Hypertension (High blood pressure)

Arterial (blood) pressure is the force responsible for pumping blood throughout the body. It is strongest when the heart is beating and weakest in between heartbeats. Therefore, when measuring arterial pressure, two values are obtained: high (systolic) and low (diastolic). Arterial pressure varies quite a lot during the day due to emotion, stress, physical activity, etc. It is also highly variable from one individual to another because of age, race, gender, diet, and lifestyle. People with high blood pressure are more likely to suffer from heart disease than others. The ideal systolic pressure is below 120 mmHg and the ideal diastolic pressure is below 80 mmHg. We talk of hypertension when the systolic pressure is above 140 mmHg or the diastolic pressure is above 90 mmHg. The higher the blood pressure, the more damage can occur. Though hypertension can appear at any age, it usually affects adults and the elderly. Usually it doesn’t cause any symptoms and so goes unnoticed. Occasionally it causes headaches. When hypertension goes untreated, it can damage the heart, arteries, kidneys and eyes, which may result in angina, heart failure, heart attacks, strokes, renal failure and blindness. Hypertension must be detected and put under control as soon as possible. Other risk factors can influence the goals of therapy. Usually, our goal is to maintain the blood pressure under 140/90 mmHg, but for patients suffering from diabetes or renal disease the targets are even lower.

How can you know if you have high blood pressure?

You can find out by going to your doctor who will measure your blood pressure. Only your doctor can confirm whether you have high blood pressure. Arterial pressure is measured with a sphygmomanometer (a pressure sensing device). An inflatable cuff is placed around the arm and inflated. The pressure necessary to stop blood circulation (systolic value) is recorded. The second value (diastolic) corresponds to the return of normal blood flow. Because blood pressure varies during the day, several measurements are required before a diagnosis of hypertension can be made. Blood pressure is measured in both arms, while the patient is lying down, sitting, and standing. The doctor will wait a few weeks before taking these measurements again and will repeat them a third time a few weeks later. Only when all of these tests are done can a diagnosis be made.

Keeping track of your own blood pressure

Blood pressure is easy to measure and anyone can learn how to do it. Home blood pressure monitoring devices are available in pharmacies and department stores. Devices that use a stethoscope (a device for listening to the heart) and a gauge are affordable and accurate. Digital blood pressure monitoring devices are easier to handle but are more expensive. When you take your blood pressure, follow this advice:
  • do not smoke or drink coffee during the 30 minutes before taking your blood pressure
  • sit down or relax for 5 to 10 minutes
  • place your arm on a smooth surface at heart level
  • use a cuff that is suitable for the circumference of your arm (a cuff that is too large or too small will provide an inaccurate result)
  • follow the instructions for your equipment
  • note your results, indicating the date, time and arm used

Can you cure hypertension?

Unless it is induced by another disease, hypertension is not curable. However, it can be controlled. In mild cases, it can even be controlled without medication. The following measures can help control hypertension and may also be useful for people with normal blood pressure who wish to prevent hypertension:
  • eat a balanced diet that includes fresh fruits and vegetables
  • reduce your fat and sugar intake
  • reduce your salt intake (avoid saltcellar and already prepared food)
  • 5 g of dietary sodium intake or less if you are 50 years old or younger
  • 3 g of dietary sodium intake or less if you are between 50 and 70 years old
  • 2 g of dietary sodium intake or less if you are 70 years old or older
  • increase your fibre intake (eat whole cereals)
  • exercise of moderate intensity 3 to 4 times a week or more, for at least 30 minutes each time
  • do not smoke
  • never drink more than 2 ounces of alcohol per day (should not exceed 14 drinks per week for men and 9 drinks per week for women)
  • keep a healthy weight (BMI 19 to 25)
  • learn how to handle stress

How is hypertension treated with medication?

When the preceding measures are not enough to bring blood pressure under control, the physician may prescribe a medication. Several agents are available; each has advantages and disadvantages. Remember, none can cure hypertension; there are only long-term, sometimes lifelong therapies. Lifestyle changes have to be continued during therapy. Drug therapies must be tailored to the patient’s unique needs in order to normalize blood pressure with minimal side effects. Patients frequently require more than one drug. In order to ensure effective treatment, be sure to get follow-up by your physician, who may advise you to take your blood pressure regularly at home.

For more information or for support

The Heart and Stroke Foundation of Canada www.heartandstroke.com