It's Important to Know Your Blood Pressure

with John Cafaro, M.D., family medicine physician, Columbia St. Mary's

Posted: Feb. 1, 2006

High blood pressure, otherwise known as hypertension, has been called a "silent killer" because it seldom exhibits any symptoms. If left untreated, it can cause serious and sometimes fatal illnesses, cautioned John Cafaro, M.D., a family medicine physician with Columbia St. Mary's.

"High blood pressure can trigger heart and kidney diseases, strokes, retinal and other vision problems, as well as other circulatory diseases and erectile dysfunction," he said.

The good news is that hypertension is easily treated in the vast majority of patients. "The earlier it's diagnosed and treated, the healthier the patient is," Dr. Cafaro said.

A blood pressure reading measures the pressure that is forcing the blood against the walls of the arteries as the heart pumps. That is why it is recorded as two numbers. Systolic pressure (as the heart beats) is the top number. Diastolic pressure (as the heart relaxes between beats) is the bottom number.

There are two types of hypertension, Dr. Cafaro explained. "Primary hypertension is the most common form of high blood pressure. There are no causes; it just occurs."

In contrast, secondary hypertension is high blood pressure which can be caused by kidney problems, some medications and pregnancies.

Hypertension also is age-related. As people grow older, their arteries become less pliable and the incidence of high blood pressure increases.

Adults 40 and older should have their blood pressure checked by their doctor at their annual physical exam, and should take advantage of free blood pressure screenings between visits to their doctors. Individuals in their 20s and 30s should have their blood pressure checked once or twice a year.

Dr. Cafaro noted that guidelines have recently changed for diagnosing and treating high blood pressure. "People whose readings are at 130/80 used to be called borderline hypertensive. But now they're considered hypertensive and should be treated," he said. "Normal blood pressure is illustrated by a reading of 120/80 or below. When you're in the that zone, your blood is flowing more easily throughout your body and your vital organs are getting the blood they need more easily."

Dr. Cafaro said that "white coat syndrome" -- a supposed temporary rise in blood pressure when a fearful patient is visiting a doctor -- is no longer considered valid. "We believe that this condition is now indicative of high blood pressure. To make sure of that fact, we recommend that the patient purchase a blood pressure cuff and take blood pressure readings twice daily at home for several weeks. After that, we can make a definite diagnosis."

According to Dr. Cafaro, there are many types of safe, effective medications for reducing blood pressure. These include diuretics, beta-blockers, angiotensive converting enzymes (ACE inhibitors), angiotensive receptor-blockers (ACE inhibitors), and calcium channel-blockers.

"Exercise and weight control are important in lowering blood pressure," he said. "Even losing as little as five pounds can help reduce blood pressure and possibly prevent heart disease and diabetes," he said.

It's important to watch your diet, reduce your salt intake and exercise for about 30 minutes a day, he emphasized. Drinking alcohol only in moderation and not smoking are additional recommendations.

"Monitoring your blood pressure is important. Blood pressure readers at drugstores can give you a ballpark reading, but they're not as accurate as blood pressure cuffs," Dr. Cafaro said. You should see your doctor if the blood pressure reading at the drugstore is above normal so you can have the reading verified and get information about options to lower your blood pressure.

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