High Blood Pressure: The “Silent Killer”

by Patrick S. Coleman, MD
High blood pressure, or hypertension, is a condition in which the force of blood against the walls of the arteries remains elevated over a period of time. It can lead to heart disease and stroke, which are the first and third leading causes of death in the United States. About 65 million American adults have high blood pressure. The problem is that a third of them don’t know it.
Hypertension sends the heart and kidneys into overdrive. It can wreak havoc on those organs. But in the initial stages, there may be no recognizable symptoms. Therefore, it’s important to understand the risk factors.
People who are overweight or who have a family history of hypertension are most at risk. Also, more blacks develop hypertension than whites. But no one is immune. Those who don’t have high blood pressure by middle age have a 90 percent chance of developing it later on.
Why Does It Happen?
Three factors play a role in high blood pressure: a narrowing of the arteries, a higher-than-normal volume of blood, and a heart that is beating faster or more forcefully than it should. Any of these circumstances can exert excess pressure on the arterial walls.
In many cases, the onset of high blood pressure can be prevented. Sadly, many people assume that medical professionals can help them stave off the side effects of smoking, poor eating habits, and a sedentary lifestyle; they tend to ignore basic health measures that could lower risk. Many experience a rude awakening in the form of a heart attack or bypass surgery. Early detection is key to prevention or control.
How Blood Pressure Is Measured
The first step is to test blood pressure with a blood pressure cuff. The reading consists of two figures: One (systolic) measures the force against artery walls when the heart beats, and the other (diastolic) measures the pressure against artery walls between heart beats.
Generally, a reading of 140/90 or higher indicates high blood pressure. However, even a lower reading (such as 130/80) can constitute a diagnosis if you are diabetic or have kidney disease. That lower reading can also point to “prehypertension,” indicating high blood pressure may soon be on the way.
Usually, a diagnosis cannot be made with one reading. If you are under extreme stress, for example, your blood pressure reading might be high, but then it may come down when the cause of your stress is removed. Also, a small number of people have what is known as “white-coat hypertension,” meaning blood pressure is high only when they are in the doctor’s office. Testing under more relaxed circumstances, such as at home, could yield a normal result.
Keys To Prevention And Control
Fortunately, once high blood pressure develops, it can be controlled. For those who do not have it, it can be prevented. In either case, applying the tips below are key.

  • DIET: Heart healthy food makes a difference. Limit fats, red meats, salt and sweets. Emphasize fruits, vegetables, whole grains, poultry, fish, nuts and foods low in saturated fat, total fat, and cholesterol.
  • EXERCISE: Being physically active is one of the best preventive measures against hypertension. Start small, if you must – stairs vs. elevator, walk vs. bus or car – and work up to a regular exercise regimen.
  • LIFESTYLE MODIFICATION: If you smoke, quit. When it comes to alcohol, moderation is the key: no more than one drink a day for women and two for men. If you are overweight, strive to shed some of those excess pounds; even a 10-pound drop can make a difference.

Read Dr. Coleman’s article in NCMA Healthy Insights Magazine