What Is High Blood Pressure?

Steps to Follow before Taking Your Blood Pressure

—  Don’t use 30 minutes prior to taking your blood pressure:

—  Caffeine,

—  Alcohol, or

—  Tobacco.

—  Go to the bathroom.

—  Rest 3-5 minutes before taking your blood pressure.

—  Sit comfortably.

—  Legs and ankles uncrossed

—  Back supported

Tips for Accurate Use

—  Same time of day

—  Use the same arm

—  Left

—  Don’t measure

—  immediately upon waking up, or

—  immediately after exercising.

—  Wait an hour.

How to Take Your Blood Pressure

  • Place your arm, raised to the level of your heart, on a table or a desk, and sit still.
  • Wrap the correctly sized cuff smoothly and snugly around the upper part of your bare arm.
  • Make sure that if you have rolled up a sleeve to place the cuff on your arm that it does not get too tight around your arm.
  • Take a repeat reading two to three minutes after the first one to check accuracy.
  • Be certain that the bottom edge of the cuff is 1 inch above the crease of your elbow.

Observation period

If one reading is found to be high, it is usual for your doctor or nurse to advise a time of observation. This means several blood pressure checks at intervals over time. The length of the observation period varies depending on the initial reading, and if you have other health risk factors. For example, say a first reading was mildly high at 150/94 mm Hg. If you are otherwise well, then a period of several weeks of observation may be advised. This may involve several blood pressure measurements over the next few weeks. You may be given a machine to monitor blood pressure while you are going about doing your everyday activities (ambulatory monitoring) or given (or asked to buy) a machine to measure your blood pressure at home (home monitoring). One reason this may be advised is because some people become anxious in medical clinics, which can cause the blood pressure to rise. (This is often called white coat hypertension.) Home or ambulatory monitoring of blood pressure may show that the blood pressure is normal when you are relaxed. The observation period is also a good time to change any lifestyle factors that can reduce blood pressure. If the blood pressure readings remain high after an observation period then medication may be advised, depending on your risk factors. However, if you have diabetes, or have recently had a heart attack or stroke, you may be advised to have blood pressure checks fairly often over the next week or so. Also, treatment with medication is usually considered at an earlier stage if the readings remain high.

What causes high blood pressure?

The cause is not known in most cases

This is called essential hypertension. The pressure in the arteries depends on how hard the heart pumps, and how much resistance there is in the arteries. It is thought that slight narrowing of the arteries increases the resistance to blood flow, which increases the blood pressure. The cause of the slight narrowing of the arteries is not clear. Various factors probably contribute.

In some cases, high blood pressure is caused by other conditions

It is then called secondary hypertension. Specific cause of hypertension can be identified. Represents 5% of adult hypertension. Causes:

  • Coarctation or congenital narrowing of the aorta
  • Renal disease – renal artery disease / parenchymal
  • Endocrine disorders: Pheochromocytoma, Cushing Syndrome, Hyperaldosteronism, thyroid and parathyroid disorders
  • Neurology disorders – brain tumors / head injury
  • Sleep apnea
  • Medications – sympathetic stimulants
  • Pregnancy-induced hypertension etc

How common is high blood pressure?

A hospital-based study carried out by NHRC in Nepal to demonstrate the prevalence of non-communicable diseases reflected that heart diseases and hypertension are one of the leading causes, which is 40%. About half of people aged over 65, and about 1 in 5 middle-aged adults, have high blood pressure. It is less common in younger adults. High blood pressure is more common in people:

  • With diabetes. About 3 in 10 people with type 1 diabetes and more than half of people with type 2 diabetes eventually develop high blood pressure.
  • From African-Caribbean origin.
  • From the Indian subcontinent.
  • With a family history of high blood pressure.
  • With certain lifestyle factors. That is, those who: are overweight, eat a lot of salt, don’t eat sufficient fruit and vegetables, don’t take enough exercise, drink a lot of coffee (or other caffeine-rich drinks), or drink a lot of alcohol.

Who should have a blood pressure check?

High blood pressure usually causes no symptoms. You will not know if you have high blood pressure unless you have your blood pressure checked. Therefore, everyone should have regular blood pressure checks at least every five years. The check should be more often (at least once a year) in: older people, people who have had a previous high reading, people with diabetes, and people who have had a previous reading between 130/85 mm Hg and 139/89 mm Hg (that is, not much below the cut-off point for high blood pressure).

Why is high blood pressure a problem if it causes no symptoms?

High blood pressure is a risk factor for developing a cardiovascular disease (such as a heart attack or stroke), and kidney damage, sometime in the future. If you have high blood pressure, over the years it may do some damage to your arteries and put a strain on your heart. In general, the higher your blood pressure, the greater the health risk. But, high blood pressure is just one of several possible risk factors for developing a cardiovascular disease.

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