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CARS REVIEW - Hypertension


Definition

Hypertension is the medical term for high blood pressure. It means that there is elevated pressure within the arteries and veins through which blood flows to and from the heart.

Blood pressure is measured in millimeters of mercury (your physician will write this down as mmHg), and expressed as systolic pressure (when your heart is contracting to pump blood) over diastolic pressure (when the heart is relaxed). Hypertension is usually defined as a blood pressure higher than 140/90 mmHg.

Hypertension is one of the most common medical conditions, affecting some 50 million Americans (African-Americans more often than whites).

About half of all people over 50 develop hypertension. But it’s a common misconception that high blood pressure is a normal part of aging. In fact, hypertension can be considered an early warning of problems developing in the cardiovascular or other organ systems. People with hypertension have a higher than normal risk for:

  • coronary heart disease and heart attacks,
  • heart failure
  • stroke or transient ischemic attack
  • peripheral vascular disease
  • kidney disease

In recent years, the long-term health risks of hypertension have become increasingly well defined. As a result, physicians have been encouraged to be extremely careful in their evaluation of people they suspect may have hypertension, and to treat the condition more aggressively. To confirm a diagnosis of hypertension, your doctor might ask you to come in for a blood pressure measurement on several different occasions, or to wear a portable monitor (a Halter monitor) that records your blood pressure changes over an entire day.

Treatment

If you have hypertension your physician will likely advise you to attempt to make some lifestyle changes that can help lower your blood pressure. These can include:

  • getting some exercise on a regular basis
  • losing a few pounds, if you are overweight
  • maintaining a healthy diet, and especially reducing your intake of fat and salt
  • smoking cessation

Most people do eventually require drug therapy for high blood pressure. There are a great many drugs available for hypertension. In selecting the right therapy for you, your doctor will consider such factors as your age, how high your blood pressure is, what other conditions or illnesses you may have (everything from asthma to diabetes and high cholesterol can affect the choice of blood pressure medication), and the particular characteristics and advantages of the various medications (such as whether they can be taken just once a day). The main classes of antihypertensive drugs are:

  • diuretics
  • beta blockers
  • calcium channel blockers (also called calcium antagonists)
  • angiotensin-converting enzyme (ACE) inhibitors
  • angiotensin receptor blockers
  • alpha-1 adrenergic antagonists.

Many people are reluctant to take treatment for their hypertension because they feel just fine. Your physician will explain in greater detail just why and how lowering your blood pressure is so crucial to your long-term health, and why it’s important to continue to take the medication prescribed for you.

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