High blood pressure (hypertension) – Diagnosis and treatment – Mayo Clinic

Diagnosis

Blood pressure measurement

Blood pressure measurement

To measure your blood blackmail, a specialist places an inflatable handcuff around your arm and measures your rake pressure using a pressure-measuring gauge. A blood imperativeness interpretation, as shown in the lineage blackmail monitor in the double, measures the atmospheric pressure in your arteries when your heart beats ( systolic pressure ) in the first act, and the pressure in your arteries between heartbeats ( diastolic imperativeness ) in the second count .
Your doctor will ask questions about your aesculapian history and do a physical examen. The doctor, harbor or other medical assistant will place an inflatable arm cuff around your sleeve and measure your lineage pressure using a pressure-measuring gauge .
Your blood pressure broadly should be measured in both arms to determine if there is a dispute. It ‘s authoritative to use an appropriate-sized branch manacle.

Blood pressure measurements fall into several categories :

• Normal blood pressure. Your blood pressure is normal if it’s below 120/80 mm Hg.
• Elevated blood pressure. Elevated blood pressure is a systolic pressure ranging from 120 to 129 mm Hg and a diastolic pressure below (not above) 80 mm Hg. Elevated blood pressure tends to get worse over time unless steps are taken to control blood pressure. Elevated blood pressure may also be called prehypertension.
• Stage 1 hypertension. Stage 1 hypertension is a systolic pressure ranging from 130 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg.
• Stage 2 hypertension. More-severe hypertension, stage 2 hypertension is a systolic pressure of 140 mm Hg or higher or a diastolic pressure of 90 mm Hg or higher.
• Hypertensive crisis. A blood pressure measurement higher than 180/120 mm Hg is an emergency situation that requires urgent medical care. If you get this result when you take your blood pressure at home, wait five minutes and retest. If your blood pressure is still this high, contact your doctor immediately. If you also have chest pain, vision problems, numbness or weakness, breathing difficulty, or any other signs and symptoms of a stroke or heart attack, call 911 or your local emergency medical number.

Both numbers in a blood pressure interpretation are authoritative. But after old age 50, the systolic reading is flush more important. Isolated systolic high blood pressure is a discipline in which the diastolic pressure is normal ( less than 80 millimeter Hg ) but systolic pressure is senior high school ( greater than or equal to 130 mm Hg ). This is a coarse character of high blood pressure among people older than 65 .
Because blood pressure normally varies during the day and may increase during a repair chew the fat ( white coating high blood pressure ), your doctor will likely take several blood atmospheric pressure readings at three or more discriminate appointments before diagnosing you with high blood pressure .

Taking your blood pressure at home

Your doctor may ask you to record your lineage blackmail at home to provide extra information and confirm if you have senior high school blood pressure .
home monitor is an important direction to confirm if you have eminent blood pressure, to check if your lineage blackmail treatment is working or to diagnose worsening high rake pressure .
Home blood pressure monitors are widely available and cheap, and you do n’t need a prescription to buy one. Home blood imperativeness monitoring is n’t a ersatz for visits to your doctor, and home lineage pressure monitors may have some limitations .
Make sure to use a validate device, and check that the handcuff fits. Bring the monitor with you to your sophisticate ‘s office to check its accuracy once a year. Talk to your sophisticate about how to start checking your blood blackmail at dwelling .
Devices that measure your blood coerce at your wrist or finger are n’t recommended by the American Heart Association because they can provide less authentic results .

Tests

If you have high blood pressure, your doctor may recommend tests to confirm the diagnosis and discipline for underlie conditions that can cause high blood pressure .

• Ambulatory monitoring. This 24-hour blood pressure monitoring test is used to confirm if you have high blood pressure. The device used for this test measures your blood pressure at regular intervals over a 24-hour period and provides a more accurate picture of blood pressure changes over an average day and night. However, these devices aren’t available in all medical centers, and they may not be reimbursed.
• Lab tests. Your doctor may recommend a urine test (urinalysis) and blood tests, including a cholesterol test.
• Electrocardiogram (ECG or EKG). This quick and painless test measures your heart’s electrical activity.
• Echocardiogram. Depending on your signs and symptoms and test results, your doctor may order an echocardiogram to check for more signs of heart disease. An echocardiogram uses sound waves to produce images of the heart.

Treatment

Changing your life style can help control and manage high blood pressure. Your doctor may recommend that you make life style changes including :

• Eating a heart-healthy diet with less salt
• Getting regular physical activity
• Maintaining a healthy weight or losing weight if you’re overweight or obese
• Limiting the amount of alcohol you drink

But sometimes life style changes are n’t enough. If diet and practice do n’t help, your repair may recommend medication to lower your blood pressure .

Medications

The type of medication your doctor order for high blood coerce depends on your blood pressure measurements and overall health. Two or more lineage imperativeness drugs frequently work better than one. sometimes finding the most effective medication or combination of drugs is a matter of trial and error .
You should aim for a blood pressure treatment finish of less than 130/80 mm Hg if :

• You’re a healthy adult age 65 or older
• You’re a healthy adult younger than age 65 with a 10% or higher risk of developing cardiovascular disease in the next 10 years
• You have chronic kidney disease, diabetes or coronary artery disease

Ask your doctor what your blood pressure treatment finish should be. besides, the ideal blood pressure treatment goal can vary with long time and health conditions, peculiarly if you ‘re older than age 65 .
Medications used to treat gamey lineage pressure include :

• Diuretics. Diuretics, sometimes called body of water pills, are medications that help your kidneys eliminate sodium and water from the body. These drugs are frequently the first medications tried to treat high blood atmospheric pressure .
  There are different classes of diuretics, including thiazide, loop and potassium spar. Which one your doctor of the church recommends depends on your rake coerce measurements and other health conditions, such a kidney disease or heart failure. Diuretics normally used to treat lineage pressure include chlorthalidone, hydrochlorothiazide ( Microzide ) and others .
  A common side effect of diuretics is increase micturition, which could reduce potassium levels. If you have a abject potassium tied, your sophisticate may add a potassium-sparing diuretic drug — such as triamterene ( Dyazide, Maxide ) or spironolactone ( Aldactone ) — to your treatment .
• Angiotensin-converting enzyme (ACE) inhibitors. These medications — such as lisinopril (Prinivil, Zestril), benazepril (Lotensin), captopril and others — help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels.
• Angiotensin II receptor blockers (ARBs). These medications relax blood vessels by blocking the action, not the formation, of a natural chemical that narrows blood vessels. ARBs include candesartan (Atacand), losartan (Cozaar) and others.
• Calcium channel blockers. These medications — including amlodipine ( Norvasc ), diltiazem ( Cardizem, Tiazac, others ) and others — help relax the muscles of your rake vessels. Some dense your heart rate. Calcium channel blockers may work better for older people and people of African inheritance than do ACE inhibitors entirely .
  Do n’t eat or drink grapefruit products when taking calcium duct blockers. Grapefruit increases blood levels of certain calcium channel blockers, which can be dangerous. Talk to your doctor or pharmacist if you ‘re concerned about interactions .

Additional medications sometimes used to treat high blood pressure

If you ‘re having trouble reaching your blood coerce goal with combinations of the above medications, your doctor of the church may prescribe :

• Alpha blockers. These medications reduce nerve signals to blood vessels, lowering the effects of natural chemicals that narrow blood vessels. Alpha blockers include doxazosin (Cardura), prazosin (Minipress) and others.
• Alpha-beta blockers. Alpha-beta blockers block nerve signals to blood vessels and slow the heartbeat to reduce the amount of blood that must be pumped through the vessels. Alpha-beta blockers include carvedilol (Coreg) and labetalol (Trandate).
• Beta blockers. These medications reduce the workload on your heart and widen your blood vessels, causing your heart to beat slower and with less force out. Beta blockers include acebutolol, atenolol ( Tenormin ) and others .
  Beta blockers are n’t normally recommended as the alone medication you ‘re prescribed, but they may be effective when combined with other blood pressure medications .
• Aldosterone antagonists. These drugs also are considered diuretics. Examples are spironolactone and eplerenone (Inspra). These drugs block the effect of a natural chemical that can lead to salt and fluid buildup, which can contribute to high blood pressure. They may be used to treat resistant hypertension.
• Renin inhibitors. Aliskiren ( Tekturna ) slows the production of renin, an enzyme produced by your kidneys that starts a chain of chemical steps that increases blood pressure .
  due to a risk of serious complications, including stroke, you should n’t take aliskiren with ACE inhibitors or ARBs .
• Vasodilators. These medications include hydralazine and minoxidil. They work directly on the muscles in the walls of your arteries, preventing the muscles from tightening and your arteries from narrowing.
• Central-acting agents. These medications prevent your brain from telling your nervous system to increase your heart rate and narrow your blood vessels. Examples include clonidine (Catapres, Kapvay), guanfacine (Intuniv) and methyldopa.

Treating resistant hypertension

If your blood pressure remains stubbornly high despite taking at least three different types of high lineage coerce drugs, one of which normally should be a diuretic drug, you may have insubordinate high blood pressure .
You ‘re besides considered to have immune high blood pressure if you have controlled high blood pressure but are taking four different types of medications at the same time to achieve that manipulate. If you do, your doctor of the church should investigate the hypothesis of a secondary cause of the eminent blood coerce .
Having tolerant high blood pressure does n’t mean your rake blackmail will never get lower. If you and your doctor can determine the causal agent, a more effective treatment plan can be created to help you meet your goal blood blackmail .
Treating repellent high blood pressure may involve many steps, including :

• Changing your high blood pressure medications to determine which combinations and doses work best
• Reviewing all the medications you take, including those that you take for other conditions or buy without a prescription
• Monitoring your blood pressure at home to see if going to the doctor causes your blood pressure to increase (white coat hypertension)
• Making healthy lifestyle changes, such as eating a healthy diet with less salt, maintaining a healthy weight and limiting alcohol

You should always take blood blackmail medications as positive. Never skip a acid or abruptly stop taking your blood atmospheric pressure medication. abruptly stopping certain blood pressure drugs, such as beta blockers, can cause a abrupt increase in lineage pressure ( rebound high blood pressure ) .
If you skip doses because you ca n’t afford the medications, because you have side effects or because you simply forget to take your medications, talk to your doctor about solutions. Do n’t change your treatment without your doctor ‘s guidance .

Potential future treatments

Researchers continue to study catheter-based sonography and radiofrequency ablation of the kidney ‘s harmonic nerves ( nephritic denervation ) as a treatment for insubordinate high blood pressure. early studies showed some benefit, but more-robust studies found that the therapy does not significantly lower blood pressure in people with repellent high blood pressure. More research is afoot to determine what function, if any, this therapy may have in treating high blood pressure.

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explore Mayo Clinic studies testing newfangled treatments, interventions and tests as a mean to prevent, detect, process or oversee this condition .

Lifestyle and home remedies

life style changes can help you control and prevent high gear blood coerce, even if you ‘re taking blood pressure medication. here ‘s what you can do :

• Eat healthy foods. Eat a heart-healthy diet. Try the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains, poultry, fish and low-fat dairy foods. Get plenty of potassium, which can help prevent and control high blood pressure. Eat less saturated fat and trans fat.
• Decrease the salt in your diet. Aim to limit sodium to less than 2,300 milligrams ( magnesium ) a day or less. however, a lower sodium intake — 1,500 magnesium a day or less — is ideal for most adults .
  While you can reduce the come of salt you eat by putting down the saltshaker, you by and large should besides pay care to the come of salt that ‘s in the processed foods you eat, such as displace soups or fixed dinners .
• Maintain a healthy weight. Keeping a healthy weight, or losing weight if you’re overweight or obese, can help you control your high blood pressure and lower your risk of related health problems. In general, you may reduce your blood pressure by about 1 mm Hg with each kilogram (about 2.2 pounds) of weight you lose.
• Increase physical activity. Regular physical activity can help lower your blood atmospheric pressure, do try, keep your weight under control and reduce your gamble of many health conditions. If you have high blood pressure, reproducible moderate- to high-intensity workouts can lower your peak blood press read by about 11 mm Hg and the bed number by about 5 mm Hg .
  Aim for at least 150 minutes a workweek of moderate aerobic activeness or 75 minutes a week of vigorous aerobic activity, or a combination of moderate and vigorous natural process. For example, try bracing walking for about 30 minutes most days of the week. Or try interval train, in which you alternate short bursts of intense natural process with short recovery periods of lighter activity. Aim to do muscle-strengthening exercises at least two days a week .
• Limit alcohol. Even if you’re healthy, alcohol can raise your blood pressure. If you choose to drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women, and up to two drinks a day for men. One drink equals 12 ounces of beer, 5 ounces of wine or 1.5 ounces of 80-proof liquor.
• Don’t smoke. Tobacco can injure blood vessel walls and speed up the process of buildup of plaque in the arteries. If you smoke, ask your doctor to help you quit.
• Manage stress. Reduce stress as much as possible. Practice healthy coping techniques, such as muscle relaxation, deep breathing or mindfulness. Getting regular physical activity and plenty of sleep can help, too.
• Monitor your blood pressure at home. Home blood imperativeness monitoring allows you to keep a casual log of rake press measurements. Your sophisticate can review the information to determine if your medicine is working or if you ‘re having complications. Home blood pressure monitoring is n’t a substitute for visits to your doctor of the church. evening if you get normal readings, do n’t stop or change your medications or alter your diet without talking to your doctor first .
  If your blood pressure is under operate, ask your repair about how frequently you need to check it .
• Practice relaxation or slow, deep breathing. Practice taking deep, slow breaths to help relax. Some research shows that slow, paced breathing (five to seven deep breaths per minute) combined with mindfulness techniques can reduce blood pressure. There also are some devices available that promote slow, deep breathing. According to the American Heart Association, device-guided breathing may be a reasonable nondrug option for lowering blood pressure, especially if you have anxiety with high blood pressure or can’t tolerate standard treatments well.
• Control blood pressure during pregnancy. Women with high blood pressure should discuss with their doctors how to control their blood pressure during pregnancy.

Alternative medicine

Although diet and drill are the most appropriate tactics to lower your blood pressure, some supplements besides may help lower it. however, more inquiry is needed to determine the likely benefits. These supplements include :

• Fiber, such as blond psyllium and wheat bran
• Minerals, such as magnesium, calcium and potassium
• Folic acid
• Supplements or products that increase nitric oxide or widen blood vessels (vasodilators), such as cocoa, coenzyme Q10, L-arginine and garlic
• Omega-3 fatty acids, found in fatty fish, high-dose fish oil supplements and flaxseed

Researchers are besides studying whether vitamin D can reduce blood pressure, but tell is conflicting. More inquiry is needed .
While it ‘s best to include these supplements in your diet as foods, you can besides take accessory pills or capsules. Talk to your repair before adding any of these supplements to your lineage pressure treatment. Some supplements can interact with medications, causing harmful side effects, such as an increased shed blood risk that could be dangerous .
You can besides drill easiness techniques, such as deep breathe or mindfulness, to help you relax and reduce your stress flat. These practices may temporarily reduce your rake coerce .

Coping and support

high blood coerce is n’t a trouble that you can treat and then ignore. It ‘s a condition you need to manage for the rest of your life. To keep your blood pressure under see :

• Take your medications properly. If side effects or costs pose problems, don’t stop taking your medications. Ask your doctor about other options.
• Schedule regular doctor visits. It takes a team effort to treat high blood pressure successfully. Your doctor can’t do it alone, and neither can you. Work with your doctor to bring your blood pressure to a safe level and keep it there.
• Adopt healthy habits. Eat healthy foods, lose excess weight and get regular physical activity. Limit alcohol. If you smoke, quit.
• Manage stress. Say no to extra tasks, release negative thoughts, maintain good relationships, and remain patient and optimistic.

Sticking to life style changes can be difficult, specially if you do n’t see or feel any symptoms of high blood coerce. If you need motivation, remember the risks associated with uncontrolled senior high school rake pressure. It may help to enlist the support of your family and friends american samoa well .

Preparing for your appointment

If you think you may have high lineage pressure, make an appointment with your doctor to have your blood imperativeness checked .
No limited preparations are necessity to have your blood pressure checked. You might want to wear a short-sleeved shirt to your appointment so that the lineage pressure cuff can fit around your arm properly. Avoid eat, drinking caffeinated beverages and smoking right before your test. plan to use the toilet before having your blood imperativeness measured .
Because some medications, such as nonprescription cold medicines, pain medications, antidepressants, birth control pills and others, can raise your rake pressure, it might be a beneficial estimate to bring a list of medications and supplements you take to your doctor ‘s appointment. Do n’t stop taking any prescription medications that you think may affect your rake blackmail without your doctor ‘s advice .
Because appointments can be brief, and because there ‘s frequently a bunch to discuss, it ‘s a good theme to be prepared for your appointment. here ‘s some information to help you get cook for your appointment, and what to expect from your doctor of the church .

What you can do

• Write down any symptoms that you’re having. High blood pressure rarely has symptoms, but it’s a risk factor for heart disease. Letting your doctor know if you have symptoms such as chest pains or shortness of breath can help your doctor decide how aggressively to treat your high blood pressure.
• Write down key personal information, including a family history of high blood pressure, high cholesterol, heart disease, stroke, kidney disease or diabetes, and any major stresses or recent life changes.
• Make a list of all medications, vitamins or supplements that you’re taking.
• Take a family member or friend along, if possible. Sometimes it can be difficult to remember all the information provided to you during an appointment. Someone who accompanies you may remember something that you missed or forgot.
• Be prepared to discuss your diet and exercise habits. If you don’t already follow a diet or exercise routine, be ready to talk to your doctor about any challenges you might face in getting started.
• Write down questions to ask your doctor.

Your clock with your doctor of the church is limited, so preparing a list of questions will help you make the most of your time together. List your questions from most authoritative to least authoritative in lawsuit fourth dimension runs out. For high lineage press, some basic questions to ask your doctor of the church include :

• What kinds of tests will I need?
• Do I need any medications?
• What foods should I eat or avoid?
• What’s an appropriate level of physical activity?
• How often do I need to schedule appointments to check my blood pressure?
• Should I monitor my blood pressure at home?
• What are the alternatives to the primary approach that you’re suggesting?
• I have other health conditions. How can I best manage them together?
• Are there any restrictions that I need to follow?
• Should I see a specialist?
• Is there a generic alternative to the medicine you’re prescribing for me?
• Are there any brochures or other printed material that I can take home with me?
• What websites do you recommend visiting?

In addition to the questions that you ‘ve prepared to ask your repair, do n’t hesitate to ask questions during your date at any clock that you do n’t understand something .

What to expect from your doctor

Your doctor is probable to ask you a number of questions. Being fix to answer them may reserve time to go over any points you want to spend more time on. Your doctor may ask :

• Do you have a family history of high cholesterol, high blood pressure or heart disease?
• What are your diet and exercise habits like?
• Do you drink alcohol? How many drinks do you have in a week?
• Do you smoke?
• When did you last have your blood pressure checked? What was your blood pressure measurement then?

What you can do in the meantime

It ‘s never excessively early on to make goodly life style changes, such as quitting fume, eating healthy foods and getting more exercise. These are main ways to protect yourself against gamey blood pressure and its complications, including heart attack and stroke .

source : https://meopari.com
Category : How To