Every time your heart beats, blood is forced out of the heart and into the blood vessels where the blood is distributed throughout your body. This surge of blood creates pressure inside your arteries which can be measured. When you have your blood pressure (BP) measured, 2 numbers are reported. The bigger number (called the SYSTOLIC blood pressure) represents the peak pressure in the artery when the heart beats. The smaller number (DIASTOLIC blood pressure) represents the pressure inside the arteries when the heart is resting between beats. An average blood pressure for adult Americans is about 120/80.

What is HIGH Blood Pressure?

High blood pressure (also called hypertension) is arbitrarily defined as a BP greater than 140/90. In fact, as the blood pressure rises above 120/70, there is increased risk of complications related to high BP. Since your blood pressure changes throughout the day, several BP's readings should be obtained before deciding whether you indeed have hypertension.

Why should I care about High Blood Pressure?

High BP is called the "silent killer" for good reason. High BP is a significant contributor to early death caused by heart attack, stroke and kidney failure. If your BP is adequately treated, these complications can be eliminated.

What causes high blood pressure?

A specific cause cannot be determined for over 90% of people with high BP. However, certain factors (called risk factors) are clearly associated with

high BP.

MODIFIABLE RISK FACTORS

• obesity
• diet high in salt (sodium)
• excessive alcohol use
• sedentary lifestyle (no exercise)
• stress
• drugs (certain medications such as decongestants and even birth control pills lead to high BP in some people)

NON-MODIFIABLE RISK FACTORS

• race (high BP is more common in blacks)
• heredity (high BP tends to run in families)
• age (as you get older, there is an increased chance of developing high BP)

How do I know if I have high BP?

Since high BP rarely causes any symptoms, the only way to find out if you have high BP is to get your BP measured. A nurse at Dubuque Internal Medicine will be happy to check your BP anytime during our normal business hours. You may want to call first so we can have your medical record available. Since BP fluctuates quite a bit during the day, several BP's must be taken before deciding if you indeed have high BP. Some people only have high BP while at the doctor's office (so called "white coat hypertension") so you may be asked to check your own BP at home, get your BP checked at a local pharmacy or be asked to wear a monitor for 24 hours which measures your BP every 10-30 minutes throughout the day as you go about your normal activities. If you consistently have a BP greater than 140/90, then you have high BP.

What can be done about high BP?

Although high BP can not be cured, it can usually be readily controlled using lifestyle modifications ("non-pharmacological") and/or drugs ("pharmacological").

NON-PHARMACOLOGICAL measures include:

DIET

• If you are overweight, decrease the total calories in your diet.
• Cut down on excessive salt(sodium)
• Limit your alcohol consumption
• Get adequate amounts of potassium, calcium and magnesium from your diet. (There is some evidence that these elements are helpful in reducing blood pressure but further research is needed to define their benefit).

EXERCISE

• aerobic exercises such as walking, running, swimming and biking all have beneficial effects on the BP and also help in reducing your weight.

TOBACCO AVOIDANCE

• DON'T SMOKE

PHARMACOLOGICAL measures:

If your BP is not adequately controlled using the non-pharmacologic methods described above, then your doctor may recommend a medication. There are a wide variety of effective medications. If you have a side effect or inadequate response to one drug, don't despair. Most people today can get their BP in a reasonable range with the medications now available. Once you are on a medication that works and has minimal side effects, it is important to take every dose prescribed.

Establishing a daily routine and finding a medication that needs to be taken only once or twice per day are helpful measures that decrease the likelihood of missing doses.

REMEMBER....

• Have your blood pressure checked.
• If you have high BP, keep on practicing lifestyle changes that can help with your BP and if medications are necessary, take them as prescribed.
• Cooperate. Controlling your BP is a team effort. The health care team at Dubuque Internal Medicine needs your help and suggestions to make your treatment successful.