Heart Clinics Northwest, Providence Heart & Vascular Institute, Spokane, Washington, Your Heart

What is essential hypertension?

Hypertension is the term for blood pressure that is consistently higher than normal. Hypertension is called essential or primary when no cause for the high blood pressure can be found. (When the cause of hypertension is known, such as kidney disease and tumors, it is called secondary hypertension.) About 95% of all people with high blood pressure have essential hypertension.

Normal blood pressures average 120/80 (“120 over 80”) but can rise and fall with exercise or rest. The pressures are measured in millimeters of mercury, with the upper number (120) being the pressure at the end of the heartbeat (systolic pressure). The lower number (80) is the pressure at the beginning of the heartbeat (diastolic pressure). If repeated checks of your blood pressure show that it is higher than 140/90, you have hypertension.

Why is high blood pressure a problem?

When your blood pressure is high, your heart has to work harder just to pump a normal amount of blood through your body. The higher pressure in your arteries may cause them to weaken and bleed, resulting in a stroke. The higher artery pressure may lead to atherosclerosis, in which deposits of cholesterol, fatty substances, and blood cells clog up an artery. Atherosclerosis is the leading cause of heart attacks. It can also cause strokes.

The added workload on the heart causes thickening of the heart muscle. Over time, the thickening damages the heart muscle so that it can no longer pump normally. This can lead to a condition called congestive heart failure. You may also have damage to your kidneys and eyes. The longer you have high blood pressure and the higher it is, the more likely it is you will develop problems.

How does it occur?

There are no clear causes of essential hypertension. However, many different factors can increase blood pressure, such as:

Stress
Being overweight
Smoking
A diet high in salt
Heavy use of alcohol

Heredity, gender, age, and race are also important factors.

What are the symptoms?

One of the sneaky things about high blood pressure is that you can have it for a long time without symptoms. That is why it is important for you to have your blood pressure checked at least once a year.

When symptoms occur, they can range from headaches and getting tired easily to dizziness, nosebleeds, chest pain, and shortness of breath. Although it happens rarely, the first symptom may be a stroke.

How is it diagnosed?

Because it is such a common problem, blood pressure is checked at most health care visits. High blood pressure is usually discovered during one of these visits. If your blood pressure is high, you will be asked to return for follow-up checks. If it stays high for three visits, you probably have hypertension.

Your provider will ask about your family, life situation, and what you eat and drink. You may have urine and blood tests. Your provider may order a chest x-ray and an electrocardiogram. You may be asked to use a portable blood-pressure measuring device, which will take your pressure at different times during day and night. All of this testing is done to look for a possible cause of your high blood pressure.

How is it treated?

If your blood pressure is mildly or even moderately high, you may be able to bring it down to a normal level without medicine. Weight loss, changes in your diet, and exercise may be the only treatment you need. Your health care provider may recommend that you:

Reduce the amount of salt (sodium) in your diet. It may be helpful to talk with a dietician about low-sodium diets.
Exercise regularly. For example, walk or swim at least 3 times a week. Talk to your health care provider about the kinds and amounts of physical activity that are best for you.
Lose weight if you are overweight.
Drink less alcohol, coffee, tea, and soft drinks containing caffeine.
If you smoke, quit.
Try to reduce stress through stress management techniques, relaxation exercises, or counseling.

If these lifestyle changes do not lower your blood pressure enough, your health care provider may prescribe a medicine that will reduce your blood pressure. There are many types of drugs for reducing blood pressure. For example, diuretics (sometimes called water pills) are one type. They help your body get rid of extra water and sodium.

When you start taking medicine, it is important to:

Take the medicine regularly, exactly as prescribed.
Tell your health care provider about any side effects right away.
Have regular follow-up visits with your health care provider.

It may not be possible to know at first which drug or mix of drugs will work best for you. It may take several weeks or months to find the best treatment for you.

How long will the effects last?

You may need treatment for high blood pressure for the rest of your life. However, proper treatment can control your blood pressure and prevent or delay complications. If you already have some complications, lowering your blood pressure may make their effects less severe.

How can I take care of myself?

Your treatment will be much more effective if you follow these guidelines:

Always follow your health care provider’s instructions for taking medicines. Don’t take less medicine or stop taking medicine without talking to your provider first. It can be dangerous to suddenly stop taking blood pressure medicine. Also, do not increase your dosage of any medicine without first talking with your provider.
Check your blood pressure (or have it checked) as often as your health care provider advises. Keep a chart of the readings.
Don’t smoke.
Use less salt. Check the levels of sodium listed on food labels. Avoid canned and prepared foods unless the label says no salt is added.
Get regular exercise, according to your health care provider’s advice. For example, you might walk, bike, or swim at least 30 minutes 3 to 5 times a week.
Limit the amount of alcohol you drink. If you are a man, drink no more than two 1-ounce drinks of hard liquor or two beers or two 6-ounce glasses of wine a day. Women should have no more than 1 ounce of liquor or one beer or one glass of wine a day.
Limit the amount of caffeine you drink.
Try to reduce the stress in your life or learn how to deal better with situations that make you feel anxious.
Ask your health care provider or pharmacist for information about the drugs you are taking.
Lose weight if you need to.
Tell you health care provider about any side effects you have from your medicines.

Information obtained from GE Medical Systems; authorization given to reproduce on HCNW web site 9/02.
Developed by Donald L. Warkentin, MD; Phyllis G. Cooper, RN, MN; and McKesson Clinical Reference Systems.
Published by McKesson Clinical Reference Systems.
Copyright © 1991-2002 McKesson Health Solutions LLC. All rights reserved.

This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.