By Charles E. Crutchfield III, MD and
J. Michael Gonzalez-Campoy, MD, PhD, FACE
High blood pressure may cause damage to vital organs over time. Brain damage causes a stroke. Heart damage causes a heart attack. And kidney damage causes kidney failure. High blood pressure may also damage the eyes and blood vessels, causing weakening of the blood vessel walls. If a blood vessel wall balloons out, this is called an aneurysm. Aneurysms may break and bleeding can happen.
What causes high blood pressure?
The blood pressure is determined by the amount of squeeze created by the circular smooth muscle of the blood vessels, by the speed at which the heart beats, and by the volume inside the blood vessels made up by the blood. The blood pressure will go up if there is too much squeeze from the blood vessels. It will also go up if there is excess volume in the circulation. And it will go up if the heart is stimulated to beat faster or stronger.
Adrenaline, the “fight or flight” hormone, causes the heart to beat faster and the blood vessels to squeeze tighter. Therefore, too much adrenaline, as is the case with stress, can cause the blood pressure to go up.
Table salt has sodium. Sodium holds on to water. So, the sodium inside blood vessels will hold on to water. This increased volume will make the blood pressure go up.
Hardening of the arteries happens with aging. It comes sooner in life if you smoke. Hardening of the arteries contributes to a high blood pressure.
How common is high blood pressure?
There are over 60 million Americans with hypertension. Hypertension affects Blacks and Hispanics disproportionately more than Whites.
How is high blood pressure diagnosed?
First, the blood pressure has to be measured. This is best done with the patient sitting and an adequately measured blood pressure cuff placed around an arm. This is usually done in the doctor’s office. But it may also be done at a pharmacy, fire station, or by purchasing a blood pressure cuff at any pharmacy.
There are two numbers in any blood pressure measurement. The top number is called the systolic blood pressure. The bottom number is called the diastolic blood pressure.
If the systolic blood pressure is 140 mmHg or more, the blood pressure is considered to be high. If the diastolic blood pressure is 90 mmHg or more, the blood pressure is considered to be high. If either the systolic blood pressure or the diastolic blood pressure remains elevated over time, then the diagnosis of hypertension is made.
Can high blood pressure be prevented?
Persistently elevated high blood pressure, which is called hypertension, is genetically programmed. It is not possible to prevent it. But the clinical onset of hypertension may be significantly delayed by keeping slim and avoiding the use of excess salt in the meal plan.
How is high blood pressure treated?
High blood pressure is always treated by the right meal and physical activity choices. Eating more fresh fruits and vegetables, avoiding added salt, and eating less canned or processed foods is very important. These food choices limit salt intake.
Regular physical activity limits the amount of body fat and makes it easier to move. Regular physical activity also helps keep the blood vessels healthy, which in turn keeps the blood pressure down.
Persistently elevated blood pressure readings, despite a healthy lifestyle, warrants treatment with medications. Medications to lower the blood pressure may be used individually or in combinations of individual drugs.
It is very important to note that there is tremendous benefit in lowering the blood pressure with medications. This benefit is far greater than any potential risks of medications.
Recommended action steps
The most important single step to take is to measure the blood pressure. This should be done not once, but regularly over the course of your life. Awareness of a high blood pressure is the very first step to take. This is especially important if other people in the family have a high blood pressure.
Additionally, if you are an adult with high blood pressure, you should teach your children the importance of checking their blood pressure regularly. You should check it at your local pharmacy, fire station, or consider investing in a home unit. The pharmacist can recommend an appropriate home blood pressure unit for you. The key is to check it regularly and write the number down for your doctor to review at all of your visits.
Make sure you have a general medical examination once per year and more frequently if directed by your doctor.
Following a healthy meal plan and taking medications as prescribed are crucial to prevent complications of high blood pressure over time.
High blood pressure has been called a silent killer. Often it is the heart attack or stroke that is the first sign of trouble. Prevention is key when it comes to high blood pressure!
Charles E. Crutchfield III, MD is a board certified dermatologist and Clinical Professor of Dermatology at the University of Minnesota Medical School. He also has a private practice in Eagan, MN. He has been selected as one of the top 10 dermatologists in the U.S. by Black Enterprise magazine and one of the top 21 African American physicians in the U.S. by the Atlanta Post. Dr. Crutchfield is an active member of the Minnesota Association of Black Physicians, MABP.org.
J. Michael Gonzalez-Campoy, MD, Ph.D, FACE, Mayo Clinic Graduate, is Medical Director and CEO of the Minnesota Center for Obesity, Metabolism and Endocrinology in Eagan, Minnesota and past president of the Minnesota Medical Association.