Summary And Future Directions
We have attempted to summarize and highlight key elements of our recent thinking on the role of the sympathetic nervous system in long-term blood pressure regulation in humans. Our goal has been to use the marked inter-individual variability in MSNA seen in humans to begin to explore this topic. In normotensive young men MSNA is proportional to total peripheral resistance but the effects of this relationship on blood pressure are limited by a reciprocal relationship between MSNA and cardiac output and the fact that adrenergic sensitivity is blunted in subjects with high levels of MSNA. In young women these relationships are absent and there is some evidence that 2-adrenergic receptor mediated vasodilation limits the relationship between sympathetic activity and vascular resistance.
When we consider our findings and those of others in the context of emerging demographic trends for conditions like obesity, sleep apnea, physical inactivity and perhaps social stress we propose that an era of sympathetically driven hypertension exacerbated by the factors discussed above is here.
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Get To Know Your Numbers
Because there arent any symptoms, its important to have your blood pressure checked regularly. Get to know the numbers and when to get help from your doctor.
Your blood pressure will have two numbers:
- Systolic is the upper number, measuring when your heart is forcing blood through your vessels.
- Diastolic is the lower number, measuring pressure between heart beats.
For example, 120/80 indicates a systolic blood pressure of 120 and a diastolic blood pressure of 80 mm/Hg.
Maintain A Healthy Weight
Being overweight is a risk factor for having high blood pressure, and your risk increases further if you are obese.
There are two ways to check if you are overweight:
- Body Mass Index – This is your weight in kilograms divided by your height in metres squared. In the UK, people with a BMI of between 25 to 30 are overweight, and those with an index above 30 are classed as obese. People with a BMI of 40 or more are morbidly obese.
- Waist size – Using a measuring tape place the tape round your waist between the bottom of your ribs and the top of your hip bone. The table below indicates how much your health might be at risk, your ethnicity should also be taken into account.
| Sex | |
| Over 80 cm |
The best way to tackle obesity is by reducing the amount of calories that you eat, and taking regular exercise. Your GP can provide you with further information and advice on how you can do this.
More about having a healthy weight
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What Changes Do You Need To Make
Make these lifestyle changes to help lower your blood pressure:
- Lose extra weight. If you are overweight, losing as little as 4.5 kg may lower your blood pressure. It may also allow you to take less blood pressure medicine. Losing weight may also lower your cholesterol.
What Is A Normal Blood Pressure
Both the American Heart Association and the U.S. Preventive Services Task Force have published guidelines for defining healthy and elevated blood pressure. You can follow either guidelines, depending on what you and your doctor agree is acceptable.
| USPSTF Guidelines for Blood Pressure |
| Normal | Systolic: Less than 120 mm Hg Diastolic:Less than 80 mm Hg |
| Elevated | Diastolic: < Less than 80 mm Hg |
| AHA Guidelines for Blood Pressure |
| Normal | Systolic: Less than 120 mm Hg Diastolic: Less than 80 mm Hg |
| Elevated | Diastolic: Less than 80 mm Hg |
| High Blood Pressure Stage 1 | Systolic: 130-139 mm Hg |
| High Blood Pressure Stage 2 | Systolic: 140 mm Hg or higher Diastolic: 90 mm Hg or higher |
| Hypertensive Crisis | Systolic: Higher than 180 mm Hg Diastolic: Higher than 120 mm Hg |
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Should I Be Concerned About Having High Blood Pressure And A Low Pulse
If youre taking blood pressure medication and have slightly high blood pressure and a low pulse, this generally isnt anything to be concerned about.
But if youre not taking any medication, its best to work with a doctor to figure out whats going on. This is especially true if you have symptoms of a low pulse, such as dizziness or shortness of breath.
The typical range of 60 to 100 beats per minute is both the average pulse measurement as well as the rate at which most peoples heart needs to beat to pump enough blood through their body.
Some people may simply have a lower pulse. Examples include athletes or those in very good shape. Theyve conditioned their heart muscle to be stronger. As a result, their heart pumps more effectively, meaning it doesnt need to beat as often. Learn more about why athletes have lower pulses.
Exercising can also temporarily raise your blood pressure. So, if you exercise regularly, you may have a naturally low pulse and higher blood pressure right after you work out.
Causes Of Sudden High Blood Pressure
According to the Centers for Disease Control and Prevention, one of out every three American adults suffers from diagnosed high blood pressure with only one half keeping their pressure under control. Sudden high blood pressure usually occurs to a small percentage of people with high blood pressure. This can include young adults, including a high number of African-American men, and those experiencing:
- Collagen vascular disorders
- Pregnancy-induced high blood pressure
Sudden high blood pressure can also be brought on by daily activities and practices.
- Medication use such as over-the-counter pain relievers, a combination of various medications, and abuse of cocaine and marijuana can spike blood pressure levels.
- Smoking can cause a sudden increase in blood pressure as the chemicals, including nicotine, damage the linings of our blood vessels.
- Diet habits are critical to maintaining normal blood pressure levels as the bad fat and sodium found in many foods increase the blood solute content. It also can build up and block the blood vessels, leading to major heart trouble such as a stroke.
- Stress is part of our everyday life and becoming anxious about your worries can increase risk for spikes in blood pressure twofold.
- Medical conditions like kidney disease, spinal injuries, adrenal gland tumors, thyroid issues, and scleroderma can raise blood pressure rapidly.
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What Questions Should I Ask My Provider
- Are there supplements or non-prescription medicines that I shouldnt take?
- Can I keep taking these medicines if I get pregnant?
- What kinds of exercise should I do?
A note from Cleveland Clinic
If you dont treat high blood pressure, it can put you at risk for developing serious illnesses later in life such as heart attack, kidney failure and stroke. But if you follow your providers instructions, you can control your blood pressure. Be sure to take any medicines your provider ordered as instructed. Keep taking them even if your blood pressure numbers begin to fall into the normal range. Living a healthy lifestyle by eating healthy foods, watching your weight and getting regular exercise is also a great way to help control your blood pressure.
Last reviewed by a Cleveland Clinic medical professional on 09/21/2021.
References
What Is Considered A High Blood Pressure Reading
If youre new to performing your own blood pressure readings, it can be helpful to understand what exactly your blood pressure reading is telling you. Your reading will be comprised of two numbers. The American Heart Association explains that the top number represents your systolic pressure or the pressure when your heart beats. The bottom number represents your diastolic pressure which is the pressure when your heart is in between beats.
For the average adult, a normal blood pressure reading is below 120 over 80 . If you have higher than normal blood pressure, it can range anywhere from elevated blood pressure to hypertensive crisis. According to Healthline, a person with elevated pressure may just need to adapt a to get their pressure to a healthy range, while hypertensive crisis warrants a trip to the emergency room. Hypertension is the medical term for high blood pressure and there are various degrees of severity which will impact what type of treatment plan your doctor prescribes.
The chart below helps explain what high blood pressure is:
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What Diet Helps Control High Blood Pressure
- Eat foods that are lower in fat, salt and calories, such as skim or 1% milk, fresh vegetables and fruits, and whole-grain rice and pasta.
- Use flavorings, spices and herbs to make foods tasty without using salt. The optimal recommendation for salt in your diet is to have less than 1,500 milligrams of sodium a day. Don’t forget that most restaurant foods and many processed and frozen foods contain high levels of salt. Use herbs and spices that do not contain salt in recipes to flavor your food. Dont add salt at the table.
- Avoid or cut down on foods high in fat or salt, such as butter and margarine, regular salad dressings, fatty meats, whole milk dairy products, fried foods, processed foods or fast foods and salted snacks.
- Ask your provider if you should increase potassium in your diet. Discuss the Dietary Approaches to Stop Hypertension diet with your provider. The DASH diet emphasizes adding fruits, vegetables and whole grains to your diet while reducing the amount of sodium. Since its rich in fruits and vegetables, which are naturally lower in sodium than many other foods, the DASH diet makes it easier to eat less salt and sodium.
Learning To Cope With Stress Can Help
Stress and hypertension have often been linked, but researchers are still looking into a direct relationship between the two. Still, the best advice to hypertensive patients: Try to relax.
When you are stressed, your body sends stress hormones adrenaline and cortisol into the bloodstream. These hormones create a temporary spike in blood pressure, causing your heart to beat faster and blood vessels to narrow. When the stressful situation is over, blood pressure goes back to its normal level.
Chronic stress, however, may cause your body to stay in this highly-charged state longer than natural.
While stress itself may or may not affect blood pressure, how you cope with stress does. For instance, overeating, smoking and drinking alcohol in response to stressful situations are direct causes of sustained high blood pressure. On the flip side, healthier coping mechanisms like exercising, practicing yoga and meditating can all help lower blood pressure.
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Recommendations For Keeping Blood Pressure At The Optimum Are:
Properly checking the blood pressure at different times of the day. Taking the proper medication advised by your physician. Stop smoking and drinking alcoholic beverages or high sodium colas. If you are a woman, birth control pills have been found to create hypertension . Therefore, physicians advise you not to take them if you have high blood pressure. Consuming coffee and tea and excessive intake of carbonated drinks and salt are not advisable..
Living With High Blood Pressure
Controlling your high blood pressure is a lifelong commitment. You will always need to monitor your weight, make healthy food choices, exercise, learn to cope with stress, avoid smoking, and limit your alcohol intake. If you need medicine to control your high blood pressure, you will likely need it all your life.
Additionally, you will need to get used to regular blood pressure checks. Your doctor may want you to come to the office regularly. Or you may be asked to check your blood pressure at home and keep track of your numbers for your doctor. Some pharmacies and retail clinics have blood pressure machines on site. You can buy your own, automated arm blood pressure cuff for use at home. Your doctor may want you to check your blood pressure several times a day. Another option is to use an ambulatory blood pressure monitor.
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Stroke And Brain Problems
High blood pressure can cause the arteries that supply blood and oxygen to the brain to burst or be blocked, causing a stroke. Brain cells die during a stroke because they do not get enough oxygen. Stroke can cause serious disabilities in speech, movement, and other basic activities. A stroke can also kill you.
Having high blood pressure, especially in midlife, is linked to having poorer cognitive function and dementia later in life. Learn more about the link between high blood pressure and dementia from the National Institutes of Healths Mind Your Risks®external icon campaign.
How Is It Treated
If you have high blood pressure, your doctor will give you a blood pressure goal. Your goal will be based on your health.
You can help lower your blood pressure by making healthy changes in your lifestyle. If those lifestyle changes don’t work well enough, you may also need to take pills. Either way, you will need to control your high blood pressure throughout your life.
Treatment depends on how high your blood pressure is, whether you have other health problems such as diabetes, and whether any organs have already been damaged. Your doctor will also consider how likely you are to develop other diseases, especially heart disease.
Most people take more than one pill for high blood pressure. Work with your doctor to find the right pill or combination of pills that will cause the fewest side effects.
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How Common Are High Blood Pressure And Kidney Disease
Almost 1 in 2 U.S. adultsor about 108 million peoplehave high blood pressure.1
More than 1 in 7 U.S. adultsor about 37 million peoplemay have chronic kidney disease .2
High blood pressure is the second leading cause of kidney failure in the United States after diabetes, as illustrated in Figure 1.2
Almost 1 in 2 U.S. adultsor about 108 million peoplehave high blood pressure.
What Can I Expect If I Have This Condition
Since high blood pressure doesnt cause many symptoms at first, you probably wont feel any different with a high blood pressure diagnosis. But its important to follow your providers instructions to bring your blood pressure down so it doesnt cause serious illnesses later in life.
How long does high blood pressure last?
If you have primary high blood pressure, youll need to control it for the rest of your life.
If you have secondary high blood pressure, your blood pressure will most likely come down after you receive treatment for the medical problem that caused it. If a medication caused your high blood pressure, switching to a different medicine may lower your blood pressure.
What is the outlook for high blood pressure?
You can get seriously ill if you dont treat your high blood pressure. However, if you take the medicines your provider ordered, you can control your blood pressure. Exercising and eating healthy foods also helps lower your blood pressure.
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How Can You Reduce Your Risk Of High Blood Pressure
Fortunately, there are certain things you can do to help reduce your risk of developing high blood pressure. These include the following:
- Eat right: A healthy diet is an important step in keeping your blood pressure normal. The DASH diet emphasizes adding fruits, vegetables and whole grains to your diet while reducing the amount of sodium. Since its rich in fruits and vegetables, which are naturally lower in sodium than many other foods, the DASH diet makes it easier to eat less salt and sodium.
- Keep a healthy weight: Going hand-in-hand with a proper diet is keeping a healthy weight. Since being overweight increases your blood pressure, losing excess weight with diet and exercise will help lower your blood pressure to healthier levels.
- Cut down on salt: The recommendation for salt in your diet is to have less than 1,500 milligrams of sodium a day . To prevent hypertension, you should keep your salt intake below this level. Don’t forget that most restaurant foods and many processed and frozen foods contain high levels of salt. Use herbs and spices that do not contain salt in recipes to flavor your food do not add salt at the table.
- Keep active: Even simple physical activities, such as walking, can lower your blood pressure .
- Drinkalcoholin moderation: Having more than one drink a day and two drinks a day can raise blood pressure.
Is There Anything I Can Do To Lower My Blood Pressure
If your doctor prescribes medication for your high blood pressure, make sure you take it as directed. Don’t skip or increase a dose or stop taking your medication without checking with your doctor first.
A healthy lifestyle is important for anyone with hypertension. Some tips for a healthy lifestyle include:
- Stop using products containing nicotine, such as cigarettes, cigars, pipe tobacco, chewing tobacco, snuff and nicotine-containing gum.
- Reduce your exposure to second-hand smoke.
- Limit your alcohol intake to no more than two standard drinks per day for men, and one drink for women.
- Spend time on things you enjoy doing and being with people you like being with.
- Manage the stress in your life by figuring out what situations make you feel stressed and find ways to avoid these situations.
- Maintain a healthy weight by eating healthy foods and enjoying physical activity most days of the week. If you’re overweight, losing 8-10 pounds can significantly reduce blood pressure.
- Choose foods according to the Dietary Approaches to Stop Hypertension eating plan.
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