Hypertension

Basic Facts

  • Defined by the American College of Cardiology/American Heart Association (ACC/AHA) as an average blood pressure above 130/80. 
  • Systolic blood pressure: the top number of your blood pressure (Ex: 120/80). This number indicates how much pressure your blood is exerting against your artery walls when the heart contracts.  
  • Diastolic blood pressure: the bottom number of your blood pressure (Ex: 120/80). This number indicates how much pressure your blood is exerting against your artery walls while the heart muscle is resting between contractions.  
  • In the U.S., treatment of hypertension is one of the most common reason for office visits and for the use of chronic prescription medications. 
Blood Pressure

Often called the “silent killer” because hypertension is often present without symptoms. However, some people can note headaches, flushing, or visual disturbances. 

 

  • Obesity and being overweight
  • Sleep apnea, especially if untreated
  • High sodium diet
  • Physical inactivity
  • Heavy alcohol use
  • Excessive caffeine consumption (over 400mg in a day)
  • Older age
  • Family history of hypertension
  • African descent
  • Chronic kidney disease
  • Hormone imbalances such as thyroid disease, hyperparathyroidism, or Cushing’s
  • Medications  such as oral contraceptives, NSAIDs, steroids, stimulants, and certain antidepressants 

 

Hypertension is not diagnosed by one reading, unless that reading >180 / >120. Diagnosis requires repeated blood pressure measurements, using appropriate equipment and technique, both in and out of the office. An average reading over 130/80 is considered hypertension. 

“We treat the patient, not the number.” Treatment of hypertension is individualized based on your age, medical history, and other risk factors. 

Treating hypertension reduces risk of heart attack, stroke, and congestive heart failure 

All patients with hypertension are recommended lifestyle measures: 

  • Low salt diet (<2000 mg/day), such as the DASH diet 
  • Lose excess weight
  • Exercise
  • Limit alcohol intake
  • Stress management
  • Potassium supplementation in the diet (unless contraindicated by the presence of chronic kidney disease) 
  • Various medications help lower blood pressure, including ACE inhibitors, ARBs, beta-blockers, and calcium channel blockers, among others. 
  1. Hypertension affects nearly half of US adults and 1 billion people worldwide. Untreated hypertension places patients at higher risk for stroke and heart attack.
  2. About 50% of patients with hypertension are not meeting their goal blood pressures despite medications and lifestyle changes. These patients have resistant hypertension.
  3. While some patients will experience headache or fatigue when they have high blood pressure, hypertension is usually asymptomatic. This is why hypertension has often been called a "silent killer".
  4. Blood pressures typically increases which age, which is one of the reasons hypertension is so common in the US.  Other contributory factors include obesity, inactivity (lack of exercise), stress, smoking, sleep apnea, and high-sodium diets.
  5. Renal denervation is a minimally invasive procedure we offer to treat resistant hypertension in certain patients.