High Blood Pressure or
Hypertension
(HTN) is an arbitrarily defined condition in which the systolic or
highest
pressure(SBP) in the blood vessel system or the diastolic or lowest
pressure(DBP)
in the blood vessel system regularly exceeds
particular amounts while the
person
is at rest. What has been defined as HTN has changed over
time.
In the 1950s and 1960s it was commonly believed that the upper limit
for
the systolic pressure was determined by adding 120 to the person's age,
thus suggesting the higher acceptable limit for someone 70 years of age
as being 190 (units are mm of mercury or mmHg by convention). We
now understand that that was very wrong and no one's systolic pressure
should exceed 140 and more conservative opinions hold that 130 should
be
considered the higher threshold for intervention. Likewise, the
lower
blood pressure in the circulatory system or diastolic pressure has
received
similar attention suggesting that 90 is the uppermost tolerable value
and
more conservative opinions opt for the mid 80s as the threshold
mandating
treatment.
What causes High Blood
Pressure?
There are many causes of HTN
and
some are to date unknown with speculation on the part of doctors
continuing
to be offered. Those causes accepted for HTN include hormone
imbalances
associated with the adrenal glands, peripheral vascular disease
affecting
the blood supply to one or the other kidney, tumor produced chemicals
which
act like adrenalin, and something known as essential hypertension which
has not had a cause identifed.
What should happen when I
have
been found to need treatment?
Once you are found to have HTN
you
qualify for treatment. Unfortunately, there is little to be done
by way of lifestyle adjustments to make the blood pressure
normalize.
Elimination of the consumption of alcoholic beverages and moderation in
salt intake represent two of the most potent non-medication
treatments.
At the time of initial evaluation certain simple tests including blood
testing and physical examination is performed. If the blood
pressure
is exceedingly high or difficult to control, additional and special
testing
for the cause of the HTN is undertaken. This is done because
there
are some treatable causes of HTN which, once corrected, will be
associated
with the normalization of the blood pressure.
Testing for the various
types
of HTN can be performed by most doctors and treatment is
straightforward
although it still involves a trial and error approach as to which of
the
various medications will best control the patient's HTN. Certain
medications are generally believed to best serve certain patients
depending
on their co-existing medical diseases, but the effectiveness and
tolerability
of any particular drug is variable from one patient to the next.
