TAMU Health Science Center
High blood pressure, also called hypertension, is a serious illness that affects nearly 65 million adults across the nation. “Hypertension is a silent killer that can cause very serious health issues if left untreated,” said Jason McKnight, MD, MS, primary care physician at Texas A&M Family Care and clinical assistant professor at the Texas A&M College of Medicine’s Texas A&M Family Medicine Residency Program. “Patients typically only show symptoms of hypertension if the pressure is very high. It is important to always monitor your blood pressure and take any medications prescribed, whether you feel symptoms or not.”
What is high blood pressure?
When health care providers measure blood pressure, they measure the amount of pressure the heart exerts against the walls of your blood vessels. They use two numbers and often speak about them by saying “top number over bottom number.”
The first number, or the number on top, is the systolic blood pressure. Systolic pressure is the pressure in your blood vessels when your heart beats. The second number, or the bottom number, is call diastolic blood pressure. The diastolic pressure represents the amount of pressure on the walls of your vessels when the heart is resting in between beats.
A ”normal” blood pressure occurs with a systolic (top) number of less than 120 and/or a diastolic (bottom) number of less than 80. While there are new guidelines suggesting a change in the definition of hypertension from the traditional 140 over 90, McKnight recommends you speak with your primary care provider about the need to take action to reduce your levels if they fall above the 130 over 80 range.
Impact on the heart
Hypertension can cause an enlarged heart. “The higher the blood pressure, then the harder the heart works,” McKnight said. “The harder the heart works, then the bigger the heart muscle gets.” Over time, an enlarged heart can cause congestive heart failure.
On a similar note, the harder the heart works, then the more blood it needs. “If you have any blockages in the blood vessels supplying your heart, or coronary arteries, then you are more likely to experience a heart attack,” explained McKnight. “The high pressure in your vessels will increase the chance one of those blockages will break off and cause a blockage.”
Hypertension can also affect the blood vessels leading to the rest of the body. The vessels may balloon out, causing an aneurysm within the aorta. If the vessels rupture, then it can be fatal. Furthermore, when pressure on the vessel wall is high, the wall could essentially split in half causing an aortic dissection. An aortic dissection can be fatal. If the person does survive, the aortic dissection usually requires surgical repair.
Impact on the brain
Hypertension can cause symptoms like a major headache, symptoms of a stroke, seizures and even death. “Your blood pressure can run so high that you get a rupture in an artery of the brain. This causes an intracerebral hemorrhage,” McKnight said. An intracerebral hemorrhage is a life-threatening stroke caused by bleeding within the brain tissue.
Hypertension is also associated with vascular dementia, which is dementia caused by a series of small strokes over a long period of time. Dementia is defined as a gradual and permanent loss of brain function. It often affects memory, thinking, language, judgement and behavior.
Impact on the eyes
If you ever wonder why your ophthalmologist is checking your blood pressure, then here is your answer. They are looking at the blood vessels in your eyes to search for clues about blood pressure.
“The retina—the part of the eye that actually sees things—has blood vessels running through it, and we know high blood pressure causes changes in these blood vessels,” McKnight said. “In bad cases of uncontrolled hypertension, it can cause blindness, macular degeneration and glaucoma.”
Impact on the kidneys
The kidneys filter excess fluid and waste from the blood, so they understandably use a lot of blood vessels to do so. “Long-standing hypertension can eventually lead to renal failure, which sometimes requires dialysis to stay alive,” McKnight said. “Over time, hypertension can cause the vessels and arteries around the kidneys to weaken or harden, which prevents the kidneys from getting enough blood.”
“The majority of high blood pressure is called essential hypertension, which means there is no major cause,” McKnight said. “With essential hypertension, you are mostly predestined to get high blood pressure through genetics or get it due to lifestyle factors. There is no identifiable cause that we can treat, so we are just treating the high blood pressure.”
Additionally, people with pre-existing kidney disease or other kidney problems are more likely to suffer from hypertension. Moreover, people with hormonal issues like with their thyroid or adrenal gland can often find themselves with hypertension as well. “Sometimes medications we use to treat other medical problems can lead to hypertension,” McKnight said. “The most common of which are decongestants for allergies or colds.”
A healthy diet and active lifestyle can decrease blood pressure. Exercise dilates the blood vessels, which encourages a better flow of blood through the body. If it cannot be controlled through diet or exercise, a health care provider may suggest a medicine or another therapy.
“Patients need to know how serious hypertension can be when left untreated,” McKnight said. “Many people may not know they have hypertension unless they get it regularly checked. People often do not notice symptoms until the pressure is already very high.” He encourages everyone to get regular check-ups with their primary care provider. Also, take any medications they are prescribed, whether or not they notice symptoms of high blood pressure.
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