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Nurse Practitioner

What is
High Blood Pressure?

High blood pressure (BP) is also known as hypertension. This condition is present when the force of your blood against the walls of your blood vessels is higher than normal. Hypertension is referred to as “The Silent Killer” because individuals are unable to feel when their blood pressure is high and as a result, a lot of organ damage can occur before the problem is diagnosed and corrected. Once organs are affected, symptoms such as headache, fatigue, nausea, vomiting, shortness of breath, restlessness and blurred vision may occur. High BP affects the blood vessels, brain, heart, eyes and kidneys and if not treated can result in stroke, heart attack, blindness and kidney disease. It is reported that approximately 30% of people are unaware they have hypertension.

When blood pressure is checked, two values are recorded. The higher one occurs when the heart contracts (known as systole); the lower number occurs when the heart relaxes between beats (known as diastole). Blood pressure is written with the systolic number on top of the diastolic separated with a slash i.e.: 120/80 or “one twenty over eighty”.

It is normal for blood pressure to vary throughout a person’s life. Infants and children normally have a lower blood pressure than adults. Activity and time of day will also affect one’s blood pressure. In Canada a blood pressure higher than 140/90 is considered to be hypertensive. If an individual already has kidney disease or diabetes then the blood pressure goal should be lower than 130/80.

In about 90% of individuals high blood pressure is known as “primary hypertension” which means that there is no specific cause. When the cause is known it is called secondary hypertension. Some known causes of secondary hypertension are kidney disease, hormonal disorders and some drugs. Obesity, a sedentary lifestyle, stress and excessive amounts of alcohol or salt in food can also play a role in the development of hypertension in sensitive people.

There are many lifestyle changes that can be made to help prevent and control high blood pressure. Your health care provider will recommend lifestyle changes if your BP is found to be high. If lifestyle changes alone haven’t worked to lower your BP, then medication will be added. However, it is very important to keep up the lifestyle changes even with the medication. Usually more than one medication will be added as they all work a little differently to help bring down the blood pressure and medications can be tailored to suit an individual’s specific needs. Some individuals that already have other illnesses such as kidney disease or diabetes will have to start medication along with lifestyle changes right away to avoid, or at least minimize, the complications of hypertension. Some lifestyle changes that need to be made to help prevent and treat hypertension are as follows:

1. weight loss – losing as little as 10 lbs for overweight people can help lower your blood pressure

2. Limit alcohol consumption – no more than 2 drinks/day for healthy adults, no more than 14 drinks/week for men and no more than 9 drinks/week for women.

3. Increase physical activity – 30 to 60 minutes of moderate physical activity (walking, running, cycling or swimming) four to seven days each week.

4. Diet which is low in salt (sodium intake) and high in fresh fruits, vegetables and low-fat dairy products which are also reduced in fat and cholesterol

5. Reduce Stress – examine your situation to determine if stress is a big part of your life and discuss with your health care provider some strategies in reducing your overall stress

6. Continue to take anti-hypertensive medication as prescribed by your doctor

7. Stop smoking

If your health care provider diagnoses you with hypertension, then expect that some tests will follow. It will be important to check for any organ damage that may have already occurred. An electrocardiogram will be ordered to examine the heart. Urine and blood tests will also be acquired in order to evaluate the kidneys and cholesterol. A physical exam will also be completed including an eye and heart examination.

Once diagnosed and treated, it is very important to monitor your BP at least every 3 months. Your health care provider may take more than one reading at the same visit. Some individuals may experience what is known as “white coat” which means they can get somewhat nervous when the blood pressure is taken resulting in a falsely elevated BP reading. A good remedy is to repeat the BP test at the end of the visit when most people are more relaxed. Some individuals choose to purchase a blood pressure machine so they can monitor their pressure at home. It is still important to check with your doctor or nurse practitioner every 3 months for on-going monitoring.

For more information, contact the Heart and Stroke Foundation by telephone at 1-877-755-6677 or at the website at www.heartandstroke.ca.

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