High Blood Pressure

Blood pressure is the pressure of the blood against the walls of the arteries. Too much pressure on those walls can damage the arteries and weaken them to the extent that they develop bulges (aneurysms).

Chronic high blood pressure — also known as hypertension — can damage the heart by contributing to coronary artery disease and heart failure, and can also lead to stroke and kidney damage.

If you’re concerned about high blood pressure, WakeMed’s experienced cardiologists can help you on your path to heart health and work with you to develop a personalized care plan.

Causes of and Risk Factors for High Blood Pressure

A number of factors can lead to hypertension, including:

• Poor eating habits, particularly too much sodium in the diet
• Medical conditions such as chronic kidney disease, obesity, sleep apnea, thyroid issues and certain types of tumors
• Advancing age
• Family history of hypertension
• Excessive alcohol consumption
• Sedentary lifestyle
• Race: African Americans are at higher risk for developing high blood pressure than other ethnicities.

Symptoms of High Blood Pressure

Generally, people with hypertension have no symptoms. As blood pressure increases and stays high for extended periods of time, patients can experience headaches, dizziness and in rare cases, organ damage.

Contact your doctor if you believe you have chronic high blood pressure.

Measuring Blood Pressure

Blood pressure is measured using an inflatable cuff that is wrapped around the upper arm. A gauge on the cuff shows two numbers: the systolic (“top”) number, which indicates the peak blood pressure as the heart beats, and the diastolic (“bottom”) number, which indicates blood pressure when the heart rests between beats.

A variety of factors can affect the reading, and the circumstances under which blood pressure is measured are as important as the numbers themselves. Make sure you’re well rested before you measure your blood pressure.

Blood pressure often varies over the course of a day. Typically, however, here’s how to look at your reading:

• Less than 120 systolic/80 diastolic = Normal blood pressure
• 120-139 systolic/80-89 diastolic = Pre-hypertension
• 140-159 systolic/90-99 diastolic = Stage 1 hypertension
• Anything above 160 systolic/100 diastolic = Stage 2 hypertension

Chronic high blood pressure can’t be diagnosed with a single reading. Blood pressure must be measured on at least two different occasions, with a diagnosis based on the average of the multiple readings.

Determining Whether High Blood Pressure Has Affected the Heart

If you suffer from chronic hypertension, your cardiologist might use cardiac imaging to see if it has damaged your heart or coronary arteries. Imaging technologies that may be used include:

• Echocardiogram ("echo") tests: Echocardiography is a type of cardiac imaging that uses sound waves to create moving pictures of the heart and its blood vessels at rest and during exercise. Echocardiogram images help cardiologists diagnose, evaluate and monitor many heart conditions. Types of echo tests include:
  • Transthoracic 2-D echocardiography (TTE): This common, non-invasive echo study is performed externally, outside of the chest. TTE can be performed using bubbles (to identify problems with cardiac blood flow) or DEFINITY^® contrast (to further clarify imaging).
  • Transesophageal echocardiography (TEE): This minimally invasive study can help cardiologists get a closer look at cardiovascular structures if more information is needed after a TTE study.
• Cardiac CT and MRI: Cardiac computed tomography (CT) and magnetic resonance imaging (MRI) are two advanced, non-invasive ways to look inside the heart and thoroughly assess the cardiovascular structures. These can be performed with or without calcium scoring.

Treating High Blood Pressure

People with pre-hypertension generally do not require drug treatment. Instead, they are encouraged to make lifestyle changes that can significantly lower their blood pressure. These changes — when applicable — include:

• Losing weight
• Reducing fat and sodium in the diet
• Better managing stress
• Exercising daily
• Limiting alcohol intake
• Not smoking

Patients diagnosed with hypertension typically are urged to make the same lifestyle changes and are prescribed medication to reduce their blood pressure to normal levels.

Medications used to treat high blood pressure include:

• Angiotensin-converting enzyme (ACE) inhibitors
• Angiotensin II receptor blockers (ARBs)
• Calcium channel blockers
• Diuretics

Make an Appointment

If you or someone you know has high blood pressure, we encourage you to make an appointment with one of WakeMed’s experienced cardiologists.

• Request a Heart and Vascular Appointment
• Refer a Patient (Physicians)