Understanding High Blood Pressure
Venule
Waste
Capillaries
Effects of High Blood Pressure
What Is Blood Pressure?
A person with high blood pressure usually has no symptoms until he or she has had it
for quite some time and serious damage has occurred. For this reason, it is often called
the “silent killer.” Long-term damage from uncontrolled high blood pressure is often
irreversible and can lead to an early death:
Blood pressure is the force of circulating blood against the inner
walls of the blood vessels. It is affected by:
■
how hard the heart pumps
the amount of blood in the body
■
Tissue
■
the diameter of the blood vessels
Generally, blood pressure increases when the heart pumps harder,
the amount of blood in the body increases or the diameter of the
blood vessels decreases.
Arteriole
Nutrients
Capillaries
What Is High Blood Pressure?
More than 65 million Americans have high blood pressure. The term hypertension
is also used to describe this condition. Hypertension occurs when blood is flowing
through the vessels at a pressure that is too high for the long-term health of the
blood vessels. Generally, a blood pressure higher than 120/80 is considered
unhealthy. Over time, vessel walls exposed to high levels of pressure become
damaged. This damage can lead to serious health problems.
Blocked
coronary
artery
Damage to Blood Vessels
Artery walls become damaged from high pressure. Fat
accumulates and the walls thicken. Calcium is deposited
in the fatty areas, “hardening” the arteries, making them
unable to increase in size. Blood flow through the arteries
decreases. Damaged artery walls may also cause blood
clots to form which block the artery itself or break off and
block arteries in other organs.
Normal artery
Damaged heart tissue
What Causes High Blood Pressure?
Enlarged heart
Normal heart
Blocked artery
In 90 to 95 percent of high blood pressure cases, the cause is unknown. When
the cause is unknown, it is called essential or primary hypertension. Secondary
hypertension, the least common type, can be caused by factors such as kidney
abnormality, a structural abnormality of the aorta, or narrowing of the arteries.
Arteries in
Cross-Section
Artery with plaque
Ruptured plaque
Damage to the Heart
■
Heart disease leading to heart attack: Fat deposits and blockages form in the arteries that supply the
heart with blood.
■
Congestive heart failure: Heart becomes damaged and enlarged from working so hard to pump blood
against the higher blood pressure.
Brain in Cross-Section
Area of burst
arterioles
Dead brain
tissue
Area of damaged
arterioles
Area of burst arterioles
Circle of Willis
Measuring Blood Pressure
Damage to the Brain
Blood pressure is a measurement consisting of a top number,
Risk Factors
systolic pressure (pressure when the heart is contracting), and a bottom
number, diastolic pressure (pressure when the heart is resting). It is measured with
a pressure cuff and sphygmomanometer or digital monitor. The cuff is placed around
the upper arm and tightened until blood flow through the brachial artery is stopped.
Pressure is gradually decreased in the cuff. Sounds or vibrations detected in the
brachial artery while the pressure is dropping will determine the blood pressure.
■
Stroke:
Family history of high blood pressure
Race (African Americans have the highest incidence)
Age (risk increases w ith age)
Obesity
A portion of brain tissue dies when it is deprived of blood supply. This can happen when a bulging artery (called an
aneurysm) ruptures or an artery becomes blocked by a blood clot or fat deposits.
■
Cerebrovascular insufficiency:
A series of mini-strokes occurs in the smaller vessels of the brain. Tiny arterioles bulge, then burst from high pressure
or become blocked by small blood clots. There are no symptoms until damage accumulates over time.
Sedentary lifestyle
Damage to the Kidneys
Diabetes mellitus
■
Blood vessel damage:
Arteries become narrowed and stiff from high pressure. Blood flow to the kidneys is decreased. Receptors respond by
recruiting mechanisms throughout the body to raise overall blood pressure even further.
■
Kidney disease leading to failure:
Blood Pressure Guidelines
It becomes more and more difficult for the kidneys to remove impurities from the blood. Toxic materials accumulate.
According to the National Heart, Blood and Lung Institute (NIH), more than 65 million Americans have
hypertension and another 45 million are prehypertensive totaling 110 million people at risk. Guidelines have
been issued in hopes that people will adopt a healthier lifestyle to lower their blood pressure.
Taking Control of Your Blood Pressure
BP Classification
Systolic BP
(mmHg)
Diastolic BP
(mmHg)
■
Measure blood pressure regularly at home.
■
Maintain a low-fat diet.
Decrease salt intake to less than a teaspoon per day (2000 mg).
Shed extra weight to decrease strain on your heart.
Don’t smoke.
Restrict caffeine and alcohol consumption.
Follow all of your physicians instructions.
Take prescribed medications as part of your daily routine.
Consult your physician about an appropriate exercise plan and follow it.
■
Normal
<120
and
or
<80
■
Prehypertensive
Stage 1 Hypertension
Stage 2 Hypertension
120-139
140-159
≥160
80-89
90-99
≥100
■
■
or
■
■
or
■
■
Continue taking medication even after your blood pressure has reached a good level.
Source: the Seventh Report of the Joint National Committee on Prevention, Evaluation and Treatment of High Blood Pressure.
National Heart, Lung and Blood Institute - May 2003
Effective control of high blood pressure can prevent most of its complications.
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