Diagnose and treat chronic hypertension

Blood pressure is the force of blood against the inner walls of your arteries. It can change throughout the day and throughout your life. When your blood pressure is well above the normal healthy range, it is called high blood pressure or hypertension.

Sometimes you may have temporary spikes in blood pressure, caused by stress or other factors, including pregnancy. But when high blood pressure becomes a chronic disease, it is considered chronic.

There is no cure for chronic hypertension, but there are medications and lifestyle adjustments that can help control your blood pressure.

Regardless of how high blood pressure begins, it is important to work closely with a doctor and adopt a heart-healthy lifestyle to prevent chronic high blood pressure from causing serious and potentially life-threatening complications. deadly.

Blood pressure is expressed by two numbers: the systolic pressure, or the upper number of your blood pressure reading, and the diastolic pressure, or the lower number. Pressures are measured in millimeters (mm) of mercury (Hg).

Systolic pressure refers to the pressure of blood in your arteries as your heart contracts and pumps blood to the body. Diastolic pressure is the force of blood against the walls of the arteries when your heart is at rest.

High blood pressure is considered systolic pressure of 130 mm Hg or higher or diastolic pressure of 80 mm Hg or higher. The Centers for Disease Control and Prevention (CDC) estimate that nearly half of all adults in the United States suffer from high blood pressure.

Chronic hypertension is also called essential hypertension or primary hypertension. It accounts for about 90% of high blood pressure cases, according to the World Heart Federation. There is usually no known cause for primary or chronic hypertension, although there is a long list of risk factors, including:

  • Advanced age
  • Diabetes
  • excessive consumption of alcohol
  • family history
  • high sodium intake
  • obesity
  • sedentary lifestyle
  • tobacco use

Secondary hypertension, which accounts for far fewer cases than chronic hypertension, is high blood pressure caused by another medical condition, such as kidney disease or thyroid problems. It is not considered chronic hypertension because treating the underlying condition can often lead to a return to normal blood pressure.

It is quite common for a pregnant person to develop high blood pressure. The CDC reports that hypertension occurs in approximately 1 in 12 to 17 pregnancies. But during pregnancy, chronic hypertension takes on a slightly different meaning and concern.

Chronic hypertension differs from other high blood pressure problems associated with pregnancy, including preeclampsia and gestational hypertension. Chronic hypertension means you had high blood pressure before you got pregnant (or before the pregnancy reached 20 weeks) and you continue to have high blood pressure throughout the pregnancy and after.

Preeclampsia is high blood pressure that first develops during pregnancy and means there is protein in your urine or other related health problems after 20 weeks. Gestational hypertension is also high blood pressure that first develops during pregnancy, but is not accompanied by protein in the urine or other heart or kidney problems.

Because chronic hypertension in pregnancy is such a common occurrence, it has been an active area of ​​research for a long time.

For example, a study 2017 suggests that someone with gestational hypertension or preeclampsia may be more prone to developing chronic hypertension, although this risk can be significantly reduced by keeping weight moderate and adopting heart-healthy behaviors.

A 2022 study suggests that treating chronic hypertension in pregnant women with blood pressure below 140/90 mm Hg leads to better pregnancy outcomes, even in those with mild chronic hypertension.

Discuss lifestyle options for lowering your blood pressure when you are diagnosed with primary or chronic hypertension.

Lowering your blood pressure can be done with a combination of medications and lifestyle changes designed to support healthy heart function. Behaviors that should help include:

Diet

Being overweight or obese is associated with high blood pressure while losing weight, and maintaining a moderate weight is key to controlling your blood pressure.

Additionally, a diet high in sodium and unhealthy fats is associated with high blood pressure.

To that end, health experts recommend the DASH (Dietary Approaches to Stop Hypertension) diet or the Mediterranean-style diet to promote better cardiovascular health. These diets emphasize fruits, vegetables, whole grains, and lean proteins, while the DASH diet specifically focuses on reducing sodium intake.

A study 2020 suggests that adhering to the DASH diet is a particularly effective way to control your blood pressure.

Exercise

The American Heart Association recommends 150 minutes per week moderate-intensity exercise for better heart health. Ideally, you want to exercise at least 30-40 minutes most days of the week.

A brisk walk or similar activity not only helps promote weight management, but also gives your cardiovascular system a good workout, which promotes vascular health and blood pressure control.

Other steps

Other lifestyle adjustments can make a big difference in lowering blood pressure. Consider the following changes for lower blood pressure and better overall health:

  • Get at least 7-8 hours of sleep a night and treat any sleep disorders, such as obstructive sleep apnea.
  • Keep alcohol consumption to a minimum.
  • Manage stress through relaxation efforts, such as meditation and deep breathing techniques.
  • Stop smoking.

In addition to adopting a heart-healthy lifestyle, the main way to control chronic hypertension is to take medication that lowers blood pressure. Some of the more common antihypertensives include:

  • Diuretics: These drugs reduce fluid levels in the body to relieve the load in the arteries, but can also reduce potassium levels, leading to muscle-related side effects. People with diabetes may experience blood sugar spikes after taking diuretics.
  • Angiotensin converting enzymes (ACE) inhibitors: These ACE inhibitors help keep the arteries relaxed and open to improve blood flow and reduce blood pressure. They are generally safe for most people, although anyone who is pregnant or planning to become pregnant should speak with a doctor about alternative medication.
  • Angiotensin II receptor blockers: Commonly called ARBs, they help keep blood vessels relaxed and open, although they do so through a different mechanism. ARBs should also not be used during pregnancy.
  • Calcium channel blockers: These drugs lessen the force with which the heart contracts, thereby reducing the pressure of blood flowing through the arteries.

A study 2019 management of hypertension also suggests that antihypertensive drugs – also called antihypertensives – are safe and effective treatments for most people and may be particularly helpful in reducing the risk of cardiovascular complications, such as heart attacks and cerebrovascular accidents.

Chronic hypertension is a common but treatable condition that can affect adults of all ages and sometimes children. Controlling high blood pressure requires discipline and the ability to adopt heart-healthy lifestyles, including a healthy diet and regular exercise. This usually requires daily medication.

If you follow your medication regimen and a healthy eating and daily exercise routine, you can avoid some of the most serious complications of high blood pressure.

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