High Blood Pressure

High blood pressure increases your chance (or risk) for getting heart disease and/or kidney disease, and for having a stroke. It is especially dangerous because it often has no warning signs or symptoms. Regardless of race, age, or gender, anyone can develop high blood pressure. It is estimated that one in every four American adults has high blood pressure. Once high blood pressure develops, it usually lasts a lifetime. You can prevent and control high blood pressure by taking action.

What Are High Blood Pressure and Prehypertension?

Blood pressure is the force of blood against the walls of arteries. Blood pressure rises and falls during the day. When blood pressure stays elevated over time, it is called high blood pressure.

The medical term for high blood pressure is hypertension. High blood pressure is dangerous because it makes the heart work too hard and contributes to atherosclerosis (hardening of the arteries). It increases the risk of heart disease and stroke, which are the first- and third-leading causes of death among Americans. High blood pressure also can result in other conditions, such as congestive heart failure, kidney disease, and blindness.

A blood pressure level of 140/90 mmHg or higher is considered high. About two-thirds of people over age 65 have high blood pressure. If your blood pressure is between 120/80 mmHg and 139/89 mmHg, then you have prehypertension. This means that you don't have high blood pressure now but are likely to develop it in the future. You can take steps to prevent high blood pressure by adopting a healthy lifestyle.

Those who do not have high blood pressure at age 55 face a 90 percent chance of developing it during their lifetimes. So high blood pressure is a condition that most people have at some point in their lives.

Both numbers in a blood pressure test are important, but for people who are 50 or older, systolic pressure gives the most accurate diagnosis of high blood pressure. Systolic pressure is the top number in a blood pressure reading. It is high if it is 140 mmHg or above.

What is systolic blood pressure?

Systolic pressure is the force of blood in the arteries as the heart beats. It is shown as the top number in a blood pressure reading. High blood pressure is 140 and higher for systolic pressure. Diastolic pressure does not need to be high for you to have high blood pressure. When that happens, the condition is called "isolated systolic hypertension," or ISH.

Is isolated systolic high blood pressure common?

Yes. It is the most common form of high blood pressure for older Americans. For most Americans, systolic blood pressure increases with age, while diastolic increases until about age 55 and then declines. About 65 percent of hypertensives over age 60 have ISH. You may have ISH and feel fine. As with other types of high blood pressure, ISH often causes no symptoms. To find out if you have ISH — or any type of high blood pressure — see your doctor and have a blood pressure test. The test is quick and painless.

Is isolated systolic high blood pressure dangerous?

Any form of high blood pressure is dangerous if not properly treated. Both numbers in a blood pressure test are important, but, for some, the systolic is especially meaningful. That's because, for those persons middle aged and older, systolic pressure gives a better diagnosis of high blood pressure.

If left uncontrolled, high systolic pressure can lead to stroke, heart attack, congestive heart failure, kidney damage, blindness, or other conditions. While it cannot be cured once it has developed, ISH can be controlled.

Clinical studies have proven that treating a high systolic pressure saves lives, greatly reduces illness, and improves the quality of life. Yet, most Americans do not have their high systolic pressure under control.

Does it require special treatment?

Treatment options for ISH are the same as for other types of high blood pressure, in which both systolic and diastolic pressures are high. ISH is treated with lifestyle changes and/or medications. The key for any high blood pressure treatment is to bring the condition under proper control. Blood pressure should be controlled to less than 140/90 mmHg. If yours is not, then ask your doctor why. You may just need a lifestyle or drug change, such as reducing salt in your diet or adding a second medication.

What is diastolic blood pressure?

Diastolic pressure is the force of blood in the arteries as the heart relaxes between beats. It's shown as the bottom number in a blood pressure reading.

The diastolic blood pressure has been and remains, especially for younger people, an important hypertension number. The higher the diastolic blood pressure the greater the risk for heart attacks, strokes and kidney failure. As people become older, the diastolic pressure will begin to decrease and the systolic blood pressure begins to rise and becomes more important. A rise in systolic blood pressure will also increase the chance for heart attacks, strokes, and kidney failure. Your physician will use both the systolic and the diastolic blood pressure to determine your blood pressure category and appropriate prevention and treatment activities.

Risk Factors

Risk factors are behaviors or conditions that can increase your chances of developing a disease. For instance, high blood pressure is a risk factor for heart disease and stroke.

There are other risk factors for heart disease and stroke. Most can be modified, though some cannot. The more risk factors you have, the greater your chances of developing disease. So it is important to take steps to prevent or control these risk factors.

Heart disease and stroke risk factors that can be controlled are:

	High blood pressure (hypertension)
	Abnormal cholesterol
	Tobacco use
	Diabetes
	Overweight
	Physical inactivity

Risk factors beyond your control are:

	Age (55 years and older for men and 65 years or older for women)
	Family history of early heart disease (having a mother or sister who has been diagnosed with heart disease before age 65, or a father or brother diagnosed before age 55) or family history of stroke

Source : NHLBI of NIH, USA.