Hypertenion or High Blood Pressure

High Blood Pressure (hypertension) is a condition commonly associated with narrowing of the arteries or atherosclerosis. Narrowing of the arteries causes blood to be pumped with excessive force against the artery walls. It is a sign that the heart and blood vessels are being overworked. Untreated, high blood pressure will cause the heart to eventually overwork itself to the point where serious damage can occur

70 - 75% of all strokes are caused by high blood pressure

Everybody’s blood pressure fluctuates with activity. Your blood pressure is higher when you are excited or active. The problem is when your blood pressure stays up even at rest. This indicates that your heart is doing more work and that the blood in your arteries is being pushed through with too much force. Blood Pressure is affected by

• Exercise
• Too much alcohol or salt consumption
• Smoking
• High cholesterol
• Increased stress
• Increased age
• Being overweight
• Alcohol consumption
• Salt consumption
• Males are reported to be more frequently afflicted with high blood pressure
• Higher risk in African-Americans

Other factors related to high blood pressure include

• kidney disease
• hormonal disorders

Ideal blood pressure is 120/80

The top number is the systolic and the bottom number is the diastolic. You are considered to have high blood pressure/hypertension when you reach the 140/90 range

Isolated systolic high blood pressure is where the diastolic remains in the normal range and only the systolic goesinto the danger zone

Cerebral edema can also be caused by severe hypertension. In this case, the blood flow into the capillaries of the brain is so great that it misaligns the tight junctions between the endothelial cells. As a result of the increase in endocellular fluid, the electrical activity of the neurons may be changed

Prevention

• Have your blood pressure checked. There is lots of controversy about exactly how high your blood pressure should be but if you try to keep it lower than 130 / 90 you are probably within some range of normal. PLEASE check with your doctor!
• If your blood pressure is high — Take your medication as prescribed
• Know what your blood pressure is (If you are on medication and if it is still high with medication, ask your doctor about utilizing different medications or a combination of medications.)

Research

“Poor BP control in the highest-risk patients, such as those with diabetes or ethnic/racial minorities, may be due to physicians’ failure to intensify drug therapy in these groups, according to the results of a US study published in the October issue of Hypertension” (Hicks LS, Fairchild DG, Horng MS, et al. Determinants of JNC VI Guideline Adherence, intensity of drug therapy, and blood pressure control by race and ethnicity. Hypertension. 2004;44:429-434.)

“Prehypertension” is under treated! Prehypertension is a Systolic Blood Pressure of 120-139 mmHg or Diastolic Blood Pressure greater than 80 mmHg. People with BP in this range, are believed to be at greater risk of developing clinical hypertension than those with lower BP. In the October 25th issue of Archives of Internal Medicine, people with prehypertension are more likely to have other risk factors for heart disease and stroke and that, as a result, have substantial health consequences. Awareness and control of prehypertension, however, remains low in the United States — just as is the case with awareness and control of hypertension. Treatment and elimination of prehypertension could avoid many hospital and nursing home admissions and premature deaths

Information

• High Blood Pressure — Heart Center Online For Patients - Heart Health Encyclopedia
• Types of High Blood Pressure — Heart Center Online For Patients - Heart Health Encyclopedia
• American Society of Hypertension, Inc.
• Latest research on High blood pressure MedlinePlus: High Blood Pressure
• This is a review article: “For the future, the current trend toward lower BP goals suggests that more effective and better tolerated antihypertensive therapies will be needed. Multiple antihypertensive agents used concomitantly will likely be needed to control elevated levels of BP in the majority of hypertensive patients. Am J Hypertens 2002;15:101SÐ107S” History And Management Of Hypertension.pdf
• Information on quality of care and blood pressure control rates should be made available to the public. A person with hypertension has the right to know the quality of care provided by his or her physician relative to the care received by others. Leenan Allhat - What Has It Taught Us So Far CMAJ 2004.Pdf
• Improvement of hypertension control in the population is expected to have a large impact on cardiovascular morbidity and mortality. Therefore,effective BP control should be the primary goal in the management of hypertension. Primary-care physicians should be informed on the difficulty in controlling systolic BP and the need for combination pharmacotherapy with two or more drugs in the majority of hypertensive patients. The IND should be the recommended treatment strategy, but further investigation is required on the reasons for treatment failure regarding the systolic BP control and the optimal strategy for its improvement. Aggressive Blood Pressure Control Can We Reach BP Targets.pdf
• In conclusion, recent guidelines have strongly supported the use of combination treatment as first step therapy in stage 2 hypertension as a means to most effectively achieve BP control.4 However, there is currently no information on the relative effects on clinical outcomes of different types of drug combinations when used as first step therapies. The importance of ACCOMPLISH is that it will be the first study to compare the effects on cardiovascular morbidity and mortality of two ACE inhibitor-based antihypertensive drug combinations. This randomized controlled trial will test the hypothesis that the cardiovascular benefits of a dihydropyridine/ACE inhibitor combination (amlodipine besylate/benazapril) are greater than those of an ACE inhibitor/diuretic combination (benazapril/ hydrochlorothiazide) in hypertensive patients at high risk. The study should be completed in 2008. Accomplish Trial Hypertension.pdf
• Practices Associated With Poor Blood Pressure Control In Diabetes.pdf