What is HTN?
When your heart consistently pushes blood through your arteries too hard and fast, this is referred to as hypertension. Hypertension is also known as HTN or HT. HTN is prevalent, with over 3 million people diagnosed each year in the United States. It is so commonplace that even with 3 million diagnosed each year in the United States, researchers estimate that 4 out of 5 people who have it have not yet been diagnosed because they have no symptoms.
When you have HTN, also known as “the silent killer” (because there are usually no symptoms), this can harm your heart, brain, kidneys, and other organs. HTN is a major cause of premature death. You are at a greater risk of developing HTN if you:
- Are Black*
- Are sedentary
- Smoke heavily
- Eat an unhealthy diet
- Are over the age of 65
- Are overweight or obese
- Have a family history of HTN
- Live in an underprivileged area
- Drink excessive amounts of alcohol
- Have coexisting diseases such as diabetes, heart, or kidney disease
* Blacks in the United States have a significantly higher incidence of HTN than Blacks living in Africa, which seems to point to the likelihood that environmental causes play a significant role in the occurrence of HTN.
HTN is a “silent killer” because most people have no warning signs until they experience complications of the disease, which is why the nurse always takes your blood pressure when you go to the doctor’s office. When you do experience symptoms, they may include:
- Vision changes
- Buzzing in the ears
- Irregular heart rhythms
- Early morning headaches
When hypertension is severe, it can also cause:
- Chest pain
- Muscle tremors
The only way to detect HTN is to measure your blood pressure. Having a blood pressure cuff at home is a good idea, but the best way to get the most accurate measurement is to have it done in your doctor’s office.
Your blood pressure fluctuates throughout the day in response to your stress level, activity level, bodily fluids, and other factors. Each reading provides a picture for just a moment in time, so readings must be taken over time and averaged together to get the most accurate blood pressure measurement.
Diagnosing HTN is easy, quick, and painless. The doctor’s office will measure your blood pressure using a blood pressure cuff combined with a sphygmomanometer instrument. You can also measure your blood pressure at home using a blood pressure cuff. An arm cuff will be more accurate than a wrist cuff. It is essential to take your blood pressure almost daily while you are calm and relaxed to get the most accurate measurement.
If another medical condition is causing your high blood pressure, that is known as secondary hypertension or secondary HTN. If your doctor suspects secondary HTN, she or he may order blood and urine tests to determine the cause.
According to the American Heart Association:
- Less than 120/80 = Normal
- 120 to 129 / Less than 80 = Elevated
- 130 to 139 or 80 to 89 = High Blood Pressure (Stage 1 HTN)
- 140 or higher or 90 or higher = Stage 2 HTN
- 180 or higher and/or 120 or higher = HTN Crisis (contact your doctor immediately)
To get the most accurate readings at home when taking your blood pressure:
- No smoking or caffeine for at least 30 minutes before taking measurements
- Sit in a quiet, comfortable place, indoors or outside, for at least five minutes before measuring
- Place your feet flat on the floor
- Make sure the blood pressure cuff is at the same level as your heart
- Relax and press the button
- Record the readings
The cuff will take a few minutes to take a reading.
Your doctor may order one or more of the following tests depending on potential causes and complications of your HTN:
- CT Scan or MRI to look for tumors
- Imaging Tests to check the heart and kidney
- Echocardiogram to visualize your heart as it moves
- Electrocardiogram (EKG) to check your heart rhythm
- Ultrasound to evaluate your kidneys and blood vessels
- Ambulatory Blood Pressure Monitoring (APBM) Device to measure your blood pressure continuously over 24-to-48-hours
Sometimes, but not always, changing your lifestyle will be enough to bring your blood pressure into a healthy range.
Lifestyle changes could include:
- Reducing your salt intake
- Eating a heart-healthy diet
- Getting regular physical activity
- Reducing or eliminating smoking
- Getting to and maintain a healthy weight
- Limiting or eliminating your alcohol consumption
Your doctor may order medications if lifestyle changes alone are not enough. There are several different types of medicines your doctor may choose from, including:
- Diuretics to help eliminate excess water and sodium.
- Angiotensin-converting enzyme (ACE) inhibitors help relax your blood vessels by blocking the formation of a chemical that narrows your blood vessels.
- Angiotensin II receptor blockers (ARBs) help relax your blood vessels by blocking the action of the chemical that narrows your blood vessels.
- Calcium channel blockers help relax the muscles of your blood vessels.
- Alpha-blockers reduce nerve signals to your blood vessels.
- Alpha-beta blockers block nerve signals to blood vessels and slow the heartbeat.
- Beta-blockers widen your blood vessels and reduce the speed and force of your heart rate.
- Aldosterone antagonists, while considered diuretics, are usually prescribed to block the effect of a hormone that may lead to salt and fluid buildup.
- Renin-inhibitors slow the production of an enzyme produced by your kidneys that increases your blood pressure.
- Vasodilators prevent the muscles in the walls of your arteries from tightening and narrowing.
- Central-acting agents keep your brain from telling your body to increase its heart rate and narrow your blood vessels.
If your doctor prescribes blood pressure medicines for you, you must not stop taking them without consulting your doctor.
Laurie Kane, MD
12555 West Jefferson Blvd., Suite 301, Los Angeles, CA 90066
Rose Lin, MD
1831 Wilshire Blvd., Suite A, Santa Monica, CA 90403
Sarah Rettinger, MD
1831 Wilshire Blvd., Suite A, Santa Monica, CA 90403