Exercise stress test: More commonly used for patients with borderline hypertension. This usually involves pedaling a stationary bicycle or walking on a treadmill. The stress test assesses how the body's cardiovascular system responds to increased physical activity. If the patient has hypertension this data is important to know before the exercise test starts. The test monitors the electrical activity of the heart, as well as the patient's blood pressure during exercise. An exercise stress test sometimes reveals problems that are not apparent when the body is resting. Imaging scans of the heart's blood supply might be done at the same time.
When a direct cause for high blood pressure can be identified, the condition is described as secondary hypertension. Among the known causes of secondary hypertension, kidney disease ranks highest. Hypertension can also be triggered by tumors or other abnormalities that cause the adrenal glands (small glands that sit atop the kidneys) to secrete excess amounts of the hormones that elevate blood pressure. Birth control pills -- specifically those containing estrogen -- and pregnancy can boost blood pressure, as can medications that constrict blood vessels.
Whelton PK, et al. (2017). Guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: A report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. Journal of the American College of Cardiology, published online November 13, 2017. DOI: 10.1016/j.jacc.2017.11.006. Accessed November 20, 2017.
National data shows that isolated systolic hypertension is becoming increasingly common among young adults, and study findings raise concern about its effect on heart health. Isolated systolic hypertension is often overlooked in young and middle-aged adults, as most studies on the issue involve older adults, among whom the condition is most common. But current findings suggest that isolated systolic hypertension does, in fact, have a serious impact on the cardiovascular health of young adults. As such, researchers encourage future research to better identify and treat young adults with isolated systolic hypertension who are at greatest risk for heart events.
Blood pressure isn’t just a number. Chronically elevated blood pressure (hypertension) significantly increases your risk of heart disease, stroke, congestive heart failure, erectile dysfunction, eye disease (retinopathy), and kidney disease. Heart disease and stroke are two of the top five causes of death in the US (heart disease is #1), and hypertension is such a big contributor to both that the CDC claims hypertension was at least partially responsible for 410,000 deaths in the US in 2014.
Though essential hypertension remains somewhat mysterious, it has been linked to certain risk factors. High blood pressure tends to run in families and is more likely to affect men than women. Age and race also play a role. In the United States, blacks are twice as likely as whites to have high blood pressure, although the gap begins to narrow around age 44. After age 65, black women have the highest incidence of high blood pressure.
High cholesterol is associated with an elevated risk of cardiovascular disease. That can include coronary heart disease, stroke, and peripheral vascular disease. High cholesterol has also been linked to diabetes and high blood pressure. To prevent or manage these conditions, work with your doctor to see what steps you need to take to lower your cholesterol.
Recent research shows that lowering your blood pressure below these levels decreases your risk of heart attacks and all-cause mortality. That’s right—lowering your blood pressure has a direct impact on your life expectancy. In fact, a person with a systolic pressure of 135 has double the risk of heart disease as someone with a systolic pressure of 115. Same goes for a diastolic pressure of 85 instead of 75. 10 points might not seem like much, but every blood pressure increase has a big impact on your health.
Recent updates to guidelines from the American Heart Association and the American College of Cardiology changed the definition of high blood pressure or hypertension for most people. High blood pressure is now generally defined as 130 or higher for the first number, or 80 or higher for the second number (previously it was 140/90). However, there are important considerations for older adults in deciding whether to start treatment for high blood pressure, including other health conditions and overall fitness. If your blood pressure is above 130/80, your doctor will evaluate your health to determine what treatment is needed to balance risks and benefits in your particular situation.
Isolated systolic hypertension can be caused by underlying conditions such as artery stiffness, an overactive thyroid (hyperthyroidism) or diabetes. Occasionally, it can be caused by heart valve problems. It is the most common form of high blood pressure in people older than age 65, but it is possible for younger people to be affected by this type of high blood pressure as well.
When discussing blood pressure issues, the healthcare professional may ask questions about past medical history, family history, and medication use, including prescriptions, over-the-counter medications, herbal remedies, and food additives. Other questions may include lifestyle habits, including activity levels, smoking, alcohol consumption, and illegal drug use.
For older people, often the first number (systolic) is 130 or higher, but the second number (diastolic) is less than 80. This problem is called isolated systolic hypertension, which is due to age-related stiffening of the major arteries. It is the most common form of high blood pressure in older people and can lead to serious health problems (stroke, heart disease, eye problems, and kidney failure) in addition to shortness of breath during light physical activity, lightheadedness upon standing too fast, and falls. Isolated systolic hypertension is treated in the same way as regular high blood pressure (130 or higher for the first number, or 80 or higher for the second number) but may require more than one type of blood pressure medication. If your doctor determines that your systolic pressure is above a normal level for your age, ask how you can lower it.
In fact, it seems that the presence of high blood cholesterol may actually predict a future presence of high blood pressure. That’s what researchers reported in a 2005 study in Hypertension. They analyzed data from 3,110 men who had not been diagnosed with hypertension or cardiovascular disease at the start, and followed them for about 14 years. Just over 1,000 of them developed hypertension by the end of the study.
Blood tests may be done to assess risk factors for heart disease and stroke as well as looking for complications of hypertension. These include complete blood count (CBC), electrolytes, BUN (blood urea nitrogen), and creatinine and GFR (glomerular filtration rate) to measure kidney function. A fasting lipid profile will measure cholesterol and triglyceride levels in the blood. If appropriate, blood tests may be considered to look for an underlying cause of high blood pressure (secondary hypertension)including abnormal thyroid or adrenal gland function.
The main risk from high cholesterol is coronary heart disease. If the cholesterol level is too high, cholesterol can build up in the walls of your arteries. Over time, this build-up -- called plaque -- causes hardening of the arteries or atherosclerosis. This causes arteries to become narrowed, which slows the blood flow to the heart muscle. Reduced blood flow can result in angina (chest pain) or in a heart attack if a blood vessel gets blocked completely.
Blood pressure monitors for use at home can be bought at drug stores, department stores, and other places. Again, these monitors may not always give you a correct reading. You should always compare your machine’s reading with a reading from your doctor’s machine to make sure they are the same. Remember that any measurement above normal should prompt a visit to the doctor, who can then talk with you about the best course of action.
HDL cholesterol: Two types of cholesterol are found in your bloodstream: HDL and LDL. HDL is the “good” kind. It acts as a scavenger, picking up extra cholesterol and taking it back to your liver. When a doctor tests your blood for cholesterol levels, you want your HDL levels to be high. HDL levels of 60 or more help to lower your risk for heart disease.
Elevated blood pressures in the medical setting may not necessarily reflect the individuals real status. "White coat hypertension" describes a patient whose blood pressure is elevated because of the stress of the visit to the doctor or other healthcare professional, and the worry that their blood pressure might be elevated. Repeated blood pressure checks at the doctor's office or the use of a home blood pressure monitoring device may be used to confirm that you have high blood pressure.
About This Image: Person receiving a blood pressure test. Medical research shows that as we age blood pressure rises slightly to accommodate an increased demand of oxygen and nutrients. It is completely natural for the first number (systolic) to be 100 plus our age. A recent study by a group of UCLA researchers came very close to corroborating Dr. Piette's guide for blood pressure of 100 plus your age for men, subtracting 10 for women, and this is after this rule had been in use for five or more decades. Are we now being taught that Dr. Piette's guide for blood pressure is wrong merely for drug company profit?
Diabetes can upset the balance between HDL and LDL cholesterol levels. People with diabetes tend to have LDL particles that stick to arteries and damage blood vessel walls more easily. Glucose (a type of sugar) attaches to lipoproteins (a cholesterol-protein package that enables cholesterol to travel through blood). Sugarcoated LDL remains in the bloodstream longer and may lead to the formation of plaque. People with diabetes tend to have low HDL and high triglyceride (another kind of blood fat) levels. Both of these boost the risk of heart and artery disease.
Hypertension, the medical term for high blood pressure, is known as "the silent killer." More than 80 million Americans (33%) have high blood pressure, and as many as 16 million of them do not even know they have the condition. If left untreated, high blood pressure greatly increases your risk for heart attack and stroke. Hypertension is projected to increase about 8 percent between 2013 and 2030.