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SUBJECT: SUCCESSFUL AGING

National Institute on Aging
National Heart, Lung, and Blood Institute

High Blood Pressure: A Common but Controllable Disorder

You may be surprised if your doctor says you have high blood pressure (HBP) because it does not cause symptoms and can occur in an otherwise healthy person. Fortunately, there are simple ways to control the condition by bringing blood pressure (BP) readings down to safe levels.

What is HBP? As blood flows from the heart out to the blood vessels, it creates pressure against the blood vessel walls. Your BP reading is a measure of this pressure, and it tells you if the pressure is normal (normotensive), high (hypertensive), or low (hypotensive). Thus, another name for HBP is hypertension.

BP readings are given in two numbers, such as 120/80. Although the average BP reading for adults is 120/80, a slightly higher or lower reading (for either number) is not necessarily abnormal or unsafe. Lower BP readings (for example, 110/70) are usually considered safe for most people. For older people, many experts feel that readings up to 140/90 are acceptable. Once the BP goes above this level, however, some form of treatment may be needed.

The BP test is painless and takes only a few minutes. When your doctor takes your BP reading, he or she may want you to stand, sit, or both. The doctor should take several readings on different days before deciding if your BP is too high. All of these steps are necessary because BP changes so quickly and is affected by many factors, including the normal feelings of anxiety during a visit to the doctor.

As many as 58 million Americans may have HBP. About 40 percent of whites and more than 50 percent of blacks age 65 and older suffer from some form of HBP. Because this disease is so common, everyone should have a BP test once a year.

Although some cases of HBP are caused by other illnesses, these cases account for very few of the total number of patients with HBP. This kind of HBP is referred to as "secondary hypertension," and it is often cured by treating the original medical problem. Most HBP, however, cannot be cured, but can be controlled by continuous treatment. These cases of HBP fall into the category known as "essential" or "primary" hypertension.

Most experts agree that there are some things that increase a person's risk of developing HBP. For example, it appears that HBP runs in families. Also, HBP is more common in blacks than whites, and it tends to be more severe in blacks. Other possible risk factors include obesity, excessive alcohol consumption, and diets high in salt. Many doctors now feel that a combination of many factors may be responsible for HBP.

Hypertension occurs not only in tense people or during periods of tension; BP will go up in all people during periods of stress or increased physical activity. Still, you can have HBP even though you are usually a calm, relaxed person.

The good news about HBP is that it can be controlled by drugs and often by changes in daily habits. The type and severity of a patient's HBP, as well as his or her other medical problems, will determine which treatment is best for that person.

Some people incorrectly believe that once BP is brought down to normal levels treatment is no longer needed. If your doctor has prescribed an antihypertensive drug, you may have to take the medicine for the rest of your life, although the amount you take may be reduced.

If you have mild HBP, your doctor might recommend that you lose weight and keep it off, eat less salt, reduce alcohol intake, and get more exercise. It may be possible to lower your BP simply by making some of these changes in your daily habits. Your doctor may suggest that you follow this advice even if drugs are needed to control your BP. These changes may help your medication work better.

If you have HBP, help yourself by remembering these facts: You may not feel sick, but HBP is serious and should be treated by a doctor.

BP can be lowered with medicines, but it will rise again if the medicine is not used. If one day's dose is missed, do not "double-up" the next day. Instead, call your doctor for his or her advice.

Try to take your medicine at the same time each day-for example, in the morning or evening after brushing your teeth. This will help you set a regular, easy-to-remember routine.

Weight loss, reduced salt and alcohol intake, and exercise may be helpful, but only as recommended by your doctor. Do not assume that these actions are substitutes for drugs unless your doctor specifically says they are.

HBP can lead to many serious conditions including stroke, heart disease, and kidney failure. You can reduce your risk of developing these problems by getting proper treatment. Have your BP checked by a doctor or nurse or at a health clinic. If HBP is diagnosed, follow your doctor's advice closely.

Resources

For more information on HBP, write to the National High Blood Pressure Education Program, 4733 Bethesda Avenue, Suite 530, Bethesda, MD 20814-4820.

For more information about health and aging, contact the National Institute on Aging (NIA) Information Center, P.O. Box 8057, Gaithersburg, MD 20898-8057. The NIA distributes free Age Pages on a number of topics, including information about nutrition, exercise, and how to stop smoking.

SOURCE: U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Public Health Service National Institutes of Health

OTHER RESOURCES: HEALTH INSURANCE, HMOs, SPORTSWEAR



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