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High blood pressure

Why do I have high blood pressure?

“Many people have what we call essential hypertension, which means they are genetically predisposed to have high blood pressure, even if they are a normal weight,” says Joe Miller III, M.D., a cardiologist and expert in preventative medicine. “High blood pressure can also be caused by the wrong lifestyle choices, like being sedentary, smoking, being overweight, stress, eating too much salt and drinking more than two alcoholic beverages a day.”

High blood pressure causes blood vessels to stiffen, which can lead to heart failure when left untreated. “We call hypertension ‘the silent killer’ because it often doesn’t have symptoms,” Dr. Miller explains. “Some people will feel stressed, uneasy, anxious and out of breath. They may also experience chest discomfort and headaches.”

In adults, physicians diagnose high blood pressure if the following conditions are met:

  • Systolic pressure of 140 mm Hg or higher
  • Diastolic pressure of 90 mm Hg or higher

Lifestyle Factors

If your physician tells you that you have high blood pressure, there are several ways you can lower it initially without medication:

  • Stress Reduction
  • Weight loss
  • Smoking cessation
  • Physical activity
  • Healthy diet
  • Decreasing sodium intake
  • Reducing alcohol consumption  

To treat hypertension, Dr. Miller advises overweight patients to begin with weight loss through a healthy diet and exercise. He recommends being physically active for at least 20 minutes, four times a week.

He notices a difference in blood pressure levels in patients who have high-stress jobs. “They might be hypertensive at work during the week, but have normal blood pressure on weekends,” says Dr. Miller. “Stress increases adrenaline levels and the body responds by raising blood pressure.”

Frequent short-term spikes in blood pressure, such as those that occur from work-related stress, can lead to blood vessel and heart damage over time. “If lifestyle changes don’t help, that’s when you talk to your doctor about medication.”

Long-Term Consequences and Treatment

Hypertension increases the risk of both stroke and heart attack. “It causes wear and tear on the blood vessels, which can then rupture and cause a stroke,” he says. “Typically, blood vessels dilate when there is an increased demand for blood flow, such as during exercise. Stiffer blood vessels don’t dilate as well and over time can cause problems and weaken the heart.”

When lifestyle modifications do not help, especially in people who are genetically predisposed to high blood pressure, there are several classes of medications that effectively treat high blood pressure, including diuretics, ACE inhibitors and beta blockers.

By working with your physician, you can get your blood pressure under control, reducing your risk of serious health events.

Need to make an appointment with a Piedmont physician? Save time, book online.

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