By Chris Iliades, MD
Medically Reviewed by Pat F. Bass, III, MD, MPH
It’s a common condition, and it doesn’t have any symptoms: About one out of three U.S. adults has high blood pressure, or hypertension. And nearly one out of three American adults has prehypertension — blood pressure numbers that are higher than normal, but not yet in the high blood pressure range — which raises the risk of developing high blood pressure.
High blood pressure is a leading cause of heart attack, stroke, heart failure, and kidney disease, so it's a serious condition that we all must be more conscious of as we age. African-Americans in particular should pay careful attention to blood pressure: In one year, the overall death rate from high blood pressure was 40 percent for African-American females and 52 percent for African-American males — more than for any other group.
When Does Blood Pressure Become High Blood Pressure?
According to guidelines followed by doctors, blood pressure is normal if it's 120/80 or below. The range of 120/80 to 139/89, which was once classified as normal to high, is now considered to be prehypertensive.
If your blood pressure falls somewhere in the prehypertensive range, it may quickly develop into high blood pressure, or 140/90 or above. Most doctors now recommend lifestyle changes to lower blood pressure for anyone with a reading above 120/80. If you have added risk factors such as being overweight or having high blood sugar or cholesterol, the concern is even greater. Even though you may not have any symptoms, high blood pressure increases your risk for cardiovascular disease. Since cardiovascular disease is the cause of death for one out of every three Americans, any evidence of high blood pressure is cause for concern.
How Can You Lower Your High Blood Pressure?
High blood pressure is a treatable condition. Most doctors recommend starting with these lifestyle changes to lower blood pressure:
Limit alcohol and caffeine
Eat a healthy, low-sodium diet
Reduce your stress levels
When lifestyle changes are not enough, your doctor may prescribe one or more antihypertensive medications. You may need to take blood pressure medication for the rest of your life to keep your condition under control. Remember: Stopping medication on your own can increase your risk of cardiovascular disease.
How Do You Handle Resistant High Blood Pressure?
What happens if you've made lifestyle changes and you're taking medication, but your blood pressure is still out of control? Doctors call this resistant hypertension. Resistant hypertension occurs in about 20 to 30 percent of people with high blood pressure. Some common causes include:
Uncontrolled risk factors. Poor control of risk factors such as obesity and diabetes can contribute to resistant hypertension.
Not taking medications as directed. Failure to take medication on schedule or stopping medication without a doctor's approval can cause blood pressure to go up.
Alcohol and salt intake. Many people with resistant high blood pressure are not controlling their intake of salt and alcohol.
Effects of other drugs. Over-the-counter pain relievers, decongestants, and some herbal compounds can interfere with blood pressure control.
Other health conditions. Medical conditions such as sleep apnea and diseases of the adrenal glands or kidneys can cause resistant high blood pressure.
If you are having trouble controlling your blood pressure, work with your doctor to find out how you can better manage risk factors. Your doctor may want to perform additional tests to make sure there are no other medical conditions contributing to your high blood pressure.
Do I Really Need Regular Blood Pressure Checkups?
To prevent cardiovascular disease and other possible effects of high blood pressure, it is important to have your blood pressure checked regularly. Blood pressure that was once considered to be high-normal is now cause for concern. If you work with your doctor to find the right combination of lifestyle changes and medication, you will probably be able to control your high blood pressure over time.
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