At a glance

Understanding Blood Pressure Readings

When you take your patient’s blood pressure you are measuring two numbers, the top number is the systolic pressure and the bottom number is the diastolic pressure.

Systolic Blood Pressure measures the amount of pressure exerted against your arteries during contraction of your heart muscle. When the heart muscle contracts it pushes oxygenated blood out to the rest of your body. 

Diastolic Blood Pressure measures the amount of pressure exerted against your arteries between contractions or when your heart is at rest. This is when your heart fills with oxygenated blood that will be pushed out into the rest of the body during systole.

Blood Pressure Chart from American Heart Association

Chart from American Heart Association

Quick Info - Hypertension

The constant force against arterial walls caused by high blood pressure leads to damage to the inner lining of the artery. When the artery is damaged it loses its elasticity and becomes hard. Plaque made from fat deposits in the blood stick to the arterial wall. The plaque causes the artery to narrow making it harder for the heart to pump blood to the brain, heart, kidneys and other organs in the body.

What happens when arteries are hardened and narrowed?

Stroke An Ischemic stroke occurs when blood flow can’t get through the narrowed arteries leading to the brain. Oxygen starved brain cells die leading to disability or death.

Subarachnoid Hemorrhage Is a type of stroke that occurs when a damaged artery is weakened from the constant pressure against the arterial wall. The weakened artery can’t sustain the pressure and eventually burst, causing bleeding between brain tissue. 

Myocardial Infarction Or a heart attack occurs when the arteries leading to the heart are narrowed or occluded with plaque. Oxygenated blood can’t get to the cells of the heart resulting in cell death and a heart attack. 

Congestive Heart Failure Occurs when the heart is overworked from trying to squeeze blood through narrowed arteries.  The overworked heart muscle becomes enlarged and weak. The weakened heart eventually fails and can’t adequately pump blood to the rest of the body. Fluid backs up into the lungs or the body. Fluid overload can cause difficulty breathing, edema, and a shortened life expectancy. 

Kidney failure Kidneys filter toxins from your blood and remove waste products and extra fluid from your body. If the arteries to your kidneys are narrowed and weakened from high blood pressure, your kidneys will become damaged and they lose the ability to remove waste products from your blood. Toxins and waste build up in your blood and cause additional health concerns. 

Blood Clots  Occur when a piece of plaque breaks off the arterial wall and occludes a vessel. Blood Clots lead to stroke, heart attack, and pulmonary embolism.

Atherosclerosis Is the condition caused by the buildup of plaque and narrowing of arterial walls.

Hypertension usually does not cause symptoms unless you are in a Hypertensive crisis. 

Symptoms of Hypertensive Crisis (BP reading 180/120 or greater) Requires immediate medical attention:

  1. Severe headache
  2. Shortness of breath
  3. Nose bleeds
  4. Chest pain
  5. Back pain
  6. Numbness and/or weakness
  7. Blurred vision
  8. Paralysis or trouble speaking

Quick Guide - Common medications used to treat Hypertension

hypertension medications
  • Diuretics, frequently called “water pills” remove sodium and fluid from your body. The decreased fluid volume in your arteries helps lower blood pressure. 

Common diuretics: Furosemide, Hydrochlorothiazide, Spironolactone

Side effects to watch for: Low blood pressure, Low Potassium or High Potassium, Low Sodium, dehydration, and frequent urination. 

Tip: Take diuretics in the morning or late afternoon to avoid nocturia

  • Angiotensin-converting-enzyme inhibitors, or ACE inhibitors work by relaxing the blood vessels and decreasing blood volume which leads to lower blood pressure. These medications inhibit the mechanism that the body uses to maintain blood pressure. 

Common ACE inhibitors: Lisinopril, Enalapril, Benazepril

Side effects to watch for: Dry cough, Elevated Potassium levels, Fatigue, Dizziness, Headache, and Loss of taste

Tips: Avoid eating salt substitutes, check with your doctor before taking over the counter medications, such as NSAIDS. Usually taken on an empty stomach one hour before meals 

  • Calcium Channel Blockers inhibit the movement of calcium into the heart and arteries. Calcium causes the heart and arteries to contract strongly.  By reducing the amount of calcium in the arteries, the vessels can relax and open wider making it easier for the heart to pump. With less Calcium, the heart doesn’t have to work as hard and blood pressure is reduced.

Common Calcium Channel Blockers: Amlodipine, Diltiazem, Felodipine

Side effects to watch for: Low blood pressure, heart rhythm problems, dry mouth, edema, GI upset

Tips: Do not take with grapefruit, Alcohol interferes with the effects of calcium channel blockers and can increase side effects

  • Vasodilators widen and relax your blood vessels, allowing blood to flow through your vessels. Your heart doesn’t have to pump as hard resulting in reduced blood pressure.

Common Vasodilators: Hydralazine, Minoxidil, Nitrates

Side effects to watch for: Rapid heart beat, Flushing, Edema, Nausea and Vomiting, Excessive hair growth

Tips: Alcohol may interfere with the effects of vasodilators

  • Beta-blockers Reduce the heart rate, the heart's workload and the heart's output of blood, which lowers blood pressure. 

Common Beta-blockers: Metoprolol, Atenolol, Nadolol

Side effects to watch for: Fatigue, bradycardia,  shortness of breath, cold extremities, weight gain

Tips: Beta-blockers can slow the heart rate, Teach your patients how to take their pulse

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Risk Factors

Age: Men age 64 and older, Women age 65 and older

Family history: Parents or close relatives

Race: African Americans are more likely to have high blood pressure than any other race.

Kidney disease: High blood pressure can cause kidney disease and kidney disease can cause high blood pressure.

Preventing High Blood Pressure 

Physical Activity is good for your heart and circulation and can help prevent high blood pressure.

Diet, eating a healthy diet that is low in sodium, low in saturated fat, and sugar helps prevent high blood pressure. Sodium causes the body to retain fluid. Fluid retention results in higher blood volume and increased pressure in the vessels.

Maintain weight, excess weight puts a strain on your heart and circulatory system

Limit alcohol intake, drinking alcohol can cause hypertension and other health concerns

Stop Smoking: Tobacco can damage your arteries and cause your blood pressure to increase 

Reduce Stress, stress is shown to cause high blood pressure

This is a quick guide only, content from this site is for reference purposes only and is not to be used as a substitute for a licenced health care provider. 

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