The Call-On-Doc Guide to Hypertension

While high blood pressure can lead to heart disease and other related conditions, the condition earns the name “silent killer” because there typically are no warning signs. According to the current stats from the American Heart Association, it's estimated that there are over 122 million people with high blood pressure, with the majority of those same people not experiencing any symptoms. In such cases, the only indication you’ll get is when you or your doctor run a test using a sphygmomanometer or a blood pressure cuff. 

Like other conditions such as type 2 diabetes and hypothyroidism, high blood pressure often presents itself with subtle symptoms in the early stages. Noticeable symptoms typically occur at stage 2 hypertension when the condition has become more severe. Even then, the condition can go unnoticed, with the most common symptoms including:

• Dizzy spells: Dizziness or lightheadedness can be a symptom of hypertension, or high blood pressure. When blood pressure is high, it can cause the blood vessels in the body to narrow and become less flexible, which can reduce blood flow to the brain. This can result in a feeling of dizziness or lightheadedness. In addition, the condition can sometimes cause damage to the small blood vessels in the inner ear, which can also contribute to feelings of dizziness or vertigo.
• Fatigue: Hypertension can reduce your energy in a number of ways. Firstly, when blood pressure is high, the heart has to work harder to pump blood throughout the body, which can cause fatigue and reduced energy levels. The condition can also cause damage to the blood vessels and organs in the body, including the kidneys, which can cause fatigue and reduced energy levels. Additionally, hypertension is also known to contribute to sleep disturbances. 
• Headaches: The frequency of headaches you get can increase in a number of ways with high blood pressure. Hypertension can cause blood vessels to become narrower and less flexible, which can reduce blood flow to the brain and increase pressure in the blood vessels. This increased pressure can lead to headaches, especially in the back of the head and neck. The condition can also cause damage to the blood vessels in the brain, leading to inflammation and the release of chemicals that can trigger headaches. Lastly, Lastly, hypertension is known to cause the heart to work harder to pump blood, which can lead to an increase in blood volume and pressure. This can lead to headaches, especially in the morning or after physical activity.
• Low libido: On top of hypertension causing fatigue and reducing the energy needed for sexual activity, hypertension can damage the blood vessels and nerves that supply the sexual organs, reducing blood flow and sensitivity. Men with hypertension may experience erectile dysfunction. 

As can be guessed, many other conditions can share these symptoms and some patients might have them on a regular basis. However, experiencing any of the following should be a reason to consider getting evaluated for hypertension. 

• Blurry vision: Like other parts of the body, your eyes can be subject to the effects of unchecked hypertension. According to the American Optometrist Association, ocular hypertension develops after a prolonged period of high blood pressure running through the blood vessels in the eye. This results in an increased risk of glaucoma, eventual damage of the ocular nerve, macular degeneration, reduced vision, and more. 
• Chest pain: On top of raising the risk of heart attacks and strokes, high blood pressure can eventually do a lot of damage to your heart. One such result is angina the American Heart Association defines as a type of chest pain that occurs when the heart muscle does not receive enough oxygen-rich blood. Additionally, hypertension left untreated can lead to coronary artery disease and heart failure. 
• Bloody urine: While not common, untreated hypertension can lead to a condition known as malignant hypertension. Causing damage to the kidneys, the symptom is considered a medical emergency due to it not only indicating high blood pressure but also being a clear sign of kidney disease and failure. 
• Shortness of breath: According to an article published by the University of Michigan, shortness of breath in relation to hypertension is an indication that the heart is not getting enough oxygen. More specifically, it can be a sign of pulmonary hypertension, a type of high blood pressure that affects the arteries in the lungs and the right side of the heart. It can cause symptoms such as shortness of breath, chest pain, and fatigue, and can lead to heart failure if left untreated.

While these symptoms sound severe, it is important to note that the vast majority of cases of hypertension are asymptomatic. According to a 10-year study, even severe hypertension can exhibit few to no symptoms, with 2.15% of people in the United States suspected of having severe asymptomatic hypertension. Combining that with the CDC’s reporting that half the country is suspected of having the condition, it is important to regularly get your own blood pressure checked and to begin hypertension treatment as soon as it is discovered. 

When blood pressure is measured, it is expressed as a ratio of two numbers, such as 120/80 mmHg. The systolic pressure is the top number (120 in this example) and indicates the pressure at the peak of a heartbeat when the heart muscle contracts. Diastolic pressure, the lower number (80 in this example) in a blood pressure reading, represents the pressure in the arteries when the heart is at rest between beats, specifically during the relaxation phase of the cardiac cycle. It indicates the minimum arterial pressure when the heart is filling with blood and preparing for the next contraction.

The systolic blood pressure reading is important because it provides information about the force with which the heart is pumping blood into the arteries. It is influenced by factors such as the strength of the heart muscle, the volume of blood being pumped, and the overall condition of the cardiovascular system. High systolic blood pressure can indicate conditions such as hypertension and can be a risk factor for cardiovascular diseases.

Diastolic pressure is equally important because it reflects the resistance in the peripheral arteries and the overall health of the cardiovascular system. It provides information about the relaxation and filling ability of the heart, as well as the condition of the blood vessels. Elevated diastolic pressure can be an indicator of hypertension and may also be associated with certain cardiovascular conditions.

Blood pressure guidelines typically vary by age, but generally, the ideal blood pressure range for adults is:

• Systolic (top number): less than 120 mmHg
• Diastolic (bottom number): less than 80 mmHg

However, blood pressure targets may vary for individuals depending on their overall health, medical history, and other factors. For example, older adults may have slightly higher blood pressure targets than younger adults due to changes in blood vessel elasticity that can occur with age.

Here is a general overview of blood pressure targets by age:

• Children and adolescents: Blood pressure targets vary depending on age, height, and sex. The American Academy of Pediatrics recommends that blood pressure be checked at least once a year, starting at age three.
• Adults under 60 years old: Blood pressure targets are typically less than 120/80 mmHg.
• Adults over 60 years old: Blood pressure targets may be slightly higher, up to 150/90 mmHg, depending on overall health and medical history.

It is important to note that blood pressure targets may vary depending on individual health factors, so it is important to discuss your blood pressure targets with a healthcare professional who can provide personalized recommendations.

According to the CDC, There are several factors that can contribute to the development of hypertension, including:

• Lifestyle factors: Lifestyle factors such as diet, alcohol intake, and smoking can all contribute to hypertension by increasing blood pressure. A diet high in salt can cause the body to retain fluid, which can increase blood pressure. Consuming saturated fats can also increase blood pressure by promoting the buildup of plaque in the blood vessels, which can narrow the arteries and make it more difficult for blood to flow through them. Smoking can damage the lining of the blood vessels, causing them to become narrow and less flexible, which can increase blood pressure. The nicotine in cigarettes can also cause a temporary increase in blood pressure.
• Genetics: A family history of hypertension can increase your risk of developing the condition. 
• Age: There are several ways in which age contributes to hypertension, such as the decrease in the elasticity of blood vessels, an increase in the stiffness of the heart muscle, and an increase in the production of hormones that can contribute to an increase in blood pressure. 
• Obesity: Obesity is a significant risk factor for hypertension, as excess body fat can lead to an increase in blood pressure. When an individual is overweight, the heart has to work harder to pump blood through the body, which can increase blood pressure. Additionally, excess body fat can cause inflammation and damage to the blood vessels, making it more difficult for blood to flow through them, which also increases blood pressure. 
• Existing medical conditions: Several existing medical conditions can contribute to hypertension. For instance, chronic kidney disease can damage the blood vessels and disrupt the body's fluid and electrolyte balance, leading to an increase in blood pressure. Diabetes can also damage the blood vessels, and high blood sugar levels can cause the body to retain fluid, increasing blood pressure. Sleep apnea and other sleep disorders can contribute to hypertension by disrupting breathing patterns during sleep and causing the body to produce stress hormones that increase blood pressure. Finally, adrenal gland disorders such as Cushing's syndrome and pheochromocytoma can also cause hypertension by leading to an excess of certain hormones that can increase blood pressure.
• Stress: Prolonged or chronic stress can contribute to hypertension by causing the body to produce stress hormones such as cortisol and adrenaline, which can increase blood pressure by constricting blood vessels and increasing heart rate. Additionally, chronic stress can lead to unhealthy lifestyle habits such as overeating, consuming excessive amounts of alcohol, or smoking, which can also increase the risk of developing hypertension. Furthermore, prolonged stress can lead to inflammation and oxidative stress in the body, both of which can contribute to the development of hypertension by damaging the blood vessels and disrupting the body's natural regulatory mechanisms for blood pressure.
• Certain medications: Certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, decongestants, and some antidepressants, can increase blood pressure in some people.

While, according to WebMD, the exact causes of hypertension are not known, there is a direct link between each of these causes contributing to its development. If hypertension runs in your family or you feel like your blood pressure should be regularly monitored, consider investing in a remote health monitor device where you can check your blood pressure at home. Additionally, such machines are publically available at most grocery stores and pharmacies.

According to a 2017 study, certain foods can worsen hypertension by increasing blood pressure levels. Some examples include:

• Sodium-rich foods: Consuming too much salt can cause the body to retain fluid, leading to an increase in blood pressure. Foods that are high in sodium include processed foods, canned foods, snack foods, and fast food.
• Sugary and high-carbohydrate foods: Eating foods that are high in sugar and carbohydrates can cause a spike in insulin levels, which can lead to an increase in blood pressure.
• Saturated and trans fats: Foods that are high in saturated and trans fats, such as fried foods, processed meats, and full-fat dairy products, can contribute to the development of hypertension.
• Alcohol: Drinking excessive amounts of alcohol can cause an increase in blood pressure.
• Caffeine: Consuming too much caffeine can cause a temporary increase in blood pressure.

While a recent study indicates there is a rise in hypertension cases across all ethnicities, the Journal of the American College of Cardiology details it is a more persistent problem with certain groups of people. More specifically, rates of high blood pressure have become more prevalent in the following racial groups: 

• Asian adults
• Alaskan Native adults
• American Indians adults
• Black adults
• Hispanic adults

A Study from the American Heart Association Journal conducted from 2013 to 2018 sheds light on the reasons. On top of lifestyle habits shared by each race present in the United States, the aforementioned groups had less awareness of one of the following subjects:

1. Knowledge of hypertension in general
2. Questioning whether they had the condition
3. Contributing factors to hypertension
4. Confusion about the treatment process

On top of affordable hypertension treatment, Call-On-Doc can be an excellent source for those seeking knowledge about high blood pressure and how it affects them. With our education initiatives, you can not only educate yourself but serve your community with the knowledge it needs to be healthier!

Each time you go to the doctor for an in-person consultation, your healthcare provider will normally check on your blood pressure along with your weight, temperature, and so on. According to the National Heart, Lung, and Blood Institute, the information gathered through these regular tests, the knowledge of surrounding factors, and your family history will allow your doctor to deduce if you are at risk or take active steps to diagnose whether you have signs of high blood pressure or not. Additional tests for further evaluation and monitoring include: 

• Blood Pressure Measurement: Blood pressure is measured using a device called a sphygmomanometer. It consists of an inflatable cuff that is wrapped around the upper arm and a pressure gauge. Blood pressure is expressed as two numbers: systolic pressure over diastolic pressure (e.g., 120/80 mmHg).
• Multiple Measurements: Blood pressure is typically measured on multiple occasions to establish a pattern and confirm the diagnosis. This helps account for normal variations in blood pressure throughout the day.
• Classification of Blood Pressure: Based on the measurements, blood pressure is classified into different categories, including normal blood pressure, elevated blood pressure, stage 1 hypertension, and stage 2 hypertension. These classifications help guide treatment decisions.
• Additional Evaluation: In addition to blood pressure measurement, healthcare providers may evaluate other factors such as medical history, family history of hypertension, lifestyle factors, and the presence of any related symptoms or complications.
• Diagnostic Tests: Depending on the specific situation, further tests may be recommended to evaluate the effects of hypertension on organs such as the heart, kidneys, and blood vessels. These tests may include blood tests, urine tests, electrocardiograms (ECG), echocardiograms, or other imaging studies.

Especially for adults who have or are planning to have families, it is important to have a family doctor familiar with your personal and family history. Additionally, it is important to get physically evaluated annually, with those worried about hypertension or other chronic conditions taking steps to monitor themselves on a more regular basis. 

As an example mentioned above, someone worried about their blood pressure can monitor it through blood pressure kiosk machines freely available in most pharmacies and grocery stores. Additionally, tools that match a person’s arm size can be purchased to test on a more regular basis. 

When it comes to measuring blood pressure, you will need to be in a state of relaxation and have nothing in your system that may affect your blood pressure. Here are some tips we often suggest to patients: 

• do not drink caffeine before you test
• Avoid anything rigorous or physically demanding before the test
• Make sure to have palms and feet flat 
• Keep your legs uncrossed
• Do not talk while taking measurement

While measuring your blood pressure is easy, the key is to be in an entirely relaxed state when measuring. However, the challenge lies in identifying hypertension consistently and accurately. Blood pressure can fluctuate throughout the day, and a single measurement may not provide a complete picture of an individual's blood pressure status. Therefore, multiple measurements taken on different occasions are recommended to establish a pattern and confirm the diagnosis.

According to the National Heart, Lung, and Blood Institute, hypertension is typically treated through a combination of lifestyle modifications and, if necessary, medication. The specific treatment approach depends on the severity of hypertension, the presence of any underlying medical conditions, and individual factors. Here are common approaches to hypertension treatment:

• Lifestyle Modifications:
  • Healthy Diet: Adopting the Dietary Approaches to Stop Hypertension or the DASH diet, which emphasizes fruits, vegetables, whole grains, lean proteins, and low-fat dairy products while limiting sodium, saturated fats, and added sugars.
  • Sodium Restriction: Reducing sodium intake by limiting the consumption of processed and packaged foods, and avoiding adding extra salt to meals.
  • Weight Management: Achieving and maintaining a healthy weight through a balanced diet and regular physical activity. Additionally, Call-On-Doc offers multiple weight loss treatment options that help a person get to the weight they’re comfortable with. 
  • Regular Physical Activity: Engaging in aerobic exercise, such as brisk walking, cycling, or swimming, for at least 150 minutes per week, or as recommended by a healthcare professional.
  • Moderation or restriction of Alcohol Consumption: Limiting alcohol intake to moderate levels or as advised by a healthcare professional.
  • Smoking Cessation: Quitting smoking and avoiding exposure to secondhand smoke.Call-On-Doc offers multiple treatment options for those pursuing smoking cessation!
• Medications:
  • Antihypertensive Medications: If lifestyle modifications alone are insufficient to control blood pressure, healthcare professionals may prescribe medications to lower blood pressure. These may include diuretics, ACE inhibitors, angiotensin receptor blockers (ARBs), beta-blockers, calcium channel blockers, or other medications, depending on individual needs.
• Regular Monitoring: Regular blood pressure monitoring is crucial to assess the effectiveness of treatment and make any necessary adjustments.

Lowering blood pressure quickly is typically not a recommended approach, as sudden drastic reductions can have adverse effects. However, if you are experiencing a temporary rise in blood pressure or seeking ways to manage it in the long-term, here are some suggestions:

• Regularly engage in relaxation techniques
• Plan out your daily exercise regimen 
• Adjust your diet and eat healthily
• Cut out alcohol and any type of smoking
• Manage your stress when appropriate

Hypertension currently has no cure. However, milder cases of the condition can be managed and brought under control through effective treatment options devised for your personal case by your doctor.  

Although there are many causes of hypertension, it is important to take the necessary actions to monitor and maintain healthy blood pressure. Connect with a medical provider to discuss the right treatment options for you and your long-term health.