High Blood Pressure/Hypertension (HTN)

What is Blood Pressure?

Blood pressure is the pressure of blood pushing against the walls of arteries, which carry blood from the heart to the rest of the body. Blood pressure does not remain constant the entire day, it may rise and fall throughout the day depending on your activity. It is measured using two numbers: Systolic blood pressure (the first number) measures the pressure in your arteries when your heart beats and diastolic blood pressure (the second number) measures the pressure in your arteries when your heart rests between beats. Hypertension is the word used for higher than normal blood pressure (normal being 120/80 mmHg.) High blood pressure may put a person at risk for other health issues, such as heart disease, heart attack, and stroke. There are different levels of high blood pressure, which are listed by the American Heart Association

Having high blood pressure does not usually come with warning signs or symptoms. Many people may not even actually know they have it until they measure their blood pressure. 

What causes Hypertension (HTN)?

High blood pressure may develop over time and can happen due to a number of things. An unhealthy lifestyle/diet, such as a diet that is too high in sodium and too low in potassium may put you at risk for hypertension. It can also be inherited through family genes. Obesity, diabetes, and heart disease have a genetic component that all may contribute to hypertension. 

Secondary hypertension is hypertension due to an underlying illness such as renal, vascular, and endocrine issues.

How to manage Hypertension (HTN)?

There are many guidelines that list the management of hypertension. Most groups such as the JNC, the American Diabetes Associate (ADA), and the American Heart Association (AHA) recommend lifestyle modification as the first step in managing hypertension. This can include getting at least 150 minutes of physical activity each week, not smoking, eating a healthy diet (limiting sodium and alcohol), keeping a healthy weight, and managing stress. 

The DASH diet, or Dietary Approaches to Stop Hypertension, is an eating plan recommended by the American Heart Association for improving health. This diet emphasizes vegetables, fruits and low-fat dairy foods, and moderate amounts of whole grains, fish, poultry, and nuts. For sample menus of the DASH diet, click here.

The Mediterranean-style diet is also recommended by the AHA as a heart-healthy dietary pattern. To read more about the Mediterranean diet, click here.

However, for some people, lifestyle modification may be insufficient in managing high blood pressure and they still may need to take the medication in addition to their lifestyle modification. There are several drug options for treating and managing hypertension. Thiazide diuretics, angiotensin-converting enzyme inhibitors (ACEI)/angiotensin receptor blockers (ARB), or calcium channel blockers (CCB) are preferred agents in non-black populations. CCBs or thiazide diuretics are recommended in black populations with hypertension.

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