Hypertension

April 30, 2007

Hypertension is defined as the elevation in overall blood pressure. Blood pressure is the amount of force exerted on the walls of the arteries by the heart in its effort to pump blood through the body. Blood pressure is measured in two numbers. The first, or top number is the "systolic" pressure, created when the heart contracts. The second, or bottom number is the "diastolic" pressure, or the period during which the heart relaxes.

An example of a normal blood pressure is 120/80. The higher the systolic or diastolic blood pressure, the greater chance of sustaining cardiac damage or illness. It should be understood that the higher the blood pressure level, even when within the normal range, the greater one's risk may be for heart attack or stroke. For example, a person with a blood pressure reading of 100/70 would be at a somewhat lower risk for heart attack or stroke than would a person whose blood pressure is 120/80, although both blood pressures would be considered within normal limits.

Previously, it was felt that patients with a systolic pressure within the range of 160 to 170 mmHg (millimeters of mercury) had an acceptable systolic blood pressure and were not at unusual risk. However, it is now strongly believed that the systolic pressure should be less than 150, with the most recent recommendations from the American Heart Association being that of lower levels for both the systolic and diastolic pressure. Practitioners in cardiology consider the diastolic blood pressure to be significantly elevated when it is found to be greater than 90 mmHg.

The incidence rates of hypertension in the United States have increased dramatically over the past 15 years. The reason for this increase is that we have a larger body of knowledge, which allows us to understand this disease process more fully and its relationship to heart attack and stroke. The likelihood of hypertension increases with age, and in the presence of other risk factors, the possibility of a major stroke is very high. It is very encouraging then that over the last 10 years, there has been a 50% reduction in incidence of serious events which may be related to high blood pressure.

Oftentimes people with hypertension don't know they have high blood pressure until an occasion arises when their blood pressure is measured. Even in those persons who feel well, high blood pressure can be serious. If it is found that the diastolic blood pressure is at a dangerous level, it is important to seek medical follow-up and possible therapy with a medication to lower the blood pressure.

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