Blood pressure is expressed as two components, with a larger top number (systolic pressure) and a smaller bottom figure (diastolic pressure). These readings are measured in millimeters of mercury. The systolic pressure reflects the heart’s contraction as blood is forced out of the heart; the diastolic measure reflects the pressure during the heart’s resting stage when its chambers are filling with blood in preparation for the next contraction. Normal blood pressure depends on age and other variables but is usually considered high if it is above 140/90 for extended time periods.
Hypertension is an elevation of systolic and/or diastolic blood pressure. There are two types: primary (essential) and secondary. The cause of primary hypertension is unknown. Heredity probably predisposes individuals to hypertension, but the condition is usually attributed to a complex of physiological, genetic, and emotional factors. Approximately 95% of all high blood pressure is diagnosed as essential hypertension. Secondary hypertension is associated with such medical conditions as kidney disorders, toxemia of pregnancy, adrenal tumors, or ovarian tumors. Blood pressure usually returns to normal once the underlying medical condition is treated.
Hypertension affects approximately 15% of the adult population in the United States. If untreated, it can cause serious and irreversible damage to the brain, heart, kidneys, eyes, and blood vessels. It can even prove fatal by causing strokes, heart attacks, or kidney failure. High blood pressure is a particularly difficult medical problem to deal with because people often have no symptoms and may not even know they have the condition.
It is mandatory that high blood pressure be medically treated. The person with hypertension can be treated with several types of antihypertensive medications. One type, called beta blockers, reduces the contractility of the heart and the output of blood. A diuretic may be administered to remove some of the sodium and water from the body and thus decrease the total volume of blood. Sympathetic nerve inhibitors keep the sympathetic nerves from causing arteries to constrict. Vasodilators reduce tension in the blood vessel walls and let them dilate. Newer types of drugs inhibit the body’s production of angiotensin, a chemical which causes arteries to constrict. Calcium antagonists can help relax blood vessels and decrease the heart rate. Salt restriction is usually prescribed, in addition to medication; dietary changes can be equally as important as taking medication. Medication used to treat hypertension can be expensive and can cause unpleasant side effects such as lethargy, weakness, sexual impotency, depression, dry mouth, and sleep disturbance. However, the long-term problems resulting from hypertension are much worse than the side effects of medication.
Many people use relaxation techniques, including biofeedback training and meditation, in conjunction with their antihypertensive medication and salt restriction. Weight loss may help return blood pressure to normal; increased physical exercise can help reduce blood pressure, and alcohol use should be restricted since more than two ounces daily raises blood pressure in some people. Lifestyle changes and the practice of relaxation methods are important adjuncts to medication. They can help reduce the dosage levels of medication required, and in some cases medication can be discontinued completely. This must always be monitored by a medical doctor since high blood pressure frequently has no symptoms. Ongoing medical supervision is required for adequate treatment of this dangerous and potentially life-threatening condition.
Research has shown that people who attend church regularly tend to have lower incidence of hypertension than does the general population. Regular churchgoers perhaps have lower levels of anxiety and anger, both of which activate the nervous system and increase blood pressure.
Because high blood pressure does not produce noticeable symptoms, it has been termed the silent killer. It is extremely important to have one’s blood pressure checked at least once each year and more frequently if high readings have ever been obtained. If hypertension is diagnosed, working closely with a physician and following the doctor’s treatment prescriptions will minimize the effects of this condition. If hypertension is detected early and treated, the hypertensive can live a long and productive life.