Under Pressure

What is Blood Pressure?

Blood pressure (BP) is the force of blood moving against the walls of your arteries. It is expressed as two numbers: The top number is called SYSTOLIC (mmHg), the pressure or force in the arteries when the heart beats. The bottom number is called DIASTOLIC (mmHg), the pressure measured between heartbeats. A normal blood pressure level is 90-120/60-80. In the most recent guidelines, 120-129/<80 is considered elevated blood pressure.

What is High Blood Pressure or Hypertension?

High BP, also known as hypertension, occurs when the force of blood against the artery walls is too high. It is often called the “silent killer” because many people are not aware of it. Over time, high BP can lead to a heart attack, stroke and other serious conditions.

What are the new guidelines on Hypertension?

The guidelines change based on how blood pressure is defined. For example, BP between 120-139/80-89 mm Hg was defined before as “prehypertension”, and the cutoff for stage 1 hypertension was 140/90 mm Hg or higher. Those cutoffs are now lower, with stage 1 hypertension starting at 130/80 mm Hg. Therefore, patients with a blood pressure between 130-139/80-89 mm Hg now are seen as having stage 1 high blood pressure.

The new guidelines replace the term “prehypertension” with “elevated” blood pressure. This label covers patients with elevated blood pressure who are at higher risk for developing full-blown hypertension.

Causes of Hypertension

The causes of Primary Hypertension or Essential Hypertension are still poorly understood but are most likely the result of numerous genetic and environmental factors that have multiple compounding effects on cardiovascular and renal structure and function. A number of risk factors are strongly and independently associated with its development, including age, obesity, family history, ethnicity, reduced nephron number, a high sodium diet, and physical inactivity.

A number of common and uncommon medical conditions may increase blood pressure and lead to secondary hypertension. The most common causes of secondary hypertension are primary aldosteronism and renal artery stenosis, chronic kidney disease, and obstructive sleep apnea. Less common causes include pheochromocytoma, Cushing’s syndrome, and aortic coarctation.

Hypertension Treatment

Treatment recommendations are not the same for all patients with high blood pressure. Experts urge patients with stage 1 hypertension at low risk for developing heart disease to adopt healthy lifestyle changes as their first line of treatment. These include:

• Lose weight if needed and keep a healthy body weight.

• Follow a healthy diet: Follow the Dietary Approaches to Stop Hypertension (DASH) diet, limit salt and eat potassium-rich foods.

• Get regular physical activity.

• Limit alcohol: no more than 1 drink per day for women, 2 drinks per day for men.

Dr. Maria Chinky B. Guingab

Family Physician

Dr. Guingab has 17 years of clinical experience and has been practicing in Shanghai for 10 years. Before moving to Shanghai, she served as Family Medicine Doctor at Healthway Clinic in the Philippines.

Shanghai United Family Pudong Hospital

Add: 1598 New Jinqiao Road

Phone: 021-3886-2888 (Open 24/7)