By: R. Mark Burke, MD, FACC and Phaedra McDonough

At the Center for Cardiovascular Health at Brattleboro Memorial Hospital we take high blood pressure seriously. We know that 1 in 3 Americans will develop high blood pressure over their lifetime and half of those people don’t have it under control. Many of the symptoms that bring people to the Center originate from high blood pressure.

Sometimes our patients are resistant to having their blood pressure treated, as they perceive the risk of blood pressure lowering medications to be higher than that of having high blood pressure. There is also the misperception that if you don’t have symptoms, why treat it? However, if you wait to have symptoms associated with high blood pressure before treating it, you are living dangerously. High blood pressure quietly damages your heart, kidneys, brain, and eyes for years before symptoms emerge. Once your symptoms arrive, you already have organ damage and it is generally irreversible.

How is Blood Pressure Measured? Blood pressure is measured by two numbers, e.g. 110/60. The top number, or systolic, is the pressure in your arteries when your heart beats. The bottom number, or diastolic, measures the pressure in your arteries when the heart rests between beats.

How do I know if I have High Blood Pressure? You need to have it checked by a health care provider or with an automatic home blood pressure cuff. Always check your blood pressure when you are at rest. We consider three consistently high reading on different days a diagnosis of hypertension.

  • Healthy Normal Blood Pressure: 120/80 or less
  • Pre-Hypertension: 120/80-139/80. This means you are at risk of developing high blood pressure.
  • High Blood Pressure: 140/90 or higher
  • Dangerously High Blood Pressure: 180/110 or higher

What Factors Cause High Blood Pressure? Being overweight is one of the strongest risks for high blood pressure. Dietary salt, especially in excess of 3000mg daily, increases your risk. Physical inactivity, smoking, diabetes, race (e.g. African American), and family history increase your risk. However, family history only increases your risk by 30%. Personality traits such as impatience and aggravation are associated with an increased risk. Depression is an often unrecognized risk factor.

A partial list of other causes includes sleep apnea, chronic use of certain medications such as NSAIDS (nonsteroidal anti-inflammatory drugs, e.g. ibuprofen of naproxen), certain antidepressants, decongestants, some weight loss medications and amphetamines. Illicit drugs such as cocaine and methamphetamines can also cause hypertension.

Why should I worry about having high blood pressure? There are many potential consequences to leaving hypertension untreated. Some of the most common are stroke, dementia, aneurysms, erectile dysfunction, heart attack, congestive heart failure, and kidney damage.

What is the treatment? At the pre-hypertensive stage (120-140/80), increasing your physical activity, losing weight, and avoiding excess dietary salt are the most important things to do. Additionally, activities such as yoga and meditation may be helpful. Once you have high blood pressure (>140/90) you should see a health care provider and discuss starting an antihypertensive medication while starting or continuing the lifestyle changes previously recommended. Once you have a diagnosis of high blood pressure it is generally permanent and requires constant monitoring, regardless of whether it is controlled with lifestyle changes or with medications.

Everyone is at risk for high blood pressure, so check it every now and then, and if it is elevated pay attention and recheck it. We are all ultimately responsible for our own health.

R. Mark Burke, MD, FACC, Medical Director of Cardiovascular Services, is a board-certified cardiologist and Phaedra McDonough is a Nurse Practitioner. Both are practicing at the Center for Cardiovascular Health, a department of Brattleboro Memorial Hospital. They can be reached at 802-275-3699.