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Incidence
Hypertension affects nearly 1/4 of American adults, or
nearly 50 million people in this country alone. Unfortunately
most don't even know they have it. It is a the major
risk factor contributing to most strokes, heart attacks,
congestive heart failure and kidney failure. Because it
causes no symptoms until one of these complications develops,
it is often called the "silent killer". For reasons
that are not completely understood, it is more common in the
black population, but occurs commonly in all
races. Hypertension also becomes more common as you get
older.
Definition
Hypertension is currently defined as having a Systolic (
top number) blood pressure of 140 or greater, or a Diastolic (
bottom number) of 90 or greater. Usually a doctor will take
your blood pressure on several different occasions before
making the diagnosis of hypertension. If three separate
readings show numbers consistent with hypertension then the
diagnosis is made.
Risk Factors
While family history is probably the most important risk
factor, there are many other factor that contribute to the
development of hypertension. Most of these other risk factors
are lifestyle issues which can be modified in order to reduce one's risk of developing
hypertension.
Initial treatment should focus on modifying as many of
these lifestyle factors as possible.
Treatment
If lifestyle changes don't control your blood pressure,
treatment often requires the use of medications. There are
now more than a half dozen major classes
of blood pressure medications available. Each class uses a
different method to control your blood pressure. Because they
work differently, combining more than one medication can be
more effective. Usually two or three medications are required
in order to get adequate control. An additional benefit to
using several medications, is that it allows the doctor to use
lower doses of each medication and thereby reduce the chance
of side effects.
Blood Pressure Myths
1) "I would know if I had
high blood pressure because I would feel it"
Actually high blood pressure
usually causes no symptoms at all. When people talk about
feeling stressed or having a headache when their pressure is
up, its usually the stress or the pain from the headache
that's causing the blood pressure to go higher not the other
way around. High blood pressure rarely causes any symptoms
until you have a stroke or heart attack.
2) " I heard that once
you start blood pressure medication you will be stuck on it
for the rest of your life"
While it is true that
treating blood pressure is usually a life long process, you do
not become "addicted to" or "dependant on"
blood pressure medication. The medications we use to treat
high blood pressure can only control the pressure, they can't
cure it. If you come off the medication your pressure will go
right back to where it would have been if you had never taken
anything. Sometimes lifestyle changes like exercise, losing
weight and quitting smoking will improve your pressure to the
point where you won't need medication, but most people do
require some sort of treatment for the rest of their lives.
3) " I only have high
blood pressure when I'm in the doctor's office. It's always
fine at home so I don't have to worry about it"
This condition is often called
"white coat syndrome". In the past most doctors
assumed that this was a harmless condition brought on by the
stress of coming to the doctor. Recent studies have shown
however, that people with white coat syndrome have a higher
risk of stroke and heart attack than people who always have
normal blood pressure. Most likely, people with white coat
syndrome do NOT just have high blood pressure in the doctor's
office. They probably have abnormal blood pressure with all
the stressful situations that we face in everyday life. More
than likely the only NORMAL blood pressure is the one they're
getting on the couch at home.
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