Hypertension (Part I)

Happy Monday, and welcome to Medical Mondays!

February is American Heart Month, so I thought I’d start off with Hypertension!

…and since hypertension (HTN) is such an important topic (one of the “big 3!”), it’s getting two posts! :O Today’s post will focus more on the diagnosis, risk factors, and screening, and Part II, which will focus more on prevention, will roll out later on this week, so keep your eyes peeled! :]

HTNPart1
In the United States, the treatment of hypertension is the most common reason for office visits in non-pregnant adults and for use of prescription drugs.

Despite the fact that hypertension awareness, treatment, and control have all improved over the last few decades, a 2005-2008 National Health & Nutrition Examination Survey revealed that only ~50% of persons with hypertension had their blood pressure under control (< 140/90 mmHg).

Hypertension is associated with a number of serious adverse effects, and is one of the major modifiable risk factors for premature cardiovascular disease.

A patient with hypertension has increased risk of:

  • Heart failure
  • Ischemic stroke or heart disease
  • Intracerebral hemorrhage
  • Chronic kidney disease + end-stage renal disease

Diagnosis

For simplicity’s sake, your systolic blood pressure is the top (higher) number, and your diastolic blood pressure is the bottom (lower) number. For instance, if your blood pressure is 120/80, 120 is your systolic blood pressure (SBP) and 80 is your diastolic blood pressure (DBP)

The diagnosis of hypertension can be made after two or more office visits of elevated blood pressure (see table below) after an initial screen:

 

Stage Systolic Diastolic
Normal < 120 mmHg < 80 mmHg
Pre-hypertension 120-139 mmHg 80-89 mmHg
Hypertension (Stage 1) 140-159 mmHg 90-99 mmHg
Hypertension (Stage 2) > 160 mmHg > 100 mmHg

 

Risk Factors

There are a number of risk factors that increase an individual’s chances of having hypertension. Although some are not modifiable (e.g. age, family history, race), there are many that can be changed and improved upon by the patient (e.g. diet, activity, nutrition).

  • Age: Advancing age is associated with increased blood pressure (especially systolic) + incidence of HTN
  • Obesity + weight gain
  • Family history: 2x more common in individuals who have 1 or 2 hypertensive parents
  • Race: tends to be more common, more severe, with earlier onset and greater target-organ damage in blacks
  • Reduced nephron number
  • High-sodium diet
  • Excessive alcohol consumption
  • Physical inactivity
  • Diabetes + dyslipidemia
  • Personality traits + depression: may be more common in individuals with certain personality traits (e.g. hostile attitudes, time urgency/impatience, depression)
  • Hypovitaminosis D

Screening

The current guidelines on screening for high blood pressure in adults is as follows:

  • Every 2 years for persons with systolic + diastolic pressures below 120 and 80 mmHg, respectively
  • Every year for persons with a systolic pressure of 120-139 mmHg or a diastolic pressure of 80-89 mmHg

 

Stay tuned for Part II, where I’ll be going into more detail about its methods for prevention, later on this week! :]


I came up with this design ages ago for our class t-shirt contest! :]
Disclaimer: The information in this post was gleaned from UpToDate articles and other med school resources. This is where I also reiterate that I am merely a medical student struggling through the world that is her clinical rotations. The statements made on this blog should not be taken as medical advice to treat, cure or prevent any disease. Please contact your own physician or health care provider before starting a health or fitness/wellness program. (See full disclaimer here.)

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34 comments

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  1. Thank you for posting this. I am looking forward to reading part 2!
    AJ @ NutriFitMama recently posted…5 Ingredient Paleo PancakesMy Profile

    1. I hope part 2 will be more helpful to people, because hoorayyy for preventative care! <3

  2. Really useful, informative post, Farrah. I’m not in any of the risk categories thankfully, but it’s good to know for my husband’s side of the family who eat a little differently to me. If anything, my blood pressure tends towards low which always confused me given how stressed I felt in my lawyer jobs LOL.
    jess meddows recently posted…Glow Worm Tunnel NewnesMy Profile

    1. I’m glad you’re not! (I had no idea that being Asian was actually a risk factor, so I guess I’ve got that one, but…mine has always been on the lower end of the spectrum too, haha. Yay us?!)

  3. I didn’t know much about hypertension before, this is really helpful! Looking forward to part 2 :)
    genevieve @ gratitude & greens recently posted…Red Dragon Fruit, Mango, and Banana Smoothie BowlMy Profile

    1. Yay! I’m glad it was! The second one should probably be even more applicable! :]

  4. Great information! My mother has hypertension so I try to do all I can to prevent it.
    Earl-Leigh recently posted…Raw Applesauce {Toddler Approved}My Profile

    1. You’re definitely doing the right things! <3!

  5. Again, great great info to get out there my friend!
    Rebecca @ Strength and Sunshine recently posted…Power Monday #68 Finding Happiness In The Little ThingsMy Profile

    1. Gotta do my part to promote American Heart Month! :D

  6. Didn’t know much about hypertension but this post is super informative. As always, thanks for sharing! Looking forward to part 2 :)
    Gloria recently posted…Barre3 UTC: Challenge ReviewMy Profile

    1. Yay, I’m glad it was helpful! Hopefully, part 2 will be even more applicable! :P

  7. Hypertension is such a huge problem for many americans!! It’s good to know that many of the risk factors are totally preventable!
    rachel @ Athletic Avocado recently posted…Paleo Skillet Carrot CakeMy Profile

    1. Yep! That’s definitely the silver lining for this one! :D

  8. It’s always a good idea to spread awareness about heart disease! Even small changes with our lifestyles, diet, physical activity, etc. can make a huge difference in the long run!
    Alanna recently posted…A Guide For Using Essential Oils {Guest Post}My Profile

    1. Definitely! :] I think that’s what a lot of people don’t realize, but it really does make a world of a difference!

  9. Wow! Super informative :) Thank you for sharing!!
    Nancy recently posted…28 Days of Love!!My Profile

    1. Tis my [future] job! ;P Thanks for reading! :]

  10. Very interesting!! I love these updates. Thanks for sharing your wealth of knowledge with us!
    Julie @ Running in a Skirt recently posted…Sandals Grande Antigua ReviewMy Profile

    1. Thanks for being my audience! ;P It helps me to review how to explain things to my future patients! :]

  11. Great info that everyone needs to know! So glad someone is doing such informative posts like this! :)
    Emily @ Zen & Spice recently posted…Roasted Chickpea & Veggies Brown Rice Bowl with ShrimpMy Profile

    1. Thank you, Emily! I’m looking forward to next week’s! ;P

  12. Great post! Informative without being too technical :) looking forward to reading more!
    Jess @hellotofit recently posted…Monday motivation – believe and achieveMy Profile

    1. Hooray! I’m glad to hear that! My constant worry is that I’m being too technical–you’re helping me to keep that in check! :D!

  13. Another great Medical Mondays! You wouldn’t believe the amount of uncontrolled hypertension that I’m seeing down here in Florida. 200 plus over diastolics in 120s-140s is practically the norm, it’s CRAZY! Compliance is such a huge factor with my patients, it’s really sad. So many young people with CKD and heart disease that could’ve been prevented.

    1. It’s the same here, although I feel like diabetes and obesity are more of the problem in this region (but since they all go hand in hand…). It makes me super sad, and I think compliance is definitely gonna be an issue with my future patients as well, but…for the differences we get to make in the ones that do comply, it’ll be worth it! :]!

  14. Such great information! I’m looking forward to reading part 2. Exercise can be really beneficial for those who suffer from hypertension, but I know I have to be extremely careful with those clients so I’m open to all the tips I can get! I deal with low blood pressure and occasionally spend a day super dizzy. My doctor’s recommendation is to eat a bag of pretzels…not sure how legit that is, but I’ll take any excuse I can to eat pretzels ;)
    Ariana recently posted…Overcoming Anxiety with ExerciseMy Profile

    1. You may well be psychic, because as I read this, I was eating a handful of pretzels and candy corn (I wanted something sweet and salt, so bam!).

      Haha, the salt in the pretzels should help to bring your blood pressure back up! :D I think part 2 should be helpful! Please bother your clients for me! ;P

  15. Great information! I check my blood pressure regularly. Mostly because I think its interesting, mine is always really low so I don’t have to worry about hypertension
    Jen @ pretty little grub recently posted…FYI Friday – 5 ways to reduce sodium in your dietMy Profile

    1. I check mine sometimes too, and it likes hanging out on the low side too. Hooray for exercise + a low-sodium diet! :P

  16. Very informative post, Farrah! I am not the patient here but my sibling is and I want to share this to him. Perhaps, high blood pressure is negatively affect the other health conditions such as kidney infection, dementia and diabetes. Yeah, he developed also a type II diabetes. Looking forward for your next post.
    Lezlie recently posted…5 Ways to Keep Your Blood HealthyMy Profile

    1. Thanks, Lezlie! I hope this information helps your sibling out! The plus side to diabetes and hypertension is that there are still a lot of lifestyle/dietary modifications that can be made to prevent the conditions from getting worse!

  17. Such great information! I had high blood pressure until I finally dropped some weight. Now, I’m in the normal range. Thank you for all information of what to watch for and what to do.
    Shann Eva recently posted…February Goals SetMy Profile

    1. Yay! Great job on the lifestyle modifications! <3

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