Heart Disease and High Blood Pressure: Controlling Your Risk Factors

December 01, 2015

Having high blood pressure, or hypertension, means the pressure of the blood inside your blood vessels is too high. If not controlled, high blood pressure can cause:

  • Heart damage. High blood pressure causes the heart to work harder. Over time this can lead to congestive heart failure.
  • Atherosclerosis. High blood pressure is one cause of initial damage to the inner walls of the arteries that leads to atherosclerosis or hardening of the arteries. This can lead to a heart attack.
  • Kidney damage. Narrowing of the arteries caused by high blood pressure can cause kidneys to malfunction.
  • Aneurysms. High blood pressure also weakens and stretches vessel walls. This can lead to balloon-like projections called aneurysms which can burst when under pressure. This commonly occurs in the brain, eyes, kidneys, or in larger blood vessels.
  • Strokes. High blood pressure can lead to strokes by causing atherosclerosis of the arteries that feed blood to the brain causing an ischemic stroke. It can also cause a rupture of blood vessels in the brain causing a brain hemorrhage.

Understanding high blood pressure

High blood pressure, or hypertension, is a common, treatable medical condition, notes Henry Ford Macomb internal medicine physician Stephen Miller, DO.

“Every time your heart beats, it pumps blood through arteries that transport blood from your heart to the rest of your body,” says Dr. Miller. “When your blood is pumped through your arteries, it pushes against the arterial walls. The force of blood against the walls of the arteries is your blood pressure. High blood pressure generally has no symptoms you can see or feel – that is why it is so important to have it checked regularly. The only way to tell if your blood pressure is high is to have it checked.”

Blood pressure evaluation

The following chart suggests when follow-up blood-pressure checks should be scheduled. Your doctor may recommend a different schedule depending on your risk factors, medical history, and current health.

Blood Pressure
Category
Systolic
(mm Hg)
Diastolic
(mm Hg)
Recommended
Follow-up

Normal

Less than 120

Less than 80

Recheck in 2 years

Prehypertension

120 to 139

80 to 89

Recheck in 1 year

HIGH
Stage 1 (mild)

140 to 159

90 to 99

Confirm within 2 months

Stage 2 (moderate)

160 to 190

100 to 110

Evaluate within 1 month

Stage 3 (severe)

180 or higher

110 or higher

Evaluate immediately

Taking your medicine

Diet and lifestyle changes may be enough to control mildly elevated blood pressure. But if your blood pressure is moderate to high, your doctor may prescribe medication and lifestyle changes.

Medications known as antihypertensives lower high blood pressure. Some, called diuretics, rid the body of excess fluids and sodium. Others, called beta blockers, reduce the heart rate and the heart’s output of blood.

Another class of antihypertensives is called sympathetic nerve inhibitors. Sympathetic nerves go from the brain to all parts of the body, including the arteries. They can cause the arteries to constrict, raising blood pressure. This class of drugs reduces blood pressure by inhibiting these nerves from constricting blood vessels.

Yet another group of drugs is the vasodilators. These can cause the muscle in the walls of the blood vessels to relax, allowing the vessels to dilate.

Other classes of drugs used to treat high blood pressure are the angiotensin converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, and the calcium channel blockers.

The ACE inhibitors interfere with the body's production of angiotensin, a chemical that causes the arteries to constrict, and the angiotensin II receptor blockers block the effects of angiotensin, also allowing the arteries to relax. The calcium antagonists can reduce the heart rate and relax blood vessels.

“People respond very differently to these medications so most patients must go through a trial period to find out which medications work best with the fewest side effects such as headaches, nausea, weakness, impotence, or insomnia,” adds Dr. Miller.

To gain the optimum benefits from your medication, follow these guidelines:

  • Take all your medication as prescribed. Be sure you know whether it should be taken with food or on an empty stomach.
  • Take your pills at the same time each day. Consider putting a check mark on your calendar after you've taken them.
  • Refill your prescription before it runs out.
  • Don't adjust your dosage without your doctor's approval.
  • Don't skip appointments to have your blood pressure checked.
  • Limit salt intake

Most people know how to avoid the basic risk factors for heart disease:

  • Stop smoking.
  • Keep your weight down.
  • Learn to cope with stress.
  • Exercise regularly.
  • Drink in moderation.

A major risk factor for high blood pressure specifically, however, is sodium. If you have high blood pressure or are at risk for it, limit your salt intake.

A diet too high in sodium may cause the body to retain water, which increases the volume of blood in circulation. This increases the pressure in the arteries. The average adult needs 2,200 mg. of sodium per day, but many Americans consume 10 times that amount.

Heart Smart Screening

Call today to learn more about a new Heart Smart Screening available at Henry Ford Macomb Hospital in Clinton Township. The screening is designed to assess your risks and determine whether early signs of heart disease exist. To register, call 1-800-532-2411.