Blood Pressure
By Bobby Gill

Blood Pressure

Blood pressure (BP) is the force of blood pushing against the walls of the arteries created by the heart as it pushes blood into the circulatory system. Blood pressure is always given as these two numbers, systolic (sis-TOL-ik) and diastolic (di-a-STOL-ik) pressures in millimeters of mercury (mm Hg). The BP is really two measurements, separated by a slash when written down, such as 120/80. The "top" number or systolic BP is the pressure while the heart is pumping blood out. The "bottom" number or diastolic BP is the pressure as the heart relaxes between beats. You measure by inflating a cuff of a device called a sphygmomanometer (pronounced: sfig-mow-mah-nah-meh-ter) around the arm. The pressure is measured as air is gradually let out of the cuff, which allows blood to begin to flow through the artery again when the pressure in the artery is greater than the pressure in the cuff.  BP is taken at rest, with the legs and arms relaxed and the back supported. Normal BP is the reading which most healthy adults have when their BP is tested. This measure at two points, a high point and a low point of pressure is an important diagnostic index, especially of circulatory function. The high point is reached when we exercise, and the low point is reached when we sleep. Blood pressure is regulated largely by the nervous system. BP is normally lower in children and in women in late pregnancy. BP that is too low is known as hypotension. The American Heart Association (AHA) suggests it’s important to get a monitor that has been clinically validated to accurately measure BP. Make sure the cuff fits - measure around your upper arm and chose a monitor that comes with the correct size cuff. Omron monitors come with two cuff sizes or have expandable cuffs to fit both regular and large-size arms.  Don’t smoke, drink caffeinated beverages or exercise within the 30 minutes of measuring your BP. Do vary the times of day and situations in which you take your BP.  BP can be elevated in the morning, if you’re stressed, or after drinking coffee and/or smoking.

Blood pressure of less than 120 over 80 is considered a normal reading for people 18 and over. BP greater than 140/90 mm Hg is considered high. There are two main reasons for high - too high amount of blood volume and narrow blood vessels due to a substance our kidneys make called angiotensin. Angiotensin causes blood vessels to constrict, and drives the BP up. It is part of the renin-angiotensin system. BP is only one of a number of factors that increase your risk of heart attack, stroke, and death. BP is the driving force within the arteries of the body, literally the hydraulic pressure that drives blood flow to all organs. BP is affected by medication, cardiovascular or urological disorders, neurological conditions, and psychological factors such as stress or anger. BP is a continuous variable, and risks of various adverse outcomes rise with it. BP is also influenced by the amount of fluid and salt in the body.

Blood pressure is affected by weather and is generally higher in the winter and lower in the summer. Cold temperatures cause your blood vessels to narrow (constrict) — which increases BP because more pressure is needed to force blood through a narrower space. Other possible causes of higher BP are weight gain and decreased physical activity in winter. However, it doesn't take a big cold snap to raise BP.  Seasonal changes also are found in climates where temperatures may change only a few degrees from summer to winter. BP increases with age because our arteries loose elasticity. BP can also rise due to anxiety, excitement, activity or nervousness. It can decrease if a person exercises, doesn't smoke, limits salt intake, limits alcohol intake and if obese, loses weight. An interesting statistic - as many as 50 million Americans aged 60 and older have high blood pressure.

Your body is very sensitive to changes in BP.  Special cells in the arteries can sense if your BP begins to rise or fall. When this happens, the cells trigger your body to try to bring BP back to normal. For example, if you stand up quickly, your BP may drop. Most forms of hypotension happen because your body can't bring BP back to normal or can't do it fast enough. Some people have low BBP all of the time. They have no signs or symptoms, and their low BP is normal for them. In other people, certain conditions or factors cause BP to drop below normal. The outlook in a healthy person, low BP without signs or symptoms usually isn't a problem and needs no treatment. If low BP causes signs or symptoms, your doctor will try to find and treat the underlying condition that's causing it.

High

blood pressure is one of the leading causes of kidney failure, also called end-stage renal disease (ESRD).Malignant high BP is a medical emergency. The only way to know whether a child has high BP is to get it checked regularly. Doctors usually start measuring BP during routine checkups when kids are 3 years old. For children, high BP is determined by comparing the child’s BP with the distribution of BP for children of similar sex, age and height. A child whose BP is greater than or equal to 95% of children of similar sex, age, and height (at or above the 95th percentile) would be considered to have high blood pressure.

Women and BP

More women are paying attention to their hearts in recent years, thanks to an increasing public awareness campaigns that emphasizes a woman’s risk for heart disease. Too many women do not recognize the critical role BP plays in heart health. Women are less likely than men to make lifestyle changes to meet target goals for healthy BP. According to a recent issue of Hypertension: Journal of the American Heart Association, forty percent of women are not controlling their high or hypertension. A frightening statistic is that high BP affects more than 100 million adults (men and women combined) in the US. A new recommendation by the American Heart Association (AHA) is for regular home BP monitoring in conjunction with a doctor’s supervision. This is especially important for pregnant women, as high BP during pregnancy is a leading cause of maternal and infant deaths.

Treatment

Treatment can effectively control high BP and help prevent the problems it causes. Treatment begins with changes you can make to your lifestyle to help lower your BP and reduce your risk of heart disease. The recommended treatment depends on how high your BP is, whether you have other health problems such as diabetes, heart failure or you are pregnant and whether any organs have already been damaged. Proper treatment of primary high BP, especially moderate or severe high BP, decreases the risk of heart failure, coronary artery disease, heart attack, abnormal heartbeats, stroke, and kidney disease, and it reduces the risk of death from these conditions. Treatment of secondary high BP varies depending on the cause. Treatment with medicine is often started in addition to lifestyle changes if you have other risk factors for heart disease, if there is evidence of damage to organs, or if you have stage 1 or 2 high BP. Treatment of high BP in people older than 50 generally focuses on lowering the systolic BP. Treatment for hypotension depends on the cause. There is no cure for primary hypertension, but BP can almost always be lowered with the correct treatment. Lowering BP can be accomplished via changes in your diet, getting regular exercise, and taking antihypertensive medications.

Symptoms

Hypertension is often called the "silent killer" because symptoms of high BP do not appear for years until a vital organ is threatened.

Symptoms of very severe high BP include:

Headaches, especially pulsating headaches behind the eyes that occur early in the morning.

Light-headedness, when standing from a sitting or lying position

Unsteadiness

Dizziness

Weakness

Blurred vision

Fatigue

Fainting.

Confusion;

Chest pain;

Ear noise or buzzing.

Symptoms of low BP may include:

Feeling tired

Dizziness, especially if you suddenly stand up

Fainting.

Shock (happens only in extreme cases)

Conclusion:

For the most part, you can't tell if you have high blood pressure, and most hypertensive people have no symptoms. The usual symptoms of high BP are dizziness, headaches, and noises or ringing in the ears but high BP usually has no specific symptoms and no early warning signs. The main point to take from this article is to educate everyone to commence regular BP checks. High BP is often called the ‘silent killer’ because it usually has no noticeable warning signs or symptoms until other serious problems arise. High is one of the most serious health problems in the United States; yet, because high BP has no symptoms, millions of people do not even know they have it. Children do not usually suffer the life threatening cardiovascular effects of high BP. Cholesterol problems often coexist with high BP, as they are both caused in many people by being overweight, and they are both risk factors for developing coronary artery disease. Since high BP is associated with cardiovascular and other diseases and even death, it is critically important to identify and treat it early.