What Are The Symptoms Of Resistant Hypertension
You can have hypertension without having any symptoms. The best way to know if you have high blood pressure is to have your blood pressure checked by a health care provider.
However, symptoms may be felt when blood pressure first rises or during a hypertensive crisis, when levels are extremely high. These symptoms may include headaches, shortness of breath, chest pain and nosebleeds.
Dizziness is usually not a symptom of high blood pressure. In fact, dizziness can sometimes be a symptom of low blood pressure. Frequent or unexplained dizziness may be a warning sign of a serious condition and should be addressed by your physician.
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How Is Resistant Hypertension Diagnosed
- Full history and physical exam, which includes letting your doctor know about all medications and supplements, whether they are prescription, over-the-counter, herbal or recreational. Its important to mention if you skip doses of daily medicines.
- True measurement of your blood pressure using correct technique and calibrated equipment.
- Home blood pressure measurement during the day and 24-hour ambulatory blood pressure monitoring to record your blood pressure throughout a regular day. It may be used if your physician suspects your blood pressure readings in the office dont tell the whole story.
- Tests for secondary conditions, which may include special blood work and imaging studies. Identifying and treating these conditions may eliminate hypertension or at least make it more treatable.
- Tests for organ damage caused by hypertension, which may include:
- Electrocardiogram to measure your hearts size and rhythm
- Echocardiogram to measure your hearts size and function
- Fundoscopic eye exam to check for damaged blood vessels inside the eye these tiny blood vessels come in from the brain and are a unique opportunity for your doctor to judge the health of similar blood vessels in your brain, heart and kidneys
- Urinalysis to check for kidney damage
- Other blood tests
- Chest X-ray
Number Of Pregnant Women With High Blood Pressure Rises More Than Thirteenfold Since 1970 Study Finds
If not treated, high blood pressure during pregnancy can lead to a number of complications for both the mother and the baby. Hypertension can affect a mother’s kidneys and increase her risk of future heart disease, kidney disease, and stroke.
It can also increase the risk of preterm delivery, low birth weight, preeclampsia, placental abruption, cesarean delivery, and HELLP syndrome .
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Stiffening Of The Arteries
Some physicians consider the most authentic form of pseudo-resistant hypertension to be caused by stiffened brachial arteries that prevent the blood pressure cuff from obtaining a true reading. If your doctor suspects this form of pseudo-resistant hypertension, they might consider other ways to measure your blood pressure.
Home Blood Pressure Testing
Blood pressure tests can also be carried out at home using your own blood pressure monitor.
Like 24-hour or ambulatory monitoring, this can give a better reflection of your blood pressure.
It can also allow you to monitor your condition more easily in the long term.
You can buy a variety of low-cost monitors so you can test your blood pressure at home or while you’re out and about.
Measure your blood pressure twice a day, ideally in the morning and the evening, while you’re sitting down.
Each time take 2 readings, 1 minute apart. Continue to measure your blood pressure twice a day for 7 days.
Your doctor or nurse will use this information to work out your average blood pressure.
It’s important to make sure you use equipment that’s been properly tested.
The British Hypertension Society has information about validated blood pressure monitors that are available to buy.
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Symptoms Of High Blood Pressure
Hypertension doesnt normally generate any outwardly visible symptoms. It can take years or even decades for the condition to reach a level severe enough for symptoms to become obvious. Even then, these symptoms may not even be hypertension, but some other ailment. The symptoms that have been associated with hypertension, however, can include:
If you are experiencing any of these symptoms, seek immediate medical attention. While this may not mean you have high blood pressure, waiting for a symptom of this condition to appear can be fatal. The surest way to know if you have hypertension is to get regular blood pressure readings. Make sure your doctor takes your blood pressure during every visit.
High Pressure High Risk
High blood pressure is the leading cause of strokes, both symptomatic and silent. Both systolic and diastolic hypertension contribute to risk the higher your pressure, the higher your risk. According to one Harvard study, hypertension increases a man’s risk of stroke by 220% according to another, each 10 mm Hg rise in systolic pressure boosts the risk of ischemic stroke by 28% and of hemorrhagic stroke by 38%.
That’s the bad news. The good news is that treating hypertension is extremely protective in round figures, if you reduce your systolic blood pressure by 10 mm Hg, you should cut your risk of stroke by a whopping 44%.
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Good Sleep Can Prevent And Manage High Blood Pressure
Most people experience a dip in blood pressure during the deepest stage of sleep , which is the body’s normal and healthy reaction to sleep. Not having that nighttime dip is a risk factor for heart disease and may increase daytime blood pressure.
Typically people spend 90 minutes to two hours in slow wave sleep per night. A recent study published in Hypertension found that men who got less slow wave sleep each night were a higher risk for hypertension than men who got more deep sleep.
While sleep disorders, like sleep apnea, and age can both affect the amount of deep sleep you get, there are steps you can take to ensure a good night’s sleep. Getting seven to eight hours of sleep a night, maintaining a consistent sleep schedule and being more active during the day can help improve the quality of your sleep.
Regular Blood Pressure Checks If Diagnosed With High Blood Pressure
If you are diagnosed with high blood pressure, your blood pressure will need to be closely monitored until it is brought under control.
After your blood pressure has been controlled, your GP or practice nurse will measure your blood pressure at agreed regular intervals .
It is important you attend these appointments to ensure your blood pressure is being maintained within an acceptable range.
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What Can I Do To Prevent Or Manage High Blood Pressure
Many people with high blood pressure can lower their blood pressure into a healthy range or keep their numbers in a healthy range by making lifestyle changes. Talk with your health care team about
- Getting at least 150 minutes of physical activity each week
- Not smoking
- Managing stress
Learn more about ways to manage and prevent high blood pressure.
In addition to making positive lifestyle changes, some people with high blood pressure need to take medicine to manage their blood pressure. Learn more about medicines for high blood pressure.
Talk with your health care team right away if you think you have high blood pressure or if youve been told you have high blood pressure but do not have it under control.
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What Is A High Blood Pressure Reading
You will probably be diagnosed with high blood pressure if your readings are consistently 140/90mmHg or higher over a number of weeks. This is the cut-off point many GPs use for diagnosing high blood pressure.
You might also have high blood pressure if just one of the numbers is higher than it should be so if the top number is over 140mmHg or the bottom number is over 90mmHg.
A single high reading doesnt necessarily mean you have high blood pressure, as many things can affect your blood pressure throughout the day and it could just be a one-off. If you have a high reading, your doctor or nurse will want to see if it stays high over time before diagnosing high blood pressure.
Hypertension: What You Need To Know As You Age
You cant see high blood pressure, also called hypertension. And most ofthe time, you cant feel it. But if youre among the 78 million Americanswith hypertension or are one of the 70 million with prehypertension, its important to understandits effects on your healthand to take action today to bring your numbersdown to healthier levels.
Blood pressure is the force of blood against the inner walls of yourarteries. It has normal fluctuations throughout the dayfalling when yourerelaxed or asleep, rising naturally in the morning, and increasingtemporarily when youre under stress, excited or exercising. But when yourresting blood pressure level rises too high, it can scar, stiffen and/orweaken blood vessels. This effect can double your risk for aheart attack quadruple your odds for astroke raise your risk forheart failure, vision loss, kidney problems,dementiaand circulation problems such asperipheral artery disease weaken your bones and contribute toerectile dysfunctionin men.
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What Is Resistant Hypertension
High blood pressure is sometimes known as the silent killer so named because it increases the risk of heart attack and stroke, but often goes unnoticed because of its lack of obvious symptoms. In fact, you may have high blood pressure and not even know it.
But resistant hypertension, just as the name says, is when your high blood pressure is difficult to control even with medication.
Resistant hypertension is the failure to reach your goal blood pressure when youre adhering to maximally tolerated doses of an appropriate three-drug regimen that includes a diuretic, explains Dr. Thomas.
Put another way: If you have high blood pressure, and youre taking the maximum dose of three different blood pressure medications including a water pill , and your blood pressure still isnt at safe levels, you may have resistant hypertension. And youll need to do more to control it.
Making Changes If You Have Anxiety Or Depression
If your high blood pressure is co-occurring with a mental health problem such as depression or anxiety, it can be even tougher to find the energy and motivation to make the necessary lifestyle changes. Just thinking about exercising or preparing a healthy meal, for example, can seem overwhelming. But by focusing all your efforts on one tiny change at a time, youll find that youre capable of more than you realized.
Take the first step. It could be as simple as going for a walk or downloading a meditation app or buying some nicotine patches. It can take time for lifestyle changes to register as a reduction in blood pressurebut sometimes they can improve your mood much sooner. Taking that first step is always the hardest.
Focus on small steps. Its easy to get overwhelmed by daily life when youre battling depression, anxiety, or another mood disorder. By taking small but positive steps each day, though, youll find that your energy and outlook will gradually start to improve. Once you feel happier and more positive, youll find it easier to forge ahead with lifestyle changes and see the results in both your blood pressure readings and your overall outlook and wellbeing.
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Favorite Online Support Networks
This online support group from the American Heart Association allows you to connect with others going through an array of heart issues, including hypertension. Ask questions, share your story, and get peer support from others going through similar experiences to take control of their heart health.
How Do I Know If I Have High Blood Pressure
Theres only one way to know if you have high blood pressure: Have a doctor or other health professional measure it. Measuring your blood pressure is quick and painless.
Talk with your health care team about regularly measuring your blood pressure at home, also called self-measured blood pressure monitoring.
High blood pressure is called the silent killer because it usually has no warning signs or symptoms, and many people do not know they have it.
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Treatments For Renal Hypertension
Medications are used first to try to control high blood pressure in renal hypertension. The most important blood pressure medications to treat renal hypertension include:
- ARBs . Examples include candesartan, losartan, olmesartan and valsartan.
For most people with renal hypertension due to renal artery narrowing, medications can effectively control blood pressure. More than one blood pressure drug is often needed, however.
In some people with renal hypertension due to narrowing of the renal artery, even taking three or more medications every day may not adequately control blood pressure. In these situations, a procedure to improve blood flow to the kidneys may help.
Possible procedures include:
Angioplasty. A doctor threads a catheter through a large artery in the groin and advances it into the renal artery. A balloon is then inflated for a few moments. This widens the artery and improves blood flow.
Stenting. During angioplasty, a wire-mesh stent can be expanded inside the renal artery. The stent stays in place. This keeps the artery open after the balloon is removed. Research, however, has not shown that stenting is more effective than medication for renal hypertension.Ã
Surgery. A surgeon can bypass the narrowed renal artery by sewing a healthy blood vessel next to it. Surgery is generally considered only when angioplasty and stenting are not possible.
These procedures are similar to those used to improve blood flow in the heart in people with coronary artery disease.
What Medications Are Used To Treat High Blood Pressure
Four classes of high blood pressure medications are considered first line when starting treatment. Sometimes other medications are coupled with these first-line drugs to better control your high blood pressure. First-line, pressure-lowering medications are:
- Angiotensin-converting enzyme inhibitors block the production of the angiotensin II hormone, which the body naturally uses to control blood pressure. When angiotensin II is blocked, your blood vessels dont narrow. Examples: lisinopril , enalapril or captopril.
- Angiotensin II receptor blockers block this same hormone from binding with receptors in the blood vessels. ARBs work the same way as ACE inhibitors to keep blood vessels from narrowing. Examples: metoprolol , valsartan or losartan.
- Calcium channel blockers prevent calcium from entering the muscle cells of your heart and blood vessels, allowing these vessels to relax. Examples: amlodipine , nifedipine , diltiazem .
- Diuretics flush excess sodium from your body, reducing the amount of fluid in your blood. Diuretics are often used with other high blood pressure medicines, sometimes in one combined pill. Examples: indapamide, hydrochlorothiazide or chlorothiazide.
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Causes Of Secondary Hypertension
When high blood pressure arises suddenly due to an identifiable condition, its called secondary hypertension.
Some conditions and drugs can lead to secondary hypertension, including the following:
- Kidney problems
Examples include pseudoephedrine and phenylephrine .
HormonesBirth control pills can also affect blood pressure. Women who take birth control pills usually experience a small rise in systolic and diastolic blood pressure .
Hormone therapy used to relieve symptoms of menopause can also cause a small rise in systolic blood pressure.
If you know you have high blood pressure, but are considering hormone therapy, talk with your doctor about the risks and benefits of undergoing hormone therapy, as well as the best ways to control your blood pressure.
Additionally, some recreational and illegal drugs, such as cocaine, ecstasy , and amphetamines, are also known to increase blood pressure.
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