High Blood Pressure

with Evelyn Burdick, M.D., Family Physician, Columbia St. Mary’s

Posted: June 1, 2004

According to recent estimates by the American Heart Association, one in four U.S. adults has high blood pressure. Because high blood pressure does not have any symptoms, nearly one-third of these people don't know they have it. This is why high blood pressure is often called the "silent killer." Many people have high blood pressure for years without knowing it. Uncontrolled high blood pressure can lead to stroke, heart attack, heart failure or kidney failure. The only way to tell if you have high blood pressure is to have your blood pressure checked.

Dr. Evelyn Burdick, a family physician practicing out of Columbia St. Mary’s, takes a moment to discuss high blood pressure.

Evelyn Burdick, M.D., Family Physician, Columbia St. Mary's "High blood pressure does not have symptoms until you get to the point that you are seeing the consequences of high blood pressure through organ damage."

What is blood pressure?

Blood pressure refers to the force of the heart pushing the blood throughout the body. The systolic number is the force of the blood when the heart is pumping. The diastolic pressure is the heart at rest. Normal systolic pressure is 120 or less. Normal diastolic blood pressure is 80 or less. High blood pressure, also called hypertension, is defined as systolic pressure greater than 140 and/or diastolic pressure greater than 90.

Why is high blood pressure a problem?

High blood pressure is a strain on your whole system. Imagine your blood vessels like the walls of a balloon. Imagine what happens when those walls get stretched beyond where they should be. When the force of the blood pressure is too great for the blood vessels, they scar, and blood flow decreases. This causes damage to all major organs — kidneys, the brain the heart.

Wouldn’t most people know if they had high pressure?

You wouldn’t know unless you had your blood pressure checked. The organs are damaged over the years. High blood pressure does not have symptoms until you get to the point that you are seeing the consequences of high blood pressure through organ damage.

How often should the average person get his or her blood pressure checked?

At a minimum for young adults, with no history of high blood pressure, once a year. Someone who has been diagnosed with high blood pressure will need to check it more often. I recommend to my patients with high blood pressure to have an electronic device at home to check it. Checking it on their own every day or two reinforces that it is staying under control — or tells people when it’s not.

Who is especially at-risk for high blood pressure?

Family history is important. Even if you are a young person who eats right and exercises, you are at risk for high blood pressure if it runs in your family — there’s something in the biochemistry that makes some people more at risk. People with diabetes are higher risk, as are African Americans, women who are post-menopausal or use oral contraceptives, smokers and heavy drinkers.

If I have high blood pressure, what can I do myself to bring it down?

The most important thing you can do is if you’re smoking, quit. Nicotine constricts the blood vessels. You can also cut down on your salt intake. Salt causes the body to hold onto more fluid, which makes it more difficult for the heart. Also, an excess alcohol use raises blood pressure.

What about diet and exercise?

Both of these are very important for high blood pressure. If you’re overweight, even losing just 10 or 15 pounds can help bring down the blood pressure. Exercise helps because it makes your heart healthier so it doesn’t need to work as hard.

How is high blood pressure treated?

There are literally dozens of medications. Your doctor will choose the medication that will work best for you. Most doctors recommend lifestyle changes paired with medication. The main thing is to begin treating it the day that you learn your blood pressure is high. The damage begins immediately. For every 20 points your systolic pressure is high and for every 10 points your diastolic pressure is high, your risk of dying from heart disease or a stroke doubles.

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