7 MINUTES
According to the American Heart Association, 46% of American adults have high blood pressure (hypertension).1 The higher the blood pressure, the greater risk of experiencing a heart attack, heart failure, stroke and kidney disease.2
Hypertension is defined as blood flowing through blood vessels, or arteries, at higher than normal pressures putting force against the artery wall.3 There are two different types of hypertension, primary and secondary. Primary hypertension is the result of an unidentifiable cause whereas secondary hypertension is the result of an underlying cause which needs to be corrected prior to diagnosis.4
There are numerous risk factors, specifically fixed and modifiable risk factors, that have been identified for the development of hypertension. Examples of these risk factors include:4
Blood pressure (BP) can be measured using either a manual or automated sphygmomanometer. Systolic pressure is the top number of a BP reading, which is the amount of pressure your blood is exerting against artery walls when the heart beats.5 Diastolic pressure is the bottom number of a BP reading, which is the amount of pressure your blood is exerting against artery walls between heart beats.5 In the American Heart Association’s 2017 Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults, hypertension was classified into four different stages to help healthcare providers determine proper treatment and follow-up: normal, elevated BP, stage 1 and stage 2.4
BP Category | Systolic BP/Diastolic BP |
---|---|
Normal Blood Pressure |
<120/<80 mmHg |
Elevated Blood Pressure |
120-129/<80 mmHg |
Stage 1 Hypertension |
130-139/80-89 mmHg |
Stage 2 Hypertension |
≥140/≥90 mmHg |
Hypertensive Urgency |
>180 mmHg/>120 mmHg |
Hypertensive Emergency |
>180 mmHg + target organ damage/>120 mmHg + target organ damage |
Detecting, diagnosing and managing hypertension requires a plan that extends beyond the four walls of the practice. To help, automated blood pressure monitors can average multiple readings across various settings to obtain the most accurate view of a patient’s blood pressure. As best practice, providers should:
Lifestyle changes, specifically diet and exercise, are useful for preventing and treating hypertension, especially in adults with elevated BP and milder forms of hypertension.6, 7 Nonpharmacologic therapy alone can reduce systolic blood pressure by approximately 4 to 11 mmHg.4 Patients can help manage their condition by:
As always, it is crucial that hypertensive patients follow their doctor’s treatment plan.
To help educate your patients and staff, we’ve created a helpful infographic that conveys key facts and statistics about hypertension including how to detect, diagnose and manage the condition from inside the office to the home.
References
1. American Heart Association. More than 100 million Americans have high blood pressure, AHA says. https://www.heart.org/en/news/2018/05/01/more-than-100-million-americans-have-high-blood-pressure-aha-says. Accessed December 4, 2018.
2. National Institutes of Health. National Heart, Lung, and Blood Institute. JNC 7 Express. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure.
3. National Heart, Lung, and Blood Institute. High Blood Pressure. https://www.nhlbi.nih.gov/health-topics/high-blood-pressure. Accessed September 17, 2018.
4. American Heart Association. 2017 Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults. Accessed September 13, 2018.
5. American Heart Association. Understanding Blood Pressure Readings. http://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings. Accessed September 19, 2018.
6. Whelton PK, Appel LJ, Espeland MA, et al; for the TONE Collaborative Research Group. Sodium reduction and weight loss in the treatment of hypertension in older persons: a randomized controlled trial of nonpharmacologic interventions in the elderly (TONE). JAMA. 1998;279(11):839-846.
7. Whelton PK. The elusiveness of population-wide high blood pressure control. Annu Rev Public Health. 2015;36:109-130.