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High Blood Pressure Science, Physics, and Tips for Management


It seems that everyone gets high blood pressure as they age. Find out about the science and physics of this condition, see if you have any risk factors, learn how it is treated, and review these tips for blood pressure management.

Blood Pressure Physics

Hypertension
(the medical name for high blood pressure) is very common and occurs when the force of your blood against the artery walls reaches a dangerous level - a pressure high enough that it can cause a number of health problems. Blood pressure follows simple physics and is a function of the amount of blood pumped by your heart as it relates to the amount of resistance to flow in your arteries. So, if your heart is working harder, and your arteries narrow, you will get hypertension. Hypertension, often called a silent disease, may exist for decades without presenting any symptoms to identify its presence. Nonetheless, it can greatly increase your risk of developing serious health problems, to include heart attack or stroke. The good news is that it is easy to detect, and in most cases, able to be controlled with help from your doctor (Mayo Clinic, 2012).

Symptoms and Checks

Although most people with hypertension experience no telling symptoms, a few individuals may experience an increased incidence of headache, dizziness or nosebleeds than is typical for them. Since hypertension usually asymptomatic, it is critical to have your blood pressure checked regularly. Experts recommend checks at least every 2 years after age 18 and more frequently if you have a history of hypertension or risk factors for cardiovascular disease. While there are often other opportunities to get your blood pressure assessed, such as at a pharmacy or health fair, these results should be looked at with some discretion since the measurement may not be as accurate as that can be obtained by your doctor (Mayo Clinic, 2012).

Blood Pressure Controllers

While the idea of increased blood pumping and/or narrowing arteries is straight forward, the science behind it is anything but. Rather, the root causes of hypertension are complicated. Blood pressure is controlled by many things. These include:


• chemical mediators in your blood
• the reactivity of your blood vessels
• the actual volume of blood in your body
• the diameter of your blood vessels; the viscosity of your blood
• the volume of blood pumped with each beat of your heart
• the elastic characteristics of your blood vessels
(emedicine, 2013)

The Road to Complicated Hypertension

It can take some time for hypertension to fully develop in a person. After a sometimes long and aymptomatic period, the disease progresses and becomes fully established as complicated hypertension. It is at this phase that target organ damage to blood vessels, the heart, kidneys, eye and nervous system can occur. The slow and sometimes insidious nature of the progression of this disease and its asymptomatic nature both make careful monitoring of blood pressure essential. The types of hypertension include:


• Pre-Hypertension: The road to complicated hypertension begins as a condition called pre-hypertension in people aged 10-30 years. At this point, the cause is typically increased output from the heart.
• Early Hypertension – This is found in persons aged 20-40 years, when increased resistance in the blood vessels becomes important.
• Established Hypertension – A form of elevated blood pressure typically seen in people aged 30-50 years.
• Complicated Hypertension – The end form of elevated blood pressure, seen in persons aged 40-60 years.
(emedicine, 2013)

Check your Risk Factors

According to a 2011 report from the US Centers for Disease Control, the overall incidence of hypertension in American adults over the time period 2005-2008 was nearly 30%. With that said, higher incidences of hypertension were seen in people over the age of 45 years, those with less education, and people of less affluence. Others at risk include:


• Non-hispanic blacks (42%)
• US born individuals (31%)
• Diabetics (57%)
• People 65 years of age and older who are dependent on public health insurance (32%)
• Obese individuals (40%)
• The disabled (39%)
(Centers for Disease Control, 2011)

Hypertension causes Heart Disease, Stroke, Dementia and Kidney Disease

High blood pressure researcher Fry published an important study after he followed the outcomes of 700 hypertensive people over a period of 25 years. Serious complications or death occurred in over 400 of these research subjects, and of these 400, half of them suffered cardiovascular complications (coronary artery disease or heart failure) and stroke. Many people with hypertension also experienced significant dementia (possibly linked to stroke) and kidney disease.

5 Tips for Hypertension Management

The root cause of hypertension is complicated, and so is its treatment. Managing hypertension requires changes in behavior and sometimes medication. An individual can do a combination of many things to treat their hypertension. The multi-pronged treatment approach includes diet changes, blood pressure medication and exercise.

1. Quit smoking. Smoking decreases arterial width and contributes to elevations in blood pressure.
2. Reduce daily stressors. Stress leads to hypertension and is easily avoided.
3. Exercise more. Physical activity helps lower blood pressure
4. Watch your diet - avoid sugars, fats and sodium. These substances contribute to the development of high blood pressure.
5. Take your prescribed medications. If your doctor gives you a medicine, you should take it as advised for blood pressure control.
(Mayo Clinic, 2012)

New Nerve Altering Procedure for High Blood Pressure

While many people are able to control their hypertension using behavior modification or currently available medication, there are always some who just cannot seem to get it down and keep it down. A new procedure for these people, called renal denervation, could help. To conduct this procedure, doctors make a small cut in an artery in the groin region, and then thread a device up the artery to the kidney. The machine then fires short bursts of radio waves designed to deaden nerves in the kidney. When these nerves are overly stimulated, they cause the body to retain too much sodium, so de-activating them allows the body to retain less salt, resulting in lower blood pressure. Preliminary results show that renal denervation works (Esler, et al, 2012).

There are two stages doctors use when diagnosing high blood pressure.

Stage One: Systolic is 140-159 or diastolic is 90-99

StageTwo: Systolic is 160 or higher or diastolic is 100 or higher.

The stage a person is diagnosed is related to the higher number, so if the systolic pressure is 160 over 80 you are said to have stage two hypertension. If your numbers are 120 over 95 you are said to have stage one hypertension.

Are you stuck with your numbers?

No, you are not stuck with your numbers. If you make healthy lifestyle changes, get ongoing medical care and follow the treatment plan you can get your blood pressure to safer ranges.

If you have other health conditions such as chronic kidney disease or diabetes your health blood pressure will be different than for a person who does not have those health issues. For a diabetic or person who has chronic kidney disease, a blood pressure of 130/80, though 140/80 is ideal. Managing blood pressure while dealing with diabetes is challenging but it can be accomplished with good medical care and a plan for healthy living.

What can happen without proper care?

Without proper care a person can cause themselves a world of pain in the hospital. There are two levels of that rate the level of potential damage related to untreated high blood pressure when the numbers become dangerously high.

Hypertensive Urgency:

The blood pressure spikes to dangerously high levels but does not result in damage to organs in the body because the blood pressure was safely brought down within a few hours with the aid of blood pressure medications.

Hypertensive Emergency:

The blood pressure is so high that damage to organs can occur. High blood pressure must be brought down as quickly as possible with IV medication and will require intensive care in a hospital. Although this form of hypertension is rare it can and does happen to patients who do not attempt to make any healthy changes in their lives nor do they follow their prescribed treatment plans.

The symptoms for a hypertensive emergency may include:


• Headache and blurred vision
• Mental confusion
• Seizure
• Increased or more intense chest pain
• Increasing shortness of breath
• Swelling or edema of body tissues ( fluid buildup in tissues)

If you do not follow medical advice you may incur damage to vital organs within the body. Untreated high blood pressure can lead to urgent or emergency medical care. The potential for damage to bodily organs is alarming and totally preventable. Some of the damages that are preventable with the right medical care are:


• Changes in mental state
• Bleeding in the brain that can be a stroke
• Heart failure
• Chest pain
• Heart attack
• Pulmonary edema (fluid in the lungs)
• Aneurism ( aortic dissection or separation)
• Eclampsia in pregnant women

Totally preventable condition

Some things happen to the body even with the best lifestyle, diet, exercise and medical care. People can be born with medical conditions that are life long and no amount of treatment will change it. But, by and large, high blood pressure is totally preventable and treatable. Annual physicals can monitor changes to general health and retain a record of your vital signs. Any marked change will alert the doctor to check you closer for medical conditions he can treat to help you live a healthy life. If your doctor discovers that you have developed prehypertension and he prescribes a treatment plan to get your number back within normal ranges, it is up to you to follow through.

How you manage your health when you are on your own is what it really comes down to. Your doctor can lead you, but you have to decide to follow. If you are already on Blood Pressure Medication and you are in need of a quick and easy solution for a refill for your medication you can go online and talk to an online doctor at QuickRxRefill



References

Telemedicine (2013). Pathophysiology of hypertension. Retrieved from: http://emedicine.medscape.com/article/1937383-overview

Esler MD, Krum H, Schlaich M. Renal sympathetic denervation for treatment of drug-resistant hypertension: one-year results from the Symplicity HTN-2 randomized, controlled trial. Circulation. 2012; 18; 126:2976-82

Fry J. Deaths and complications from hypertension. J R Coll Gen Pract. 1975; 25: 489–494.

Keenan NL & Rosendorf KA. Morbidity and Mortality Weekly Report (MMWR). 2011; 60:94-97

Mayo Clinic (2013). High blood pressure. Retrieved from: http://www.mayoclinic.com/health/high-blood-pressure/DS00100

QuickRXRefill high blood pressure hypertension page.

 

 

Mitchell Cohen
Mitchell Cohen, M.D. is Board Certified doctor specializing in Orthopedic Medicine and Spinal Surgery. Graduated from Hahnemann University in Philadelphia, PA with a degree in Human Physiology (1983) and subsequently achieved his medical degree in 1987 from Case Western Reserve University School of Medicine. Dr Cohen did his Surgical Residency at the University of New Mexico in 1992 as well as a Spine Fellowship in 1993. Dr. Cohen has published the following medical journals: "Biomechanical Efficiency of Spinal Systems in Thorocolumbar Fractures" (1993), "Kaneda Anterior Spinal Instrumentation" and "Spinal Fusion Stabilization amongst many others. View Dr Cohen's Twitter Page.

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