Hypertension is abnormally high blood pressure. When uncontrolled, hypertension can lead to stroke, heart attack, and heart failure. Unfortunately, 45.6% of adults residing in the United States suffer from hypertension, and almost half of those diagnosed with high blood pressure do not have it under control. In many cases, hypertension is diagnosed when systolic blood pressure is 140mm Hg or higher and/or diastolic blood pressure is 90 mm Hg or higher. However, this criterion does not replace a diagnosis from your physician. Physicians normally diagnose hypertension over a course of a few visits, not after one blood pressure reading. Some physicians may also suggest that a patient conducts their own blood pressure reading out of the office to confirm their hypertension diagnosis. In some scenarios, stress or anxiety from being in the doctor’s office can slightly skew a blood pressure measurement. This is often referred to as white coat hypertension- high blood pressure only while in a healthcare setting. The opposite of this phenomena is masked hypertension which is when an individual’s blood pressure is high out of the office, but low in the office. Both types of patients require monitoring from their physician and some changes in lifestyle factors to prevent a more severe hypertension diagnosis. However, if no change occurs over time, their doctor may suggest medication.
There are a few other types of hypertension. Those diagnosed with high-normal blood pressure are more likely to improve their condition with changes in lifestyle factors such as well-balanced diet, increase in physical activity, implementing healthy stress coping mechanisms, quitting smoking, limiting alcohol, and getting better quality sleep. However, physicians may suggest medication for these individuals depending on specific factors of their case. Yet, physicians are more likely to suggest hypertension medication for those with confirmed hypertension, meaning their blood pressure is clearly in the defined hypertensive range. There is also a type of hypertension called isolated systolic hypertension in which the systolic blood pressure is high, and the diastolic blood pressure is low. This is most common in younger people (children, adolescents, and young adults) and the elderly. Resistant hypertension occurs when a patient’s been treated with 3 or more medications for hypertension, yet their blood pressure is higher than 140/90 mm Hg. Their hypertension is resistant to treatment through medication. About 10% of those with hypertension experience this. Resistant hypertension can increase one’s risk for coronary artery disease, end-stage renal disease, stroke, and chronic heart failure. However, half of resistant hypertension cases are pseudo-resistant– meaning true resistance to medication is not causing the persistent hypertension. Sub-optimal blood pressure measurement devices, white coat effect, suboptimal medications, and patient non-adherence to medication guidelines are underlying factors that can explain resistant hypertension almost 50% of the time.
Although hypertension can seem scary, there are many things you can do to help decrease your risk or manage your existing hypertension. Adopting a well-balanced portion appropriate diet rich in vegetables, getting adequate exercise for your age and ability, improving your sleep quality, finding sustainable positive coping mechanisms for stress, limiting alcohol intake, quitting smoking, finding a trusted physician that you see regularly, building a strong support system and adhering to your medication guidelines (if applicable) are all ways to help decrease your risk for developing hypertension, increase your chance of living a healthy life, and successfully manage hypertension if you have already been diagnosed.