Hypertension, also known as the "silent killer," is a common ailment that affects more than 65 million Americans. Many individuals with high blood pressure do not know they have hypertension until it is discovered during a routine medical examination. Few experience any symptoms, however when symptoms do occur they may include headache, dizziness, shortness of breath, chest pain or altered vision. Untreated, high blood pressure can lead to many serious conditions such as heart disease, stroke and kidney failure.

Blood pressure is the force of a pump (the heart) squeezing fluid (blood) against a fixed resistance (the diameter of the blood vessels). This value is measured with a blood pressure cuff. The cuff is placed around the upper arm and then inflated with air. Your physician will then place a stethoscope on your upper arm and deflate the cuff. When they hear your heart beat he/she will record that number (the "systolic" blood pressure -- the "top number") and when your heart beat sound disappears, he/she records that number (the "diastolic" blood pressure -- the "bottom number").

Several years ago, an ideal blood pressure measurement was considered to be 120/80. It was also believed that blood pressures below 140/90 required no treatment. However, recent studies have shown that these blood pressure values were actually too high and new recommendations suggest that the ideal blood pressure be around 110/70.

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Fact box

Factors that may increase the risk of developing high blood pressure:

Genetics;

Obesity;

Dietary indiscretion;

Medications;

Age;

Smoking;

Diabetes;

Chronic kidney disease.

Diet and lifestyle recommendations to decrease high blood pressure:

Weight loss -- Weight loss can result in decreasing the pressure exerted on the blood vessels, thereby lowering blood pressure.

Minimize sodium intake -- Salt has been shown to increase fluid retention which may raise blood pressure.

Stress -- Stress and anxiety have been shown to transiently raise blood pressure. Constant stress can lead to organ damage.

Exercise -- Daily moderate exercise lowers blood pressure by dilating the arteries.

Relaxation -- Yoga and meditation are a few relaxation techniques helpful in reducing stress and lower blood pressure.

Medications

ACE Inhibitors work in the kidneys by dilating the size of the arteries. Side effects may include a cough or rash.

Alpha Blockers dilate the arteries by relaxing the muscles within the artery wall. Side effects may include dizziness and a rapid heart rate.

Angiotensin Receptor Blocker (ARB) works in the kidney by blocking a chemical which then dilates the artery diameter. The most common side effect is dizziness.

Beta-Blockers slow the heart rate and reduce the force of the heart. Side effects include fatigue and decreased libido. Patients with asthma and diabetes need to use these drugs with caution.

Calcium Channel Blockers work by directly enlarging the size of the arteries and reducing the force of the heart. Side effects include swelling or edema of the extremities.

Central Agonist works in the brain to dilate the size of the arteries. Side effects may include dizziness, dry mouth and fatigue.

Diuretics (water pills) decrease the amount of fluid volume in the arteries. Side effects may include frequent urination, dehydration and electrolyte (sodium, potassium) depletion.

Vasodilators directly dilate the size of the blood vessel. Side effects may include headache, swelling and hair growth.

Many of the above medication classes are often combined to improve efficacy.

Recommendations

Visit your doctor annually to have your blood pressure checked.

Home blood pressure machines are very affordable and can indicate elevations.

Quit smoking, maintain a low salt diet and exercise daily. All have been shown to reduce the risk of high blood pressure.

Maintain a healthy weight as this will have a positive influence on your blood pressure.

Never take a "friends" blood pressure pill. What may work for them, may adversely affect you.

Limit your alcohol use. Too much alcohol can worsen high blood pressure.

Take your medication as directed. Most blood pressure medications need to be taken on a daily basis. Missing a dose may result in a rapid elevation in blood pressure.

Many blood pressure medications come in generic forms. Discuss this cost saving strategy with your physician.

If you become dizzy on a blood pressure medication, your pressure may be too low. Visit your doctor and have the numbers checked.

High blood pressure may be silent, but can adversely affect your health. With proper diagnosis and treatment, blood pressure can be controlled. Visit your physician and have your blood pressure checked today -- it could save your life.

Dr. Michael Schwartz is board certified in internal medicine with a private practice in Darien. For comments or questions, please visit his website at www.drmichaelbschwartz.com.