Guest Author - Denise Howard, M.D., M.P.H.

Hypertension or high blood pressure occurs when the blood vessels of the arterial system become constricted forcing the heart to work harder to pump the blood to the tissues of the body. This pressure is determined when the blood pressure is measured. Hypertension is present when the pressure is consistently greater than 140/90. It is normal for the blood pressure to increase during times of stress such as anxiety, pain, fear and anger.

Hypertension is diagnosed by documenting the elevated pressure at random times over a period of 2-4 weeks. The pressure should be checked at stress free times. Once it is diagnosed then further evaluation is indicated. The goal is to determine the possible cause of the elevated blood pressure and the level of organ damage that may have been sustained prior to the diagnoses.

Essential Hypertension is the most common type. The cause is unknown. Secondary Hypertension results from intrinsic and extrinsic causes. Kidney problems are the major cause. Renal artery stenosis, which is narrowing of the major artery supplying the kidney, is one condition. Obstruction of the ureter and damage to the kidney from diseases such as diabetes and lupus are other examples. It is important to identify these causes in order to avoid subsequent renal failure. In addition, treating these problems could potentially resolve the hypertension. Other intrinsic problems are related to an overproduction of certain substances that affect the arteries. Examples include tumors that produce adrenaline and overactivity of the adrenal glands or the thyroid gland. Finally, medications such as birth control pills and steroids can contribute to hypertension.

Hypertension in and of itself doesn’t cause any noticeable symptoms. Many people can have high blood pressure for many years and not have any noticeable symptoms. If the pressure becomes excessively high (>200/100) then symptoms such as headaches, blurred vision and confusion can occur. This is called Malignant Hypertension and could result in stroke, rupture of an aneurysm, and a heart attack. Long term uncontrolled hypertension can lead to damage to the organs of the body. If the heart has to work harder to pump blood, it is likely to fail over time. Heat failure results in disability, diminished life quality and premature death. Chronic uncontrolled hypertension can also lead to renal failure and a possible need for dialysis, visual impairment and possible blindness, and other organ damage and failure.

Diagnosing and treating hypertension is crucial in identifying potentially life threatening problems and preventing future problems. The ultimate goal is to achieve the highest quality of life possible!