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The JNC 7 report1 states that
hypertension, or high blood pressure affects approximately 50 million
individuals in the US and approximately 1 billion individuals worldwide. It is
the most common primary diagnosis in the US.
One of the greatest problems with hypertension
is that people may not have any symptoms until the high pressure causes
problems in the heart, kidneys, brain, or retina in the eye. At least 30% of
people with high blood pressure don’t know they have it. The higher the blood
pressure, the greater the risk for heart attack, heart failure, stroke, and
kidney disease. In clinical trials, treatment to lower blood pressure resulted
in a 35-40% reduction in stroke, 20-25% reduction in heart attack, and a 50%
reduction in the development of heart failure.1
Blood Pressure Testing:1
- Should be done in the doctors office after the
individual has been seated quietly for 5 minutes with feet on the floor, and
arm supported at the level of the heart
- At least 2 blood pressure readings should be
done
- The size of the blood pressure cuff should be
appropriate, encircling at least 80% of the arm
Classification of
Blood Pressure for adults over age 18:1
| BP classification |
Systolic BP (mmHg) |
Diastolic BP (mmHg) |
| Normal |
< 120
AND |
< 80 |
| Prehypertension |
120-139
OR |
80-89 |
| Stage 1 hypertension |
140-159
OR |
90-99 |
| Stage 2 hypertension |
>= 160
OR |
>= 100 |
Treatment options for blood pressure management:
1. Lifestyle modifications
- Weight reduction
- DASH eating plan (diet rich in fruits,
vegetables, low-fat dairy products, and reduced intake of saturated fats and
total fat)
- Decreased intake of sodium (salt)
- Increased physical activity
- Moderation of alcohol intake (no more than
drinks for men and one for women)
2. Medication classes used to treat
hypertension:1
- Diuretics
- Beta blockers
- Alpha1 blockers
- Combined alpha and beta blockers
- ACE Inhibitors
- Angiotensin II antagonists
- Calcium channel blockers
- Central nervous system acting drugs
- Direct vasodilators
There are multiple medications in each class.
There are also medications that combine 2 classes. It is common to require 2 or
more different medications to control blood pressure.
Your doctor will determine the treatment that is
best for you. Everyone is encouraged to follow the lifestyle management
program. If you already have heart disease, heart failure, kidney disease, have
had a heart attack or stroke, or have Stage 2 hypertension, you will probably
be started on medication immediately.1 The process of finding the right
medication or combination of medications can be time consuming, but it is worth
the effort to reduce the risk of complications from high blood pressure.
View
More Information About Hypertension
1The Seventh Report of the Joint National
Committee on Prevention, Detection, Evaluation, and Treatment of High Blood
Pressure (JNC 7). Journal of the American Medical Association: May 21,
2003; Vol. 289, No. 19: 2560-2572.
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