High blood pressure, or hypertension, is one of the most common diseases affecting people worldwide. It has been called “the silent killer” because there are usually no symptoms before it has already damaged the body. Many conditions can raise blood pressure without having chronically elevated blood pressure. Exercise, smoking, alcohol and some over the counter medicines and herbs can raise blood pressure. Hypertension can lead to serious health problems including stroke, heart attack, heart failure and kidney failure.

You can only tell if you have hypertension by measuring your blood pressure. Many stores and pharmacies have monitors to test or for home use. The best way to have your blood pressure measured is at your doctor's office. Tobacco and caffeine should be avoided for about an hour before checking your blood pressure. You should be seated, resting comfortably for five minutes and have an appropriately sized blood pressure cuff used to check your blood pressure in each arm. Current guidelines recommend having blood pressure checked on multiple occasions if it is elevated to confirm hypertension.

Your physician will also perform an exam to look for causes of high blood pressure and any damage that hypertension may have caused. More than 90 percent of people have “essential hypertension” meaning there is no underlying cause. There are a few rare kidney and hormonal diseases however that can be treated to stop high blood pressure. These can be found by blood and urine tests. Your doctor will examine your eyes, lungs, heart, blood vessels and nervous system for problems. You will probably have an EKG done as well.

Hypertension is defined as persistently elevated blood pressures. Persistent is important because your blood pressure will be taken a few times over two to three visits. You may even have measurements done at home to measure pressure throughout the day. When quantifying blood pressure we use two numbers. The “top” number is called the systolic (sis-tol-ick) pressure and is the force the heart has to pump with. The “bottom” number is called the diastolic (dye-a-stol-ick) pressure and is the pressure that remains when the heart relaxes. Hypertension is defined as blood pressure 140/90 or above on multiple measurements.

Normal blood pressure is defined as 120/80 or below. Doctors have now also determined that blood pressure between 120/80 and 140/90 to be called “prehypertension” because many people in this range go on to develop full hypertension. Furthermore, if you have other risks for heart disease or stroke like diabetes or kidney disease, recommendations are to keep blood pressure lower than 130/80. Of note, these definitions are for adults age 18 and over. Normal blood pressures in children are much lower than 120/80 and depend on age and height. Your child's physician can determine the appropriate blood pressure.

In my next article, I will discuss treatment and complications of hypertension.

Dr. Davidd Levy is a family physician practicing in Auburn. He may be contacted at 282-0525.