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Are You Sick?

High Blood Pressure

Is this your symptom?

  • You have been told you have high blood pressure
  • You think you may have high blood pressure or are not sure
  • You have a systolic blood pressure greater than 120 or diastolic blood pressure greater than 80

Causes of High Blood Pressure (Hypertension)

  • Essential Hypertension means high blood pressure of unknown cause. Most people have this type, especially the elderly.
  • Secondary Hypertension means high blood pressure due to another health problem. Treatment of the health problem, or avoiding medicines or toxins that are the cause, will help reduce blood pressure. Examples are:
    • Kidney diseases, hormone problems and pregnancy
    • Narrowing of the aorta (the main blood vessel carrying blood away from the heart)
    • Some medicines and toxins: alcohol, cocaine, caffeine, amphetamines, birth control pills, antidepressants, some decongestants, and herbal remedies.
  • Hypertensive Crisis (serious). There are two types of crises:
    • Hypertensive urgency: systolic pressure of 180 mm Hg or higher and a diastolic of 120 mm Hg or higher. Treatment should aim to reduce blood pressure over a few days.
    • Accelerated Hypertension: systolic pressure higher than 200 mm Hg and diastolic higher than 130 mm Hg and damage to other organs (brain, kidneys, heart and lungs). This is an emergency and needs same day treatment to reduce the blood pressure quickly to prevent death.
  • Suspected Pheochromocytoma. A pheochromocytoma is a rare tumor of the adrenal glands, which are just above the kidneys. They make the hormones that control heart rate, blood pressure and metabolism. A tumor in the gland can cause it to release too much of the hormones and cause blood pressure to rise. There may also be sweating, palpitations, headaches, shaking and vomiting. Most people will need surgery to remove the tumor.
  • Hypertension in Pregnancy (serious) affects about 15% of pregnant women. These women have a higher risk of more health problems, stroke, clotting disorders, reduced growth of the baby and even death of the unborn baby. Treatment depends on the stage of pregnancy and how high the blood pressure is. Close monitoring is needed for the rest of the pregnancy and for several days after delivery.
    • Pre-existing hypertension will have been present before the pregnancy or detected before 20 weeks.
    • Gestational hypertension is caused by the pregnancy and develops after 20 weeks. It may calm down quickly or stay for the rest of the pregnancy. Untreated, pre-eclampsia or eclampsia may develop.
    • In pre-eclampsia there is pregnancy-caused hypertension, swelling and/or protein in the mother’s urine. Symptoms include severe headache, blurred vision or flashes before the eyes, severe upper abdomen pain, vomiting and sudden swelling of the hands and face.
    • Eclampsia can follow pre-eclampsia and seizures occur. This can be life-threatening for both mother and baby.
  • White Coat Hypertension. This term is used for patients who have normal blood pressure at home but raised blood pressure when measured by their doctor. Your doctor may have you wear a meter to check your blood pressure while at work, at home and while you sleep. Unneeded treatment may then be avoided.

When to Call for High Blood Pressure

When to Call for High Blood Pressure

Call 911 Now

  • You may be having a stroke or a heart attack. Symptoms could include:
    • severe chest pain
    • severe trouble breathing
    • confused
    • loss of movement in part of your body or face
    • unable to speak or slurred speech
  • Can't be awakened, hard to wake or severely sleepy
  • Seizure
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Trouble breathing, but not severe (not breathless at rest)
  • Your blood pressure (BP) is higher than 140/90 and you are postpartum (less than 2 months since giving birth)
  • BP is higher than 180 systolic and/or 120 diastolic
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Your BP is higher than 130/80 and you are pregnant or postpartum (less than 2 months after giving birth)
  • You take BP meds and you may be having side effects (cough, diarrhea or constipation, dizzy, erection problems)
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You feel well but your BP is higher than 120/80
  • Your BP is slowly getting higher over a period of time
  • You have other questions or concerns

Self Care at Home

  • BP is 120/80 (normal BP) or lower

Call 911 Now

  • You may be having a stroke or a heart attack. Symptoms could include:
    • severe chest pain
    • severe trouble breathing
    • confused
    • loss of movement in part of your body or face
    • unable to speak or slurred speech
  • Can't be awakened, hard to wake or severely sleepy
  • Seizure
  • You think you have a life-threatening emergency

Call Doctor or Seek Care Now

  • Trouble breathing, but not severe (not breathless at rest)
  • Your blood pressure (BP) is higher than 140/90 and you are postpartum (less than 2 months since giving birth)
  • BP is higher than 180 systolic and/or 120 diastolic
  • You feel weak or very sick
  • You think you need to be seen, and the problem is urgent

Contact Doctor Within 24 Hours

  • Your BP is higher than 130/80 and you are pregnant or postpartum (less than 2 months after giving birth)
  • You take BP meds and you may be having side effects (cough, diarrhea or constipation, dizzy, erection problems)
  • You think you need to be seen, but the problem is not urgent

Contact Doctor During Office Hours

  • You feel well but your BP is higher than 120/80
  • Your BP is slowly getting higher over a period of time
  • You have other questions or concerns

Self Care at Home

  • BP is 120/80 (normal BP) or lower

Care Advice for High Blood Pressure

  1. What You Should Know about Blood Pressure:
    • Blood pressure is the pressure of blood pushing against the walls of your arteries (the blood vessels which carry blood and oxygen from the heart to the rest of the body).
    • Two blood pressure measurements are recorded:
      • The systolic number is the highest of the two. It tells you what your blood pressure is when your heart is contracting.
      • The diastolic number is the lower number. It tells you what your blood pressure is when the heart is relaxed.
    • Here is some information and care advice that should help.
  2. What Do the Numbers Mean?
    • Blood pressure numbers are classified as follows. High blood pressure is also called hypertension.
      • Normal blood pressure is systolic lower than 120 and diastolic lower than 80, or 120/80 mmHg
      • Elevated (raised) blood pressure is systolic of 120-129 and diastolic lower than 80 or between 120-129/80 mmHg
      • Stage 1 hypertension is between 130-139 for the systolic pressure or 80-89 for the diastolic pressure or 130-139/80-89 mmHg
      • Stage 2 hypertension is higher than 140 for the systolic pressure or higher than 90 for the diastolic pressure or higher than 140/90 mmHg.
    • Nearly half of adults in the US have high blood pressure. It puts them at risk of heart disease and stroke: the leading causes of death in the US.
    • The pressure varies through the day. It can rise for no clear reason or it can be high due to other health problems.
    • If it stays high for a long time, it can cause permanent damage to the heart and blood vessels.
  3. What are the Symptoms of High Blood Pressure?
    • Most of the time, high blood pressure does not cause any symptoms. For that reason, it is sometimes called the "silent killer."
    • High blood pressure does not usually cause headaches, nose bleeds or dizziness.
    • Exceptions:
      • Hypertensive Crisis, when blood pressure is 180/120 or higher, there may be a headache and nose bleeds. Needs an exam and treatment right away.
      • Pregnancy-caused Hypertension is when blood pressure is higher than 140/90. There may be headache, swelling, abdominal pain and seizures. This can be life-threatening for the mother and the unborn baby. Care and treatment are needed right away.
  4. How Do I Know if I Have High Blood Pressure?
    • Have your blood pressure checked. You can ask your doctor or check it at some pharmacies.
    • You can buy a blood pressure measuring device in a pharmacy and online. Follow the instructions with the device to take an accurate measure. Do not try to diagnose yourself. Ask your doctor to check it if you think it is high.
    • Note: some blood pressure devices are more accurate than others. Ask your doctor which device you should buy.
    • One raised blood pressure reading is not usually enough to diagnose hypertension. Your doctor might ask you to wait or to come back to have it checked a second or third time.
  5. Preventing and Managing Hypertension:
    • It is best to avoid having high blood pressure. There is no "cure" once your blood vessels or heart have permanent damage.
    • Reducing high blood pressure can prevent or delay these problems from getting worse. It can also lower the risk of heart attack, stroke, heart failure, kidney damage, vision loss and sexual problems.
    • Living a healthy lifestyle is the best place to start.
    • Follow your care plan to control your blood pressure to prevent more damage and health problems.
    • Other changes you can make are:
      • Keep track of your blood pressure so you can see if your blood pressure changes
      • Eat a well-balanced diet that is low in salt
      • Limit alcohol
      • Get regular exercise
      • Manage stress
      • Maintain a healthy weight
      • Quit smoking (or never start)
      • Take your meds as prescribed
      • Work with your doctor to make changes, when needed.
  6. What to Expect:
    • If you have high blood pressure, your doctor will run tests of your blood and urine and maybe your heart.
    • You will learn about lifestyle changes you can make. You may be prescribed meds to lower your blood pressure. It takes time for the lifestyle changes to make a difference and to adjust meds to the right dose for you. Work with your doctor on this.
    • You may need to be on meds for the rest of your life. Working on a healthy lifestyle may mean that your blood pressure returns to a normal level and you can reduce or even stop the meds.
    • You will need to have your blood tests and blood pressure checked regularly.
  7. Call Your Doctor If:
    • Blood pressure has suddenly gotten much higher than usual
    • Severe headache and your blood pressure is higher than 180/120
    • You think you need to be seen
    • You get worse

And remember, contact your doctor if you develop any of the 'Call Your Doctor' symptoms.

Disclaimer: this health information is for educational purposes only. You, the reader, assume full responsibility for how you choose to use it.

Copyright 2023 Schmitt Decision Logic LLC.

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