High Blood Pressure

doctor measuring blood pressure

High blood pressure is a blood pressure reading of 140/90 mmHg or higher.
Both numbers are important.

Nearly one in three American adults has
high blood pressure. Once high blood pressure develops, it usually lasts a
lifetime. The good news is that it can be treated and controlled.

High
blood pressure is called “the silent killer” because it usually has no symptoms.
Some people may not find out they have it until they have trouble with their
heart, brain, or kidneys. When high blood pressure is not found and treated, it
can cause:

  • The heart to get larger, which may lead to heart failure.
  • Small bulges (aneurysms) to form in blood vessels. Common locations
    are the main artery from the heart (aorta), arteries in the brain, legs, and
    intestines, and the artery leading to the spleen.
  • Blood vessels in the kidney to narrow, which may cause kidney
    failure.
  • Arteries throughout the body to “harden” faster, especially those in
    the heart, brain, kidneys, and legs. This can cause a heart attack, stroke,
    kidney failure, or amputation of part of the leg.
  • Blood vessels in the eyes to burst or bleed, which may cause vision
    changes and can result in blindness.

What is blood pressure?
Blood is carried from the heart to all
parts of your body in vessels called arteries. Blood pressure is the force of
the blood pushing against the walls of the arteries. Each time the heart beats
(about 60-70 times a minute at rest), it pumps out blood into the arteries. Your
blood pressure is at its highest when the heart beats, pumping the blood. This
is called systolic pressure. When the heart is at rest, between beats, your
blood pressure falls. This is the diastolic pressure.

Blood pressure is
always given as these two numbers, the systolic and diastolic pressures. Both
are important. Usually they are written one above or before the other, such as
120/80 mmHg. The top number is the systolic and the bottom the diastolic. When
the two measurements are written down, the systolic pressure is the first or top
number, and the diastolic pressure is the second or bottom number (for example,
120/80). If your blood pressure is 120/80, you say that it is “120 over 80.”

Blood pressure changes during the day. It is lowest as you sleep and
rises when you get up. It also can rise when you are excited, nervous, or
active.

Still, for most of your waking hours, your blood pressure stays
pretty much the same when you are sitting or standing still. That level should
be lower than 120/80. When the level stays high, 140/90 or higher, you have high
blood pressure. With high blood pressure, the heart works harder, your arteries
take a beating, and your chances of a stroke, heart attack, and kidney problems
are greater.

What is normal blood pressure?
A blood pressure
reading below 120/80 is considered normal. In general, lower is better. However,
very low blood pressures can sometimes be a cause for concern and should be
checked out by a doctor.

Doctors classify blood pressures under 140/90
as either “normal,” or “prehypertension.”

  • “Normal” blood pressures are lower than 120/80.
  • “Prehypertension” is blood pressure between 120 and 139 for the top
    number, or between 80 and 89 for the bottom number. For example, blood pressure
    readings of 138/82, 128/89, or 130/86 are all in the “prehypertension” range. If
    your blood pressure is in the prehypertension range, it is more likely that you
    will end up with high blood pressure unless you take action to prevent it.

What is high blood pressure?
A blood pressure of 140/90 or higher
is considered high blood pressure. Both numbers are important. If one or both
numbers are usually high, you have high blood pressure. If you are being treated
for high blood pressure, you still have high blood pressure even if you have
repeated readings in the normal range.

There are two levels of high
blood pressure: Stage 1 and Stage 2 (see the chart below).

Categories
for Blood Pressure Levels in Adults*

(In mmHg, millimeters of mercury)

CategorySystolic
(Top number)
Diastolic
(Bottom number)
NormalLess than 120Less than 80
Prehypertension120-13980-89
High Blood PressureSystolicDiastolic
Stage 1140-15990-99
Stage 2160 or higher100 or higher

* For adults 18
and older who:

  • Are not on medicine for high blood pressure
  • Are not having a short-term serious illness
  • Do not have other conditions such as diabetes and kidney disease

Note: When systolic and diastolic blood pressures fall into different
categories, the higher category should be used to classify blood pressure level.
For example, 160/80 would be stage 2 high blood pressure.
There is an
exception to the above definition of high blood pressure. A blood pressure of
130/80 or higher is considered high blood pressure in persons with diabetes and
chronic kidney disease.

Other Names

General

  • HBP
  • Hypertension
  • HTN

Caused by another condition

  • Secondary hypertension

Other

  • Essential hypertension
  • Primary hypertension
  • Idiopathic hypertension

What Causes High Blood Pressure?

In many people with high blood pressure, a single specific cause is not
known. This is called essential or primary high blood pressure. Research is
continuing to find causes.

In some people, high blood pressure is the
result of another medical problem or medication. When the cause is known, this
is called secondary high blood pressure.

Who Gets High Blood
Pressure?

About 65 million American adults–nearly 1 in 3–have high
blood pressure.

In the U.S., high blood pressure occurs more often in
African Americans. Compared to other groups, blacks:

  • Tend to get high blood pressure earlier in life
  • Usually have more severe high blood pressures
  • Have a higher death rate from stroke, heart disease, and kidney
    failure.

Many people get high blood pressure as they get older. Over half of all
Americans age 60 and older have high blood pressure. This is not a part of
healthy aging
! There are things you can do to help keep your blood pressure
normal, such as eating a healthy diet and getting more exercise.

Your
chances of getting high blood pressure are also higher if you:

  • Are overweight
  • Are a man over the age of 45
  • Are a woman over the age of 55
  • Have a family history of high blood pressure
  • Have a “prehypertension (120-139/80-89)”

Other things that can raise blood pressure include:

  • Eating too much salt
  • Drinking too much alcohol
  • Not eating enou

Colds

woman laying in bed with tissue

Sneezing, scratchy throat, runny nose-everyone knows the first signs of a cold,
probably the most common illness known. Although the common cold is usually
mild, with symptoms lasting 1 to 2 weeks, it is a leading cause of doctor visits
and missed days from school and work. According to the Centers for Disease
Control and Prevention, 22 million school days are lost annually in the United
States due to the common cold.

In the course of a year, people in the United States suffer 1 billion colds,
according to some estimates.

Children have about 6 to 10 colds a year. One important reason why colds are
so common in children is because they are often in close contact with each other
in daycare centers and schools. In families with children in school, the number
of colds per child can be as high as 12 a year. Adults average about 2 to 4
colds a year, although the range varies widely. Women, especially those aged 20
to 30 years, have more colds than men, possibly because of their closer contact
with children. On average, people older than 60 have fewer than one cold a year.

CAUSES

The
Viruses

More than 200 different viruses are known to cause the symptoms of the common
cold. Some, such as the rhinoviruses, seldom produce serious illnesses. Others,
such as parainfluenza and respiratory syncytial virus, produce mild infections
in adults but can precipitate severe lower respiratory infections in young
children.

Rhinoviruses (from the Greek rhin, meaning “nose”) cause an estimated
30 to 35 percent of all adult colds, and are most active in early fall, spring,
and summer. More than 110 distinct rhinovirus types have been identified. These
agents grow best at temperatures of about 91 degrees Fahrenheit, the temperature
inside the human nose.

Scientists think coronaviruses cause a large percentage of all adult colds.
They bring on colds primarily in the winter and early spring. Of the more than
30 kinds, three or four infect humans. The importance of coronaviruses as a
cause of colds is hard to assess because, unlike rhinoviruses, they are
difficult to grow in the laboratory.

Approximately 10 to 15 percent of adult colds are caused by viruses also
responsible for other, more severe illnesses: adenoviruses, coxsackieviruses,
echoviruses, orthomyxoviruses (including influenza A and B viruses, which cause
flu), paramyxoviruses (including several parainfluenza viruses), respiratory
syncytial virus, and enteroviruses.

The causes of 30 to 50 percent of adult colds, presumed to be viral, remain
unidentified. The same viruses that produce colds in adults appear to cause
colds in children. The relative importance of various viruses in pediatric
colds, however, is unclear because it’s difficult to isolate the precise cause
of symptoms in studies of children with colds.

The weather

There is no evidence that you can get a cold from exposure to cold weather or
from getting chilled or overheated.

Other factors

There is also no evidence that your chances of getting a cold are related to
factors such as exercise, diet, or enlarged tonsils or adenoids. On the other
hand, research suggests that psychological stress and allergic diseases
affecting your nose or throat may have an impact on your chances of getting
infected by cold viruses.

THE COLD SEASON

In the United States, most
colds occur during the fall and winter. Beginning in late August or early
September, the rate of colds increases slowly for a few weeks and remains high
until March or April, when it declines. The seasonal variation may relate to the
opening of schools and to cold weather, which prompt people to spend more time
indoors and increase the chances that viruses will spread to you from someone
else.

Seasonal changes in relative humidity also may affect the prevalence of
colds. The most common cold-causing viruses survive better when humidity is
low-the colder months of the year. Cold weather also may make the inside lining
of your nose drier and more vulnerable to viral infection.

SYMPTOMS

Symptoms of the common cold usually
begin 2 to 3 days after infection and often include

  • Mucus buildup in your nose
  • Difficulty breathing through your nose
  • Swelling of your sinuses
  • Sneezing
  • Sore throat
  • Cough
  • Headache

Fever is usually slight but can climb to 102 degrees Fahrenheit in infants
and young children. Cold symptoms can last from 2 to 14 days, but like most
people, you’ll probably recover in a week. If symptoms occur often or last much
longer than 2 weeks, you might have an allergy rather than a cold.

Colds occasionally can lead to bacterial infections of your middle ear or
sinuses, requiring treatment with antibiotics. High fever, significantly swollen
glands, severe sinus pain, and a cough that produces mucus, may indicate a
complication or more serious illness requiring a visit to your healthcare
provider.

TRANSMISSION

You can get infected by cold
viruses by either of these methods.

  • Touching your skin or environmental surfaces, such as telephones and stair
    rails, that have cold germs on them and then touching your eyes or nose
  • Inhaling drops of mucus full of cold germs from the air

TREATMENT

There is no cure for the common cold, but you can get relief
from your cold symptoms by

  • Resting in bed
  • Drinking plenty of fluids
  • Gargling with warm salt water or using throat sprays or lozenges for a
    scratchy or sore throat
  • Using petroleum jelly for a raw nose
  • Taking aspirin or acetaminophen, Tylenol, for example, for headache or fever

A word of caution: Several studies have linked aspirin use to the
development of Reye’s syndrome in children recovering from flu or chickenpox.
Reye’s syndrome is a rare but serious illness that usually occurs in children
between the ages of 3 and 12 years. It can affect all organs of the body but
most often the brain and liver. While most children who survive an episode of
Reye’s syndrome do not suffer any lasting consequences, the illness can lead to
permanent brain damage or death. The American Academy of Pediatrics recommends
children and teenagers not be given aspirin or medicine containing aspirin when
they have any viral illness such as the common cold.

Over-the-counter cold medicines

Nonprescription cold remedies, including decongestants and cough
suppressants, may relieve some of your cold symptoms but will not prevent or
even shorten the length of your cold. Moreover, because most of these medicines
have some side effects, such as drowsiness, dizziness, insomnia, or upset
stomach, you should take them with care.

Over-the counter-antihistamines

Nonprescription antihistamines may give you some relief from symptoms such as
runny nose and watery eyes which are commonly associated with colds.

Antibiotics

Never take antibiotics to treat a cold because antibiotics do not kill
viruses. You should use these prescription medicines only if you have a rare
bacterial complication, such as sinusitis or ear infections. In addition, you
should not use antibiotics “just in case” because they will not prevent
bacterial infections.

Steam

Although inhaling steam may temporarily relieve symptoms of congestion,
health experts have found that this approach is not an effective treatment.

PREVENTION

There are several ways you can keep yourself from getting a
cold or passing one on to others