Hypertension

Hypertension

Alice is concerned about her husband's (Bob) high blood pressure. Their family doctor explains that the goal of Bob's treatment is to lower his blood pressure below 139 over 80. Unfortunately, Bob's blood pressure is not responding to three of the newest medications. Apparently, his blood pressure is being as stubborn as Bob. Alice is worried and has several questions for the doctor:

1)  What is blood pressure and how does too much cause problems?
2)  How do we detect high blood pressure (hypertension)?
3)  How much pressure is too much?
4)  Who is at risk for high blood pressure?
5)  What is typically done to treat high blood pressure?
6)  When should I see a hypertension specialist?
7)  What can a specialist do?

What Is Blood Pressure and How Does Too Much Cause Problems?

Generated by the heart and regulated by the kidneys, blood pressure is required to circulate blood around the body. Hypertension (or high blood pressure) occurs when this system is out of balance. This can be caused by too much fluid (salt) or an overproduction of hormones from the kidney. Similar to a steam boiler and pipes, when the blood pressure rises too high, the boiler (heart) or pipes (blood vessels) can rupture...causing damage to several organs such as the heart, brain and kidneys.

Hypertension is common and hard to detect. In fact, one of every three Americans over the age of 35 will develop high blood pressure. Hypertension symptoms are difficult to detect until the "pipes" break in the brain (stroke), heart (heart attack) or kidney (kidney failure). Early detection and treatment is key to the prevention of such damage.

How Do We Detect High Blood Pressure (Hypertension)?

The only way to detect hypertension is by using a blood pressure cuff to measure it. Otherwise, there are no reliable clues to suggest its existence until damage has already occurred.

How Much Pressure Is Too Much?

Who Is At Risk for High Blood Pressure?

Those over the age of 35, especially with a family history of high blood pressure or African American heritage have "non-changeable risk factors." However, some risk factors that can be changed include: obesity, high salt intake, alcohol consumption, lack of physical activity and high levels of stress.

What Is Typically Done To Treat High Blood Pressure?

If you are over the age of 35 and have one or more of these risk factors, a visit to your family physician can help determine if your blood pressure is too high. Your doctor can treat your blood pressure with medications. Most hypertension can be controlled easily with two or three medications.

When Should I See a Hypertension Specialist?

Your physician will help you determine when you should see a high blood pressure specialist. Some things your doctor will look for are: sudden high blood pressure at the extremes of age; sudden worsening of previously controlled blood pressure; signs of heart, brain or kidney damage; blood pressure that doesn't respond to three or more medications; or protein in the urine. Discussing any of these conditions with your physician can help you decide if a referral to a specialist is right for you.

What Can a Specialist Do?

A hypertension specialist can assist your doctor in determining if the current blood pressure medications are right for you by looking at the blood flow to the kidneys and measuring hormone levels produced by the kidneys. This information can identify possible cures to high blood pressure or the right medications to control it.

When Bob, who agreed to see a hypertension specialist, had his hormone levels checked, the hypertension specialist noticed an abnormal hormone level and placed him on an appropriate medication with a fast reduction in his blood pressure that may have saved his life...and precious organs.

By Andrew C. Bland, M.D., Illinois Kidney Disease and Hypertension Center