Hypertension:

Hypertension: Preventing High Blood PressureAbout 1 in every 4 American adults has high blood pressure, also called hypertension, which is a major risk factor for heart and kidney diseases, stroke and heart failure. High blood pressure is especially dangerous because it often gives no warning signs or symptoms. Fortunately, you can find out if you have high blood pressure by having your blood pressure checked regularly. If it is high, you can take steps to lower it. Just as important, if your blood pressure is normal, you can learn how to keep it from becoming high.

How Can I Prevent High Blood Pressure?

You can prevent high blood pressure by:

Maintaining a healthy weight. Being overweight can make you two to six times more likely to develop high blood pressure than if you are at your desirable weight. Even small amounts of weight loss can make a big difference in helping to prevent and treat high blood pressure.

Getting regular exercise: People who are physically active have a lower risk of getting high blood pressure -- 20%-50% lower -- than people who are not active. You don't have to be a marathon runner to benefit from physical activity. Even light activities, if done daily, can help lower your risk.

Reducing salt intake: Often, when people with high blood pressure cut back on salt, their blood pressure falls. Cutting back on salt also prevents blood pressure from rising.

Drinking alcohol in moderation, if at all: Drinking too much alcohol can raise your blood pressure. So to help prevent high blood pressure, if you drink alcohol, limit how much you drink to no more than two drinks a day. The "Dietary Guidelines for Americans" recommend that for overall health, women should limit their alcohol to no more than one drink a day.

Reduce Stress: Stress can make blood pressure go up and over time may contribute to the cause of high blood pressure. There are many steps you can take to reduce your stress. The article on easing stress will get you started.

Other things, like dietary supplements, may also help prevent high blood pressure. Here's a roundup of what's being said about them.

Potassium. Eating foods rich in potassium will help protect some people from developing high blood pressure. You probably can get enough potassium from your diet, so a supplement isn't necessary. Many fruits, vegetables, dairy foods and fish are good sources of potassium.

Calcium. Populations with low calcium intakes have high rates of high blood pressure. However, it has not been proven that taking calcium tablets will prevent high blood pressure. But it is important to be sure to get at least the recommended amount of calcium -- 1000 milligrams per day for adults 19 to 50 years old and 1200 mg for those over 50 (pregnant and breastfeeding women also need more) -- from the foods you eat. Dairy foods like low-fat selections of milk, yogurt and cheese are good sources of calcium. Low-fat and nonfat dairy products have even more calcium than the high-fat types.

Magnesium. A diet low in magnesium may make your blood pressure rise. But doctors don't recommend taking extra magnesium to help prevent high blood pressure -- the amount you get in a healthy diet is enough. Magnesium is found in whole grains, green leafy vegetables, nuts, seeds, and dry peas and beans.

Fish oils. A type of fat called "omega-3 fatty acids" is found in fatty fish like mackerel and salmon. Large amounts of fish oils may help reduce high blood pressure, but their role in prevention is unclear. Taking fish oil pills is not recommended because high doses can cause unpleasant side effects. The pills are also high in fat and calories. Of course, most fish, if not fried or made with added fat, is low in saturated fat and calories and can be eaten often.

Garlic. There has been some evidence to suggest garlics effect in lowering blood pressure in addition to improving cholesterol and reducing some cancers. Further research is being conducted to fully assess garlics potential health benefits.

Always talk to your doctor before taking a dietary supplement or alternative herbal treatment. Some may interact with other medications you may be taking or have harmful side effects.

Hypertension:Treatment OverviewHypertension, or high blood pressure, is dangerous because it can lead to strokes, heart attacks, heart failure, or kidney disease. The goal of hypertension treatment is to lower high blood pressure and protect important organs, like the brain, heart, and kidneys from damage. Treatment for hypertension has been associated with reductions in stroke (reduced an average of 35%-40%), heart attack (20%-25%), and heart failure (more than 50%), according to research.

Hypertension is classified as:

Normal blood pressure: less than 120/80 mmHg

Prehypertension: 120-139/80-89 mmHg

Hypertension: greater than 140/90 mmHg

Stage 1 Hypertension:140-159/90-99 mmHg

Stage 2 Hypertension: 160 or greater/ 100 or greater.mmHg

All patients with blood pressure readings greater than 120/80 should be encouraged to make lifestyle modifications, such as eating a healthier diet, quitting smoking and getting more exercise. Treatment with medication is recommended to lower blood pressure to less than 140/90 mmHg. For patients who have diabetes or chronic kidney disease the recommended blood pressure is less than 130/80 mmHg.

Treating hypertension involves lifestyle changes and drug therapy.

Lifestyle ChangesA critical step in preventing and treating hypertension is a healthy lifestyle. You can lower your blood pressure with the following lifestyle modifications:

Losing weight if you are overweight or obese.

Quitting smoking.

Eating a healthy diet, including the DASH diet (eating more fruits, vegetables, and low fat dairy products, less saturated and total fat).

Reducing the amount of sodium in your diet to 2,300 milligrams (about 6 grams or less than 1 teaspoon salt) a day or less.

Getting regular aerobic exercise (such as brisk walking at least 30 minutes a day, several days a week).

Limiting alcohol to two drinks a day for men, one drink a day for women.

In addition to lowering blood pressure, these measures enhance the effectiveness of antihypertensive medications.

MedicationsThere are several types of drugs used to treat hypertension, including:

Angiotensin-converting enzyme (ACE) inhibitors

Angiotensin || receptor blockers (ARBs)

Diuretics

Beta-blockers

Calcium channel blockers

Diuretics are usually recommended as the first line of therapy for most people who have hypertension. If one drug doesn't work or is disagreeable, other types of diuretics are available.

However, your doctor may start a medicine other than a diuretic as the first line of therapy if you have certain medical problems. For example, ACE inhibitors are often a good choice for a people with diabetes.

If your blood pressure is more than 20/10 mmHg higher than it should be, your doctor may consider starting you on two drugs.

Follow-UpAfter starting antihypertensive drug therapy, you should see your doctor at least once a month until the blood pressure goal is reached. Once or twice a year, your doctor will check your serum potassium (diuretics can lower this, and ACE inhibitors and ARBs may increase this) and creatinine levels (to check the health of the kidneys).

After the blood pressure goal is reached, you should continue to see your doctor every three to six months, depending on whether other diseases such as heart failure are present

Hypertension:The DASH DietOne of the simplest and most effective ways to lower your blood pressure is to eat a healthy diet. Doctors recommend:

Eating more fruits, vegetables, and low-fat dairy foods

Cutting back on foods that are high in saturated fat, cholesterol, and total fat

Eating more whole grain products, fish, poultry, and nuts

Eating less red meat and sweets

Eating foods that are rich in magnesium, potassium, and calcium

The DASH diet, which stands for Dietary Approaches to Stop Hypertension, is an example of such an eating plan. In studies, patients who were on the DASH diet reduced their blood pressure within two weeks. Another diet -- DASH-Sodium -- calls for reducing sodium (salt) to 1,500 mg a day (about 2/3 teaspoon). Studies of patients on the DASH-Sodium plan significantly lowered their blood pressure.

Implementing the DASH DietThe DASH diet calls for a certain number of servings daily from various food groups. The number of servings you require may vary, depending on your caloric need. When beginning the diet, start slowly and make gradual changes. Consider adopting a diet plan that allows 2,400 milligrams of salt per day (about 1 teaspoon) and then once your body has adjusted to the diet further lower your salt intake to 1,500 mg per day (about 2/3 teaspoon). These amounts include all salt consumed, including that in food products, used in cooking, and added at the table.

Here are some tips to get you started:

Add a serving of vegetables at lunch and at dinner.

Add a serving of fruit to your meals or as a snack. Canned and dried fruits are easy to use.

Use only half the butter, margarine, or salad dressing, and use low-fat or fat-free condiments.

Drink low-fat or skim dairy products three times a day.

Limit meat to six ounces a day. Try eating some vegetarian meals.

Add more vegetables, rice, pasta, and dry beans to your diet.

Instead of typical snacks (chips, etc.), eat unsalted pretzels or nuts, raisins, graham crackers, low-fat and fat-free yogurt and frozen yogurt; unsalted plain popcorn with no butter, and raw vegetables.

Read food labels carefully to choose products that are lower in sodium.

Staying on the DASH DietThe following is a list of food groups and suggested serving amounts for the DASH diet:

Grains: 7-8 daily servings

Vegetables: 4-5 daily servings

Fruits: 4-5 daily servings

Low-fat or fat-free dairy products: 2-3 daily servings

Meat, poultry and fish: 2 or less daily servings

Nuts, seeds, and dry beans: 4-5 servings per week

Fats and oils: 2-3 daily servings

Sweets: try to limit to less than 5 servings per week

How Much Is a Serving?

When you're trying to follow a healthy eating plan, it may help to know how much of a certain kind of food is considered a "serving." The following table offers some examples.

SERVING SIZES

Food/amount

1/2 cup cooked rice or pasta

1 slice bread

1 cup raw vegetables or fruit

1/2 cup cooked vegetables or fruit

8oz. of milk

1 teaspoon olive oil

3 ounces cooked meat

3 ounces tofu

Hypertension:Blood Pressure BasicsBlood pressure is the force of blood pushing against blood vessel walls. The heart pumps blood into the arteries (blood vessels), which carry the blood throughout the body. High blood pressure, also called hypertension, is dangerous because it makes the heart work harder to pump blood to the body and it contributes to hardening of the arteries or atherosclerosis.

What Is "Normal" Blood Pressure?There are several categories of blood pressure, including:

Normal: Less than 120/80

Prehypertension: 120-139/80-89

Stage 1 hypertension: 140-159/90-99

Stage 2 hypertension: 160 and above/100 and above

People whose blood pressure is above the normal range should consult their doctor about methods for lowering it.

What Causes Hypertension?The exact causes of hypertension are not known. Several factors and conditions may play a role in its development, including:

Smoking

Obesity

Lack of physical activity

Too much salt in the diet

Too much alcohol consumption (no more than 1 to 2 drinks per day)

Stress

Older age

Genetics

What Are the Symptoms of Hypertension?There are usually no symptoms or signs of hypertension. In fact, nearly one-third of those who have it don't know it. The only way to know if you have hypertension definitely is to have your blood pressure checked.

If your blood pressure is extremely high, there may be certain symptoms to look out for, including:

Severe headache

Fatigue or confusion

Vision problems

Chest pain

Difficulty breathing

Irregular heartbeat

Blood in the urine

Who Is More Likely to Develop Hypertension? People with family members who have high blood pressure.

People who smoke.

African-Americans.

Women who are pregnant.

Women who take birth control pills.

People over the age of 35.

People who are overweight or obese.

People who are not active.

People who drink alcohol.

People who eat too many fatty foods or foods with too much salt.

How Is Hypertension Diagnosed?Your health care provider can tell if you have hypertension by checking your blood pressure with a special meter called a sphygmomanometer, which consists of a stethoscope, arm cuff, dial, pump, and valve. You can also measure your own blood pressure at home. You should have your blood pressure checked at least once a year to make sure you don't have hypertension.

What Health Problems Are Associated With Hypertension?Hypertension is a serious condition that can damage the blood vessels, and can eventually lead to several other conditions, including:

Stroke

Heart failure

Heart attack

Kidney failure

Vision problems

How Is Hypertension Treated?Hypertension is typically treated by making changes in your lifestyle, and with drug therapy. Lifestyle changes include losing weight, stopping smoking, eating a healthy diet (such as the DASH diet, which includes lowering sodium but including daily servings of fruits, vegetables, and whole grain foods), and getting enough exercise, especially aerobic exercise.

Several types of drugs are available to treat hypertension, including ACE inhibitors, angiotensin receptor blockers (ARBs), diuretics, beta-blockers, and calcium channel blockers.

Hypertension:Symptoms of High Blood PressureOne of the most dangerous aspects of hypertension is that you may not know that you have it. There are generally no symptoms, so you usually don't feel it. In fact, nearly one-third of people who have hypertension don't know it. The only way to find out if you have high blood pressure is to get your blood pressure checked on a regular basis. This is especially important if you have a close relative who has high blood pressure.

If your blood pressure is extremely high, there may be certain symptoms to look out for, including:

Severe headache

Fatigue or confusion

Vision problems

Chest pain

Difficulty breathing

Irregular heartbeat

Blood in the urine

If you have any of these symptoms, see a doctor immediately. You could be having a hypertensive crisis that could lead to a heart attack or stroke

Hypertension:Risk FactorsAlthough the exact cause of hypertension is unknown, there are several factors and conditions that may contribute to its occurrence, including:

Obesity

Smoking

Little or no exercise

Too much salt in the diet

Drinking too much alcohol

Stress

Ethnic background

History of high blood pressure in the family