Hypertension

WHAT YOU SHOULD KNOW

Hypertension (hi-per-TEN-shun) is another name for high blood pressure. Blood pressure is a measure of the force the blood puts on the walls of veins, arteries, and the heart. There are 2 parts to a blood pressure reading. One is called systolic (sis-TAHL-ic). It is the first number in a blood pressure reading. The other is called diastolic (DI-as-tahl-ic). It is the second number in the reading. For example: in the reading of 120/80, 120 is the systolic number, and 80 is the diastolic number. The systolic (first) number tells you how hard the blood is pushing against the walls of the arteries, veins, and heart when the heart is pumping blood (during a heartbeat). The diastolic (second) number gives the pressure when the heart is resting between beats. A good systolic number is between 100 and 140 millimeters of mercury (mm Hg). For some people, a number between 80 and 100 is normal. A good diastolic number is usually lower than 90 mm Hg. Your doctor can tell you what is normal for you. If the systolic number is higher than 140 or the diastolic number is higher than 90, you are said to have high blood pressure. Only one of the numbers needs to be high. For example, you have high blood pressure if your reading is 120/98, because even though the first number (systolic) is normal, the second (diastolic) number is high. Likewise, you have a problem if your reading is 180/88, where the first number is high even though the second is not.

Causes

Often there is no specific cause. Some illnesses that can cause high blood pressure are kidney or other organ problems, pregnancy, or taking drugs.

Do's/Don'ts

To bring your blood pressure down, you need to quit smoking, lose weight, exercise, eat a diet low in salt and fat, avoid alcohol and caffeine, and avoid or learn to control stress. Talk to your doctor about how to make these changes.

Risk Factors

Your risk of high blood pressure is greater if someone in your family has it, if you are over 50, male, or black, and if you smoke or are over-weight.

Care

You may need to take medicine to lower your blood pressure. If so, take it as directed and do not stop taking it unless you are told to by your doctor. If there is another illness causing your high blood pressure, that illness will be treated also.

Risks

Millions of Americans who have high blood pressure and don't know it. High blood pressure is often called ""the silent killer'' because often it has no symptoms. Without treatment, however, it can lead to heart disease, a stroke, kidney failure, or a heart attack. With treatment to keep your blood pressure under control, there is less chance of having these problems.

WHAT YOU SHOULD DO

• Always take your medicine as directed by your doctor. If you feel it is not helping, call your doctor. Do not quit taking it on your own.
• If you take aspirin regularly, continue to take it. Aspirin helps thin the blood so blood clots don't form. Do not take acetaminophen or ibuprofen instead.
• If you are taking more than one medicine, make a list of what you are taking and when you take it. You can buy a plastic pill holder that has 7 sections, one for each day of the week.
• If you are on blood pressure medicine:
  • You may get dizzy when you change from a lying to a sitting position. Get up slowly. If you feel faint lie down right away.
  • Your medicine may make your nose stuffy or make you feel weak. It can also diminish your appetite.
  • You may need to have your medicine or the dose changed many times before finding the right treatment.
  • Take your blood pressure and pulse regularly. Ask your doctor to teach you or a family member how.
  • Vomiting, diarrhea, or heavy sweating can lower your blood pressure and make you dizzy. Hot baths, hot weather, fever, or drinking alcohol can also lower your blood pressure. If this happens, call your doctor so your medicine or its dose can be changed.
• A diet low in fat, salt, and cholesterol is very important. It keeps your heart healthy and strong. Ask your doctor what you should and should not eat.
• It may take time getting used to a new diet. Special cookbooks may help you and the cook in your family find new recipes.
• Quit smoking. It harms the heart and lungs. If you are having trouble stopping, ask your doctor for help.
• Exercise daily. It helps make the heart stronger, lowers blood pressure, and keeps you healthy. If your exercise plan seems too hard or too easy, speak with your doctor.
• Excess weight can raise your blood pressure. If you need to lose weight, talk to your doctor about a plan.
• Since it is hard to avoid stress, learn to control it. Ways to relax include deep breathing, relaxing the muscles, and imagery. Also, don't hesitate to talk to someone about things that upset you.
• If you have other illnesses like diabetes or high blood pressure, you need to control them. Take medicines as directed. Because of these illnesses, you have a higher chance of getting a heart attack.
• For more information about the heart, call the American Heart Association at 1-800-AHA-USA1 (1-800-242-8721) or call your local Red Cross.

Call Your Doctor If...

• You are dizzy and the feeling does not go away.
• You have chest pain during exercise that doesn't go away with rest.
• You have a fever, vomiting, or diarrhea that makes you dizzy.

Seek Care Immediately If...

• Your blood pressure is higher than usual.
• You pass out or have a seizure.
• You have chest pain that does not go away with rest or medicine.
• You have a headache; are sleepy, confused, or have numbness and tingling in your hands and feet; are coughing blood; have nosebleeds; or have a lot of trouble breathing. These are signs of very high blood pressure. Call 911 or 0 (operator) to get to the nearest hospital or clinic. Do not drive yourself!

IF YOU'RE HEADING FOR THE HOSPITAL...

What to Expect While You're There

You may encounter the following procedures and equipment during your stay.

• Taking Vital Signs: These include your temperature, blood pressure, pulse (counting your heartbeats), and respirations (counting your breaths). A stethoscope is used to listen to your heart and lungs. Your blood pressure is taken by wrapping a cuff around your arm.
• Oxygen: Your body may need extra oxygen at this time. It is given either by a mask or nasal prongs. Tell your doctor if the oxygen is drying out your nose or if the nasal prongs bother you.
• Pulse Oximeter: While you are getting oxygen, you may be hooked up to a pulse oximeter (ox-IM-uh-ter). It is placed on your ear, finger, or toe and is connected to a machine that measures the oxygen in your blood.
• IV: A tube placed in your vein for giving medicine or liquids. It will be capped or have tubing connected to it.
• ECG: Also called a heart monitor, an electrocardiograph (e-lec-tro-CAR-dee-o-graf), or EKG. The patches on your chest are hooked up to a TV-type screen or a small portable box (telemetry unit). This screen shows a tracing of each heartbeat. Your heart will be watched for signs of injury or damage that could be related to your illness.
• 12 Lead ECG: This test makes tracings from different parts of your heart. It can help your doctor decide whether there is any problem with your heart.
• Medicine:
  • Blood Pressure Medicine: Given for constant high blood pressure. It may be given in an IV at first, and later taken by mouth.
  • Diuretics (di-your-ET-ics): Also called ""water pills,'' these medicines make you pass urine more often and thus get rid of any extra fluid your body or lungs may have collected. It can be given as a pill or in your IV.
• Activity: It is important to rest and relax until your blood pressure is lower. If you are anxious, call a doctor. Keeping the head of your bed up slightly may help lower your blood pressure.
• Blood: Usually taken from a vein in your hand or from the bend in your elbow. Tests will be done on the blood.
• Other tests: Chest and kidney x-rays may need to be done to help find the cause of your high blood pressure.

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