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Hypertension or high blood pressure is a medical condition in which the blood pressure in the arteries is higher than it should be, or simply where the force of blood against wall of the arteries in the body is high.
For many patients, hearing the word 'hypertension' for the first time is frightening. The patient reacts, usually blaming it on stress, nervousness, or white coat syndrome and any of these causes can be true. Some people who usually have normal blood pressure find that it spikes whenever they visit a doctor.
It is necessary to understand and make the diagnosis after measuring blood pressure on two or more occasion before starting any patient on medication, since high blood pressure if left untreated could develop heart disease, stroke, and/or kidney disease.
The heart is like a pump with two drains, one on each side of the heart. The right one (vein) brings the impure blood from the entire body and empties in the right side of the heart, while the left one (artery) pumps it out into the vascular system after it gets purified (oxygenated) by the lungs. High blood pressure requires the heart to work harder than normal, putting strain on the heart that can be detected on an EKG.
Systolic pressure is the amount of pressure in your arteries during the contraction of your heart.
Diastolic pressure refers to when your heart is relaxed between beats.
Systolic/diastolic should be below 140/90mnHg. It is best to have your blood around 120/80 mmHg.
Hypertension is "primary" and "secondary".
Primary Hypertension (90-95%)
Often no cause for high blood pressure can be identified.
- It's genetic--there's tendency to develop blood pressure with a family history of hypertension.
- Obesity, sedentary lifestyle, stress, smoking, excessive intake of salt, and a high-fat diet on a regular bases could be a factor.
- Aging may contribute to hypertension, because with aging, the arteries gradually stiffen and narrow. This may also explain why blood pressure increases with age. It is like pushing water through a rigid and narrow pipe.
Secondary Hypertension (5-10%)
This is secondary to kidney disease or hormonal disorder.
No matter primary or secondary, it can damage our bodies for years before symptoms develop. Left uncontrolled and untreated, it may result in poor quality of life, coronary artery disease, myocardial infarction, heart failure, stroke, and renal failure.
- Blood tests: Fasting lipids, comprehensive metabolic panel, serum uric acid.
- Thyroid tests, urinalysis, and urinary albumin: Creatinine, c-reactine protein
- EKG, chest x-ray, and echo only if advised
Hypertension can often be treated with changes in lifestyle, diet with low cholesterol, and exercise on a regular bases 3-5 times per week.
Here's what you can do:
- Lower your salt intake
- Limit the amount of alcohol, stop smoking
- Maintain calcium, magnesium, and potassium with supplements
- Lose weight
Antihypertensive drugs may be given. If lifestyle changes do not decrease blood pressure, the patient may need to be on medications. A doctor will choose which medications to use based on other associated medical problems if any.