight Increasing physical activity
  • Having a healthy eating plan: lean protein, more vegetables and fruit
  • Choosing foods that are low in sodium (salt), calories and fat
  • Choosing foods high in fiber
  • Limiting serving sizes
  • Reducing or omitting alcoholic beverages

Treatments

Treatments are determined depending on the source of the hypertension. For patients with pulmonary hypertension (elevated pressure in the pulmonary artery providing blood to the lungs), more advanced treatments may be used, such as a combination of medication and/or surgery, based on the underlying cause of elevated blood pressure in the lungs. If a blood clot is present, surgery can be used to remove it.

Start your heart health journey.

Explore our services and treatments with our cardiac experts.