High Blood Pressure

Blood pressure consists of two different measures: systolic and diastolic. (Learn More – Blood Pressure) 

The American Heart Association recognizes five categories of blood pressure readings (Learn More – Blood Pressure Categories) and two types of high blood pressure. (Learn More –Types of High Blood Pressure)

Many Americans may not be aware that they have high blood pressure. (Learn More –Facts About Hypertension) 

There are many different risk factors that can contribute to the development of high blood pressure. (Learn More – Risk Factors)

There are quite a few medications that can be used to treat high blood pressure. (Learn More – Medications to Treat High Blood Pressure) 

All of these medications are best used in combination with lifestyle changes. (Learn More – Medications Work Best With Lifestyle Changes)

Blood Pressure


Blood pressure measures the pressure of the blood against the walls of your blood vessels. It is usually measured using the brachial artery in your arms.

There are two components to a blood pressure reading.

  • Systolic blood pressure component measures the pressure in your arteries when your heart contracts (beats).
  • Diastolic pressure measures the pressure in your arteries when the heart is relaxed (between beats).
  • The pressure reading is at its highest in the systolic component and its lowest in the diastolic component, although it does not go to zero.

When your blood pressure is measured, systolic and diastolic pressure are measured separately. You will see your blood pressure being reported as two numbers with one over the other, such as 120/80. The 120 represents the systolic component, and 80 represents the diastolic component of your blood pressure.

Which Number Gets More Attention?

In most cases, when physicians or medical personnel take blood pressure readings, they pay more attention to systolic blood pressure as a major risk factor for cardiovascular disease, especially if you are over 50 years old. The systolic blood pressure reading will most often rise as you age due to many factors, like stiffening of your arteries and the buildup of plaque in your arteries.

However, both figures may be considered for diagnosis of hypertension (high blood pressure).

Blood Pressure Categories


The American Heart Association (AHA) has developed five blood pressure categories or ranges.

  1. Blood pressure readings less than 120/80 are considered to be within the normal range.
  2. Blood pressure ranges of 120–129/<80 are categorized as elevated blood pressure. People with this reading are at risk of developing high blood pressure.
  3. Hypertension stage 1 is diagnosed when your blood pressure consistently measures 130–139/80–89. Prescribed interventions include changes in diet, exercise, and in some cases, medication.
  4. Hypertension stage 2 occurs when your blood pressure is consistently 140/90 or higher. Physicians are likely to prescribe medication and strongly suggest that you change your lifestyle.
  5. A hypertensive crisis occurs when your blood pressure readings suddenly spike above 180/120. If the reading remains at these levels or higher, you may need emergency treatment.

Types of High Blood Pressure


Hypertension can also be classified into two types according to the AHA:

  • Primary or essential hypertension occurs when there is no identifiable cause for the high blood pressure. This type of high blood pressure most often develops gradually over time.
  • Secondary hypertension occurs as a result of some other type of medical condition. This type of high blood pressure tends to be higher than primary hypertension and often occurs subtly or more quickly.

Many different types of medical conditions can cause secondary hypertension:

  • Thyroid issues
  • Issues with the kidneys (kidney disease or kidney infections)
  • Tumors in the adrenal gland
  • Obstructive sleep apnea
  • Congenital problems in the blood vessels
  • Use of drugs or alcohol
  • As a side effect of certain medications, such as decongestants, over-the-counter pain relievers, and others

Facts About Hypertension

Nearly half of American adults have diagnosable hypertension.

Many people in the United States do not know they have high blood pressure. In fact, the condition is often referred to as a silent killer because there are no obvious symptoms associated with hypertension for many people.

Over time, if it is left untreated, it can significantly increase one’s risk of having a serious stroke, heart attack, or some other serious and potentially fatal disorder.

Risk Factors

According to Mayo Clinic, some risk factors for hypertension include:

  • Age. High blood pressure is more common in men under the age of 65, and women are more likely to develop high blood pressure after they turn 65.
  • Heredity. High blood pressure runs in families.
  • Ethnicity. African Americans have higher rates of high blood pressure and are often diagnosed earlier in life than Caucasians.
  • Obesity. If you are overweight, you need more blood to supply oxygen and nutrients to your tissues. The larger the volume of blood being circulated in your body, the higher your blood pressure.
  • Lack of exercise. This often leads to higher resting heart rate and therefore higher blood pressure.
  • Tobacco use. Tobacco damages the lining of the veins and arteries, causing them to narrow and increasing blood pressure as a result.
  • Dietary factors. Too much salt (causes your body to retain fluid), too little potassium (potassium balances sodium in your blood), eating high-cholesterol or fatty foods, or drinking too much alcohol can all contribute to high blood pressure.
  • Stress. Constant exposure to stress releases hormones that can increase blood pressure.
  • Medical conditions. Again, various medical conditions can lead to an increase in blood pressure.

Medications for Treating High Blood Pressure

According to the AHA and Mayo Clinic, there are many different medications that can be used to treat hypertension. The choice of medication or combination of medications depends on the suspected cause of your hypertension and other personal variables, such as overall health, other medications, and so forth.

  • Beta blockers: These medications can reduce your heart rate, which can lower your output of blood and decrease how hard the heart needs to work to lower your blood pressure. Beta blockers work by blocking the hormone epinephrine (adrenaline). Some better-known beta blockers include Sectral (acebutolol) and Lopressor (metoprolol tartrate). 

Some of the side effects of beta blockers include problems sleeping, fatigue or depression, reduced heart rate, asthma-like symptoms, and drowsiness. Beta blockers may not be appropriate for pregnant women.

    • Diuretics: These can be prescribed to help you to get rid of excess water and sodium. Diuretics are commonly prescribed in conjunction with other medications and treatments.

      Some diuretics may cause you to lose potassium, which can lead to muscle cramps and other issues. Diuretics may also lead to fatigue in some people. For people with diabetes, diuretics may increase their blood sugar.
    • ACE inhibitors: Angiotensin-converting enzyme inhibitors (ACE inhibitors) help the blood vessels relax and dilate by inhibiting the production of angiotensin, a chemical in your system that can narrow the arteries. This class includes drugs like Lotensin (benazepril hydrochloride).

      Side effects of ACE inhibitors include rash, cough, and, in rare cases, kidney damage. These drugs are not intended for pregnant women.
    • Angiotensin II receptor blockers: This class of drugs blocks the effects of angiotensin.
    • Calcium channel blockers: These drugs block calcium from entering the cells in the arteries, leading to less forceful contractions, reduced heart rate, and vein and artery dilation.

      The drugs Norvasc (amlodipine besylate) and Vasocor (bepridil) belong to this class.  Side effects include heart palpitations, dizziness, and swollen ankles.

      Some drugs, like Lotrel (amlodipine besylate and benazepril HCL), act like ACE inhibitors and calcium channel blockers. This drug can be used for people who do not respond to either class of drugs but respond to both drugs together.
    • Alpha blockers: Alpha blockers work by relaxing small blood vessels and helping them to remain open, reducing blood pressure. This class of drugs includes the drug Cardura (doxazosin mesylate). 

      Potential side effects include accelerated heart rate and orthostatic hypotension (a sudden drop in blood pressure when you go from a sitting or lying position to a standing position).
    • Combined alpha and beta blockers: Combined alpha and beta blockers like Coreg (carvedilol) can be used for people who have a high risk of heart failure or people suffering from a hypertensive crisis.
    • Alpha 2 receptor agonists: Alpha 2 receptor agonists decrease activity in the sympathetic nervous system, especially the production of adrenaline.

      Methyldopa is a drug in this class. This drug may be a primary treatment for hypertension in pregnant women.
    • Central agonists: These medications interfere with signals from the brain to increase heart rate, and they also help dilate blood vessels.

      Catapres (clonidine hydrochloride) is a drug in this class. It may lead to dryness of the mouth, drowsiness, or constipation.
    • Peripheral adrenergic inhibitors: These drugs block neurotransmission in the brain that tell the heart to contract. This class of drugs is rarely used, but it includes Serpasil (reserpine).
  • Vasodilators: Blood vessel dilators (also known as vasodilators) work by relaxing the muscles in the blood vessels. This leads to the blood vessels dilating and a decrease in blood pressure. Apresoline (hydralazine hydrochloride) belongs to this drug class.

Medications Work Best With Lifestyle Changes

The combination of a medication, a diet low in fatty and processed foods, exercise, and other healthy choices can reduce hypertension and lead to a decreased risk of cardiovascular problems.

References

Blood Pressure Readings Explained. (January 2018). Healthline.

Understanding Blood Pressure Readings. (November 2017). The American Heart Association. 

High Blood Pressure-A Silent Killer. (June 2013). OnHealth.

High Blood Pressure (Hypertension). (May 2018). Mayo Clinic.