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What You Should Know About Hypertension

Paul has been battling hypertension for a long time. He is on two kinds of medication to control his high blood pressure.

Author measuring blood pressure on November 18, 2021.

Author measuring blood pressure on November 18, 2021.

Understanding Hypertension

Hypertension or high blood pressure is a silent killer that many people don't know they have. Unless high blood pressure is life-threatening, most people don't even realize they have it.

I have had hypertension for most of my life but wasn't aware of it until 1991 at the age of 46. At that time, a dentist noticed my blood pressure was high. He would not extract a number of my teeth until the blood pressure was under control.

A few days later, the family doctor diagnosed my hypertension and put me on medication to control it. Since 1991, I have been taking hypertension medicine, and in November 2021, a doctor put me on a second medication.

In this article, I relate what you should know about hypertension. This includes:

  1. Definition of Hypertension
  2. Types of Hypertension
  3. Risk Factors for Having Hypertension
  4. How it Is Diagnosed
  5. Why Hypertension Must be Treated
  6. How Hypertension Is Treated

Definition of Hypertension

Hypertension or high blood pressure is a common condition among people. It is the condition in which the long-term force of blood against artery walls is high enough that it may cause health problems such as heart attacks or stroke.

Blood pressure is determined by the quantity of blood that the heart pumps and the amount of resistance to blood flow in arteries. The narrower your arteries are, the higher blood pressure will be.

Blood pressure is measured with systolic and diastolic readings. A systolic reading is the upper measured pressure in arteries when the heart beats. The lower measured reading or diastolic is the pressure in the arteries between heartbeats

Any systolic/diastolic reading of 130/80 mm Hg or above would indicate a person has hypertension. There are three stages of hypertension that will be discussed later in this article.

How Blood Pressure Works

Types of Hypertension

The two types of hypertension are primary and secondary.

Primary or essential hypertension has no identifiable cause. Most people and the author of this article have this type. It tends to develop over many years due to factors later identified in this article.

Secondary hypertension is caused by an underlying condition and appears suddenly. It will indicate blood pressure higher than primary. Some of the causes of secondary hypertension are kidney disease, thyroid and congenital problems, and responses to medications.

Hypertension Risk Factors

No one wants to have high blood pressure. There are, however, several risk factors that you should be aware of. They include:

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  1. Age
  2. Race
  3. Family history
  4. Being overweight
  5. Not being physically active
  6. Tobacco use
  7. Excess salt in the diet
  8. Not enough potassium in the diet
  9. Too much alcohol use
  10. Stress
  11. Chronic conditions

1. Age

As you get older, you are more liable to have hypertension. This is because your arteries become less elastic through aging.

2. Race

High blood pressure is more common among Afro-Americans and people of African heritage.

3. Family History

Hypertension runs in families suggesting that it is inherited. My mother and father had high blood pressure and my brother and two of my sisters also have it.

4. Being Overweight

Although some normal and underweight persons have hypertension, it is more common among the overweight. This is probably due to an overweight person's heart having to pump more blood through the body. I have been overweight much of my life and have noticed that my blood pressure drops when I lose weight.

5. Not Being Physically Active

Lack of physical activity or exercise is a high blood pressure risk. Periodically being on a treadmill or brisk walking and jogging will help your heart and lower blood pressure.

6. Tobacco Use

I am certain that my 28 years of cigarette smoking contributed to my hypertension. The chemicals in cigarette smoke cause the hardening of the arteries and thickened blood in the arteries. Therefore, it is more difficult for the blood to pass through arteries.

7. Excess Salt in Diet

When I was younger, my wife cooked a lot of salty foods. This was one of the factors leading to my hypertension. Too much salt in your diet makes your body hold extra water to cleanse the sodium in the salt from your body. This causes blood pressure to rise because added water puts extra stress on the heart and arteries.

8. Not Enough Potassium in Diet

Potassium's important role is in relaxing blood vessels which lower blood pressure. Potassium also helps balance sodium levels in the body.

9. Excessive Alcohol Use

Too much alcohol increases levels of the hormone renin which causes blood vessels to constrict or get smaller in diameter. Renin also decreases the amount of fluid the blood eliminates as urine. High fluid levels in the body and smaller arteries increase blood pressure.

10. Stress

Your body produces a surge of hormones when you are under stress. Hormones temporarily increase blood pressure by making the heart beat faster and blood vessels narrower.

11. Chronic Conditions

Finally, chronic conditions such as kidney and hormone problems, diabetes, and high cholesterol increase blood pressure.

How Hypertension Is Diagnosed

High blood pressure is usually diagnosed by a doctor who is a general practitioner. My family doctor diagnosed my hypertension by listening to my heart and measuring my blood pressure with a blood pressure monitor. I think my blood pressure at that time in 1991 was 160/95.

In diagnosing hypertension, the following categories are used:

  1. Normal blood pressure if 120 mm Hg systolic or lower
  2. Elevated blood pressure if 120-129 systolic and diastolic 80 or lower
  3. Stage 1 hypertension if 130-139 systolic and diastolic 80-89
  4. Stage 2 hypertension if 140 or higher systolic and diastolic 90 or high

Doctors also can diagnose hypertension with lab tests such as an urinalysis, EKG/ECG, and Echo-Cardiograms.

Why Hypertension Needs to Be Treated

Uncontrolled high blood pressure can lead to several complications. They include:

  1. Heart attack or stroke
  2. Aneurysm
  3. Heart failure
  4. Weakened and narrowed blood vessels in the kidney
  5. Torn blood vessels in the eyes
  6. Metabolic syndrome includes increased waist size, high triglycerides, decreased high-density lipoprotein (HDL) cholesterol, and high insulin levels
  7. Memory problems
  8. Dementia

How to Manage and Treat Hypertension

Having high blood pressure is not a death sentence. If you know how to manage and treat hypertension, it is possible to live into your 80s or 90s.

By correctly managing high blood pressure that is not too out of control, it is possible to avoid taking medication. Many times this will require changes in your lifestyle.

If you must take medication to control hypertension, it is important to understand what medicine you are taking and the effect it has on your body.

Managing hypertension with and without medication is described below.

How to Manage Hypertension Without Medication

Managing hypertension without medication involves making the following changes in your lifestyle:

  1. A different dietary approach
  2. More exercise
  3. Losing weight
  4. Quitting smoking

1. A Different Dietary Approach

It is very important to watch your diet in controlling hypertension. If you eat a lot of fast food or junk food like potato chips, cookies, cake, and candy, you should give up these foods.

As a cardiologist told me, you should be striving to have half of each meal consist of fruits and vegetables. The other half should include grains, non-fat dairy, and lean meat or fish. Strive for the low sodium content of 1500 mg per day and limit sweets and fats. If you must have alcoholic beverages, have no more than two small servings daily.

2. More Exercise

Aerobic exercise is necessary to get your heart pumping blood faster. For about 30 minutes daily Monday-Friday, it would be best to be on a treadmill, jogging, brisk walking, or riding a bicycle.

3. Losing Weight

Losing weight is an excellent way to lower high blood pressure. If your body mass index (BMI) is not in the range of 18.5-25, it would be best to consider losing some weight.

I am 5'9" in height and weigh 210 pounds. My BMI is 31.38 which is in the category obesity I. In the past, my weight was down to 195 and my blood pressure also decreased significantly.

4. Quitting Smoking

When I was diagnosed with hypertension, I was a heavy smoker. After I quit smoking in 1995, I immediately noticed a reduction in blood pressure and heartbeat. Doctors report that arteries and blood vessels start to widen five years after you stop smoking.

Managing Hypertension With Medication

If high blood pressure is too out of control or can not be managed with lifestyle changes, it is probably necessary to treat it with medication.

Medications work on different parts of the body to lower blood pressure. They are divided into nine different classes.

In the following three sections of this article, I will list the classes of medication and how they work. I will also give examples of generic and brand names for each class and conclude with my experience taking blood pressure medication.

Classes of Blood Pressure Medication

  1. Diuretics–(water pills) cause the body to rid excess fluids and sodium by urination
  2. ACE inhibitors–block a key enzyme responsible for blood pressure and reduce the heart's workload
  3. Beta blockers– decrease heart rate and the force of blood pumped to lower blood pressure
  4. Calcium channel blockers–block calcium from entering the muscle cells of the heart and arteries because calcium causes the heart to contract and arteries to narrow
  5. Peripherally acting alpha-adrenergic blockers–relax blood vessels
  6. Centrally acting alpha adrenergics–block nerve impulse causing arteries to constrict or narrow
  7. Angiotensin II antagonists (ARBS)–effects similar to ACE inhibitors
  8. Vasodilators–dilate (open) blood vessels to allow easier blood flow
  9. Direct renin inhibitors (DRI)

Examples of Generic Followed by Brand Names for Classes of Blood Pressure Medication

  1. Diuretics–Bumetanide (Bumex) and Indapamide (Lozol)
  2. ACE inhibitors–Benazepril (Lotensin) and Lisinopril (Prinivil and Zestril)
  3. Beta blockers–Atenolol (Tenormin) and Bisoprolol (Cardicor or Emcor)
  4. Calcium channel blockers–Amlodipine (Norvasc) and Nisoldipine (Sular)
  5. Peripherally acting alpha adrenergics blockers–Prazosin and Doxazosin
  6. Centrally acting alpha adrenergics–Clonidine (Catapres) and Guanfacine (Tenex)
  7. Angiotensin II antagonists–Azilsartan (Edarbi) and Losartan (Cozaar)
  8. Vasodilators–Benazepril (Lotensin) and Captopril (Capoten)

My Experience Taking Blood Pressure Medication

Since 1991, I have taken a variety of medications for my hypertension. The generic and brand names I have used include Lotensin, Lisinopril, Madiplot, Norvasc, Amlodipine, and Hydralazine.

Up until November 8, 2021, I was taking only one blood pressure medication daily. Most recently it was Amlodipine 5mg. When my blood pressure suddenly slowly increased, my cardiologist prescribed a second medication for me to take. It is Hydralazine 25 mg, a vasodilator.

I take one pill of Amlodipine every morning after breakfast. Hydralazine is taken three times daily following breakfast, lunch, and dinner.

Aside from an initial slight headache, I haven't had any side effects using my medications.

When managing hypertension with or without medication, you should often take blood pressure readings with a machine. I have a machine at home and take readings in the morning after I get up, two hours after lunch, and one hour after dinner. Make sure you have been sitting at rest for at least five minutes before taking your blood pressure readings.

My readings are the highest in the morning and lowest in the evening. My average blood pressure readings have been 132/68 with a pulse of 70 since going on Hydralazine.

Hopefully, with more exercise, losing weight, and watching my diet, my blood pressure will decrease even further.

Sources

  • mayoclinic.org
  • webMD.com
  • medicine.org.uk
  • secondscount.org

This content is accurate and true to the best of the author’s knowledge and does not substitute for diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed health professional. Drugs, supplements, and natural remedies may have dangerous side effects. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.

© 2021 Paul Richard Kuehn

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