Q:At a recent clinic visit, I learned I have high blood pressure, but I don’t understand what the numbers mean. What is the difference between hypertension and high blood pressure? What are the risks? What do I need to know?
Many times the two conditions — high blood pressure and hypertension — will be used synonymously. But there’s a slight difference.
Blood pressure is a measurement of the pressure inside the circulatory system where arteries deliver blood and oxygen throughout the body. This can change from hour to hour depending on a person’s stress level, diet
and other variables. There are two numbers provided when your blood pressure is checked. The top number, called the systolic pressure, represents the pressure in your arteries during the contraction of your heart. The bottom number, called the diastolic pressure, is the pressure in your arteries when the heart muscle is at rest between heart beats.
High blood pressure or hypertension? Both.
Consistent elevated blood pressure over time is called hypertension. It can cause health problems including heart disease, heart attack, stroke, kidney disease and damage to blood vessels in the eyes. While some people may experience symptoms such as headache, shortness of breath, nosebleeds and blurry vision, most people do not have symptoms when they have high blood pressure. That’s why it is critically important to check your blood pressure regularly. Hypertension is diagnosed when two or more properly-measured blood pressure readings at two or more office visits after an initial screening are deemed high.
A blood pressure reading may fall into four general categories:
— Normal blood pressure is systolic < 120 mmHg and diastolic < 80 mmHg.
— Prehypertension is systolic 120-139 mmHg or diastolic 80-89 mmHg.
— Stage 1 hypertension is systolic 140-159mmHg or diastolic 90-99 mmHg.
— Stage 2 hypertension is systolic 160 mmHg or higher or diastolic 100 mmHg or higher.
There are two main forms of hypertension. Primary essential hypertension typically has no symptoms and accounts for about 90 percent of hypertension. This usually develops over time and is more likely to occur in older adults, males, smokers, heavy drinkers and those who have a family history of the condition. Secondary hypertension can appear suddenly and is caused by an underlying condition such as alcohol abuse, illegal drugs, medications, thyroid, kidney or adrenal gland problems or sleep apnea. If your blood pressure is continually elevated, your provider should screen for underlying conditions and check an electrocardiogram to evaluate for heart enlargement.
Lifestyle impacts your blood pressure. Eating a healthy diet, regularly exercising, limiting smoking and alcohol, managing stress and maintaining a healthy weight lowers blood pressure. The DASH diet, which stands for Dietary Approaches to Stop Hypertension, was designed to specifically reduce blood pressure. It’s low in salt with plenty of fruits, vegetables, whole grains, poultry, fish and low-fat dairy foods. Beyond cutting back on salty snacks, an easy way to decrease sodium in your diet is removing the saltshaker from the table.
If you smoke, enroll in a cessation program. Quitting will drastically reduce your chances of hypertension and other heart-related conditions.
If after you’ve changed your lifestyle and hypertension persists, medications are available.
Your provider should be able to easily answer questions about ideal blood pressure for your age and health status, so don’t hesitate to ask if you need clarification.
Michelle Napral is a nurse practitioner at the University of Minnesota Health Nurse Practitioners Clinic, 3rd Street & Chicago. Send questions to firstname.lastname@example.org.