A Guide to High Blood Pressure: Causes, Symptoms, Diagnosis and Treatment
The best way to monitor blood pressure is to have readings taken on a regular basis. Once someone is diagnosed with high blood pressure, more frequent screening is necessary.
Simple lifestyle changes, such as exercising more, reducing salt intake, and losing weight, can help to reduce high blood pressure. However, medication is required when blood pressure cannot be controlled naturally. Today there is even the convenience of being able to get a prescription for blood pressure medication.
What is high blood pressure/hypertension?
As the heart beats, it pushes blood through arteries, veins, and capillaries. The first number of a blood pressure reading is of the force that occurs as the heart pumps the blood out of the heart (systolic) and the second number is created as the heart rests between the beats and fills with blood (diastolic).
Blood pressure is defined as high if it is above 120/80 by the American Heart Association, although some medical professionals use 140/80 as the cut-off point. When blood pressure is high, medication is usually necessary. High blood pressure is considered severe if it is above 180/120.
SPRINT Trial
The Systolic Blood Pressure Intervention Trial (SPRINT), a study supported by the NHLBI, made a significant contribution to high blood pressure research and helped to inform the American College of Cardiology high blood pressure clinical guidelines.
For example, it found that when patients were treated until reaching a target of less than 120mm Hg, this decreased cardiovascular events by 25 percent and reduced the risk of death by 27 percent.
What causes high blood pressure?
In many cases, the underlying cause of high blood pressure is unknown, but many factors may contribute to it. These factors include being overweight, overeating salt, or taking certain medications.
Smoking, stress, too much alcohol, a lack of physical activity, unhealthy lifestyle choices, genetics, sleep apnea, chronic kidney disease, and adrenal or thyroid disorders can also contribute. It tends to run in families and is more likely to affect men than women. Age and race have also been found to play a role.
Symptoms of high blood pressure
High blood pressure is known as the "silent killer" because individuals may not feel any symptoms. It can quietly cause damage that has long term consequences. Specific symptoms may appear when blood pressure levels are very high. These may include nose bleeds, headaches, and dizzy spells.
Chest pains, shortness of breath, blurry vision, loss of balance, nausea, or headaches may occur when blood pressure is at dangerous levels, and intervention is necessary. Emergency personnel will follow guidelines to lower the blood pressure and keep monitoring it safely.
Sometimes an individual will not get a blood pressure medication refill for some reason, which can precipitate a crisis. This is avoidable by getting a blood pressure medication refill.
How do you know if you have high blood pressure?
The only way to find out if someone has high blood pressure is to test it with a blood pressure cuff. This involves inflating the cuff to a pressure higher than the systolic blood pressure. It tightens around the arm, and as the cuff deflates, the first sound heard through the stethoscope is the systolic blood pressure and the point where the noise goes away marks diastolic blood pressure.
A doctor may test blood pressure in his office, or a nurse may check it in another setting like a pharmacy. Ambulatory blood pressure monitoring (ABPM) is one of the most useful ways to determine if blood pressure is high. Patients wear the blood pressure cuff over 24 hours, and measurements are taken throughout that time to give a more accurate overall reading.
High blood pressure is not diagnosed with a single high reading. It needs to be taken at different times, and at least three elevated readings are usually required before treatment is recommended. Getting a medical prescription for hypertension may be necessary.
Some patients suffer from white coat syndrome, which means readings are elevated when taken in a clinical setting. This is not uncommon, and one study suggests that 15% to 30% of people who have high blood pressure readings may be suffering from white coat hypertension. Failure to identify this condition can result in prescribing medication that is not really necessary.
Reading blood pressure at home
Home blood pressure readings can help diagnose and monitor high blood pressure, especially for those with white coat hypertension.
- When taking blood pressure readings at home, it is essential to relax and not take readings straight after a big meal or within half an hour of drinking caffeine.
- Both arms may give a slightly different reading, so it is best to stick to one arm to track readings over time.
- Rest for five minutes before taking a reading.
- Sit with feet firmly on the floor, supporting the back and arm resting on a flat surface.
- Place the cuff around the arm, so it is level with the heart.
- Take several readings and work out the average.
- It sometimes happens that people have a higher reading at first. Keep taking readings until they are roughly the same and use that as the reading to record.
It can be convenient to obtain a prescription for high blood pressure medication once it has already been diagnosed, and a refill is necessary.
Further tests
In addition to testing blood pressure, doctors will take a medical history and ask about various risk factors. They will also conduct a physical exam. This may include using a stethoscope to listen to the heart and to sounds that could indicate blockage of arteries.
A doctor may recommend further tests, such as an electrocardiogram or an ECG. This test measures the rate, electrical activity, and rhythm of the heartbeat via electrodes attached to the chest, arms, and legs.
An echocardiogram is another test where ultrasound waves show the heart's valves and chambers to study the pumping action, measure the chambers, and the thickness of the heart wall.
Other tests may include blood tests to assess kidney involvement, urine tests for electrolytes or hormones, an eye examination to evaluate ocular damage, lipid profiles for various types of cholesterol or thyroid tests.
What happens when high blood pressure is untreated?
When blood pressure is high, it means the heart and blood vessels work harder and not as efficiently.
Over time the force of the high blood pressure starts to damage the tissue inside the arteries. The tiny tears in the artery walls become coated with plaque from bad cholesterol.
The narrower the arteries become, the higher the blood pressure, and this starts a vicious cycle that can eventually lead to arrhythmia, stroke, kidney disease and/or failure, and heart attacks.
Untreated high blood pressure can also lead to poor brain health and play a role in memory and thinking problems over time. If parts of the brain cannot get the oxygen they need from the blood, cells begin to die.
This is why it is so essential to keep high blood pressure under control. It is possible to get a prescription via telemedicine for high blood pressure medication today.
Ways to lower blood pressure naturally over time
There are no fail-safe ways to swiftly lower blood pressure, but it is certainly possible to improve your numbers over time. Here are a few simple recommendations:
Exercise at least 30 minutes a day. Being physically active for this amount of time every day of the week can go a long way towards reducing blood pressure levels.
Eat a low-fat, balanced diet. Your diet should include plenty of fresh fruit and vegetables.
Lose weight. Find out your ideal BMI and try to lose weight if you are overweight. Shedding 20 pounds can result in a drop in blood pressure of between 5 and 20 points.
Consume less salt. Too much salt (sodium) causes blood pressure to rise. It is best to keep intake at less than 2 grams a day.
Reduce stress. Stressful situations will make your blood pressure go up, but if you are always stressed, it will stay high. Find calming activities, like walking, gardening, coloring, or listening to relaxing music to keep stress levels low.
Limit alcohol intake. More than one drink for women and more than two for men can cause blood pressure to rise. Drinking too much alcohol can also increase the weight, which also raises blood pressure.
Give up smoking. Smoking can raise blood pressure. When trying to lower blood pressure naturally, it is essential to do it safely and remember that recommendations about diet and physical activity will vary from person to person. If you cannot manage to lower blood pressure naturally, do not just ignore it. You may have to start using a medication, and it is possible to get a prescription for hypertension.
Prescribed medications for high blood pressure. There are several types of medications to control high blood pressure, and people often take a combination of different ones.
Diuretics, commonly known as ‘water pills,' help your body to get rid of excess salt and water through peeing. This makes pressure less, and it is easier for the heart to pump. These are usually used first when trying to control blood pressure. Side effects include peeing after a dose. Feeling dizzy or lightheaded is common, and taking diuretics may make it harder to control sugar levels, and you could end up with too little or too much sodium and potassium in your system.
Angiotensin-converting enzyme (ACE) inhibitors dilate or widen the blood vessels and increase blood flow, which means the heart does not have to work as hard. There are many different types of ACE inhibitors, and some of the side effects from taking them may include a cough, red itchy skin or a rash, dizziness, and swelling of the face, neck, and tongue.
Angiotensin-2 receptor blockers (ARBs) work in a similar way to ACE inhibitors and may be recommended if they have difficulty with the side effects of ACE inhibitors.
Calcium-channel blockers work by widening the blood vessels. Possible side effects include constipation, headaches, and swollen ankles.
Beta-blockers block the effects of the hormone adrenaline. This slows down the heart rate and eases the force with which the heart squeezes. Doctors usually try the other medications first before trying a beta-blocker.
It is essential to take medications exactly as prescribed and not to skip a couple of days here and there. Rather, they rely on high blood pressure medication rather than sitting without medication due to not having the time to get a new prescription.
Online treatment for high blood pressure
Only a doctor can accurately diagnose and treat the symptoms of high blood pressure. It is not possible to get a prescription for hypertension without consulting with a medical doctor. This can be done online via phone or video chat.
It can be very convenient to have an online doctor issue a blood pressure medication refill. This usually requires filling in a questionnaire which the doctor will review to see whether the patient should continue taking the medication.
For patients who do not have any new symptoms related to their condition, being able to get a blood pressure medication, refills, telemedicine offers excellent convenience. Lost medications, travel or relocation, primary care interruptions, and other problems can make obtaining an appropriate prescription difficult, and this is when an online doctor can help.
A final word
Those with high blood pressure need to improve their lifestyles and work with a doctor to find the right combination of medication to bring blood pressure down to the right level safely. It can take some patience and persistence, but the consequences of living with uncontrolled high blood pressure are too significant to ignore.
References
Systolic blood pressure intervention trial (SPRINT)
Untreated high blood pressure could lead to poor brain health
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