Get the Facts on High Blood Pressure

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High blood pressure (HBP or hypertension) is when your blood pressure, the force of the blood flowing through your blood vessels, is consistently too high.

If you have high blood pressure, you are not alone. About 85 million Americans — one out of every three adults over age 20 — have high blood pressure. (Nearly 20 percent don’t even know they have it.) The best way to know if you have high blood pressure it is to have your blood pressure checked.

Your blood pressure is recorded as two numbers: Systolic blood pressure (the upper number) — indicates how much pressure your blood is exerting against your artery walls when the heart beats. Diastolic blood pressure (the lower number) — indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.

Typically, more attention is given to systolic blood pressure (the top number) as a major risk factor for cardiovascular disease for people over 50. In most people, systolic blood pressure rises steadily with age due to the increasing stiffness of large arteries, long-term build-up of plaque and an increased incidence of cardiac and vascular disease. However, elevated systolic or diastolic blood pressure alone may be used to make a diagnosis of high blood pressure. And, according to recent studies, the risk of death from ischemic heart disease and stroke doubles with every 20 mm Hg systolic or 10 mm Hg diastolic increase among people from age 40 to 89.

The abbreviation mm Hg means millimeters

of mercury. Why mercury? Mercury was used in the first accurate pressure gauges and is still used as the standard unit of measurement for pressure in medicine.

High blood pressure is a “silent killer.” Most of the time there are no obvious symptoms. Certain physical traits and lifestyle choices can put you at a greater risk for developing high blood pressure. When left untreated, the damage that high blood pressure does to your circulatory system is a significant contributing factor to heart attack, stroke and other health threats.

The five blood pressure ranges as recognized by the American Heart Association are:

Normal blood pressure

Blood pressure numbers within the normal (optimal) range of less than 120/80 mm Hg means you are doing good work sticking with heart-healthy habits like following a balanced diet and getting regular exercise.

Prehypertension (early stage high blood pressure)

Prehypertension is when blood pressure is consistently ranging from 120-139/80-89 mm Hg. People with prehypertension are likely to develop high blood pressure unless steps are taken to control it.

Hypertension Stage 1

Hypertension Stage 1 is when blood pressure is consistently ranging from 140-159/90-99 mm Hg. At this stage of high blood pressure, doctors are likely to prescribe lifestyle changes and may consider adding blood pressure medication.

Hypertension Stage 2

Hypertension Stage 2 is when blood pressure is consistently ranging at levels greater than 160/100 mm Hg. At this stage of high blood pressure, doctors are likely to prescribe a combination of blood pressure medications along with lifestyle changes.

Hypertensive crisis

This is when high blood pressure requires emergency medical attention. If your blood pressure is higher than 180/110 mm Hg and you are NOT experiencing symptoms such as chest pain, shortness of breath, back pain, numbness/weakness, changes in vision or difficulty speaking, wait about five minutes and take it again. If the reading is still at or above that level, you should CALL 9-1-1 and get help immediately. Learn more about the two types of hypertensive crises.

Know the two types of HBP crisis to watch for

A hypertensive (high blood pressure) crisis is when blood pressure rises quickly and severely. There are two types of hypertensive crises — both require immediate medical attention.

Hypertensive Urgency

If you get a blood pressure reading of 180/110 or greater, wait about five minutes and try again. If the second reading is just as high, seek immediate medical help. Early evaluation of organ function is critical to determine an appropriate course of action. Your elevated reading may or may not be accompanied by one or more of the following symptoms:

• Severe headache

• Shortness of breath

• Nosebleeds

• Severe anxiety

Treatment of hypertensive urgency may involve adjusting or adding medications, but rarely requires hospitalization.

Hypertensive Emergency

Hypertensive emergencies generally occur at blood pressure levels exceeding 180 systolic OR 120 diastolic, but organ damage can occur at even lower levels in patients whose blood pressure had not been previously high.

The consequences of uncontrolled blood pressure in this range can be severe and include:

• Stroke

• Loss of consciousness

• Memory loss

• Heart attack

• Damage to the eyes and kidneys

• Loss of kidney function

• Aortic dissection

• Angina (unstable chest pain)

• Pulmonary edema (fluid backup in the lungs)

• Eclampsia

• AHA recommendation

If you get a blood pressure reading of 180 or higher on top or 110 or higher on the bottom, AND are experiencing signs of possible organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision, difficulty speaking, do not wait to see if your pressure comes down on its own. Call 9-1-1.

If you have been diagnosed with high blood pressure, track your blood pressure and medications. If possible during an emergency, having these logs with you can provide valuable information to the medical team providing treatment.

Source: American Heart Association

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