Essential Hypertension

What is essential hypertension?

Hypertension is the term for blood pressure that remai.ns high for a long period. If your blood pressure is 140/90 or higher each time it is measured and you are under age 65, you have hypertension. Blood pressure in the elderly can be higher and still be normal.

The condition of hypertension is often called essential hypertension if there is no obvious cause. When a disease or physical problem is the cause of high blood pressure, the condition is called secondary hypertension.

How does it occur?

Blood flows from the heart through the arteries to the arterioles, the smaller blood vessels that branch off from the arteries. Deposits of fat, small blood clots, or certain chemicals in the blood may cause the arterioles to become stiff and narrow. It is harder for blood to pass through narrowed arterioles. Thus, the pressure rises and the heart has to work harder to circulate blood through the body.

Many different factors are associated with high blood pressure: heredity, sex, age, race, stress, weight, smoking, a diet high in salt, heavy use of alcohol, and use of oral contraceptives. Exactly how these factors affect blood pressure is not yet well understood.

What are the symptoms?

You often have hypertension without knowing it. This is why it is important to have your blood pressure measured by a health care professional at least once every year. Complaints may include dizziness, racing or irregular heartbeat, easy tiring, impotence, nose bleeding, chest pain, and/or difficult or labored breathing.

How is it diagnosed?

If your blood pressure is high, your doctor will ask you to

come in again for other measurements. If three or more blood pressure readings on different days are high, you have hypertension.

Frequently hypertension is discovered as an underlying disease when symptoms of a very different nature are being investigated.

How is it treated?

Treatment depends on how high your blood pressure is and the degree of risk you have for heart and blood vessel disease and other complications of the disorder. The goal of treatment is to lower your blood pressure to a level as near normal as possible and to reduce risk of heart disease.

The first steps in treating essential hypertension often include modifying diet, activity, and risk factors for heart disease. These include:

- Reducing the amount of salt in your diet.

- Exercising regularly, for example, walking or swimming. (Talk to your doctor about what exercise might be best f or you. )

- Losing weight if you are overweight.

- Limiting the amount of alcoholic and caffeinated beverages you drink.

- Reducing stress.

- Stopping smoking.

If these lifestyle changes do not lower your blood pressure enough, your doctor may prescribe an antihypertensive drug.

There are many types of antihypertensive drugs. Diuretics help your body get rid of extra water and sodium. Others open up narrowed blood vessels or stop the vessels from constricting and getting narrower.

How long will the effects last?

The tendency toward essential hypertension does not go away and usually requires treatment all your life. Proper treatment can control your blood pressure and prevent or delay complications. If you already have some

complications, lowering your blood pressure can make the effects of the complications less severe.

Untreated high blood pressure is dangerous because the heart must work much harder to keep the blood circulating. This stress and damage to blood vessel linings and organs can lead to serious or life-threatening problems, such as heart disease, stroke, and kidney failure.

How can I take care of myself?

Learn to modify factors that control the level of your blood pressure. Your treatment will be much more effective if you follow these guidelines for taking good care of yourself:

- Always follow your doctor's instructions for taking medications. Don't take less medication or stop taking medication without talking to your doctor about it first.

- Check your blood pressure (or have it checked) as often as your doctor advises. Keep a chart of the readings. Many patients prefer to check their own blood pressure at home.

- Use less salt. Check the levels of sodium listed on food labels. Avoid canned and prepared foods unless the label specifically says "no salt added."

- Develop and maintain an exercise program that includes 30 to 45 minutes of walking, bicycling, or swimming three to five times a week.

- Drink no more than two 1-ounce drinks of hard liquor, two beers, or two 6-ounce glasses of wine a day.

- Stop smoking.

- Limit the amount of caffeine in your diet.

- Try to reduce the stress in your life or learn how to deal better with situations that make you feel anxious.

- Ask your doctor and pharmacist for information about the drugs you are taking.

- Tell your doctor about any side effects you have from the drugs you are taking.

What can be done to help prevent essential hypertension?

Changes in lifestyle, such as eating less salt, quitting smoking, and controlling your weight, may help prevent high blood pressure.