Health Matters: High Blood Pressure Shouldn’t Go Untreated
Imagine a garden hose lined with a thin layer of cement that makes the hose narrower and less flexible, thereby increasing the pressure of the water running through it. This is basically what hypertension looks like with human blood vessels. And if the pressure goes unchecked, it can increase the risk of stroke and heart attack, two leading causes of death in America.
The human vascular system has three types of blood vessels: arteries that carry oxygenated blood away from the heart, veins that carry blood from the body back to the heart, and capillaries that go between the two to distribute oxygen-rich blood to the body. In a healthy vascular system, the heart pumps blood so that pressure is high enough to reach the furthest points of the body and return to the heart, but low enough to safeguard the smallest, most delicate vessels. With hypertension, calcium deposits on the inside of vessels become harder and more substantial over time, narrowing and sometimes completely blocking essential pathways, and causing pressure high enough to rupture vessels.
Normal blood pressure goes up and down over the course of a day depending on physical or emotional stress. Hypertension refers to chronically high blood pressure, and the only way to know your blood pressure is to check it periodically. Normal blood pressure is around 120/80 mmHg. Hypertension, especially for older adults, is closer to 140-150/80-90 mmHg and higher.
Hypertension affects tens of millions of Americans and contributes to almost half a million deaths annually according to the Centers for Disease Control and Prevention. In the early stages, symptoms are often minimal or unnoticeable, but as the condition worsens, small vessels such as those in the brain, eyes, and heart are damaged or destroyed, leading to a whole host of problems, including headaches and pressure in the head, retinal hemorrhaging (bleeding into the eyes), double vision, shortness of breath, edema (swelling) in the legs and feet, nausea, strokes, and heart attacks.
For younger adults facing hypertension, a lower-salt, lower-fat diet can sometimes lower blood pressure. Exercise is also good because the hormones released during exercise are vasodilators (vessel openers).
Otherwise, especially for older adults whose vessels have calcified, ongoing medication is often required to maintain a safe blood pressure. There are four primary types of antihypertensive medication: A, B, C and D. A stands for ACE inhibitors. B stands for beta blockers. C stands for calcium channel blockers. And D stands for diuretics. The right medication depends on several factors, including a patient’s age, family history, other medications in use, and other medical conditions.
Finding the right medication (and the right dose) is essential. High blood pressure can be dangerous, but so can low blood pressure. If you are just starting blood pressure medication and you feel dizzy or lightheaded, especially when standing from a sitting position, notify your medical provider so they can make adjustments. I understand that some people do not like the idea of using medication for extended periods, but uncontrolled hypertension can lead to problems that ruin your quality of life.
If you are at risk for hypertension, consider purchasing a blood pressure cuff to monitor your numbers daily. Ignoring this problem will not make it go away. A quick blood pressure check is far easier and less expensive than a hospital stay or worse.
Dr. Mehta is an internist at MCHC Health Centers—a local, non-profit, federally qualified health center offering medical, dental and behavioral health care to people in Lake and Mendocino Counties.