Do you know that one in three American adults has high blood pressure? Are you aware that in the U.S., high blood pressure occurs more often in African Americans than in other groups? Even more disturbing, a vast number of people who have high blood pressure are not aware of it, and many of those who are, do not consider it a serious problem.

When it comes to your health, blood pressure matters. This “silent killer” confronts many people, including not only older adults, but children, youth, and young adults as well.

Blood pressure is the force exerted by the blood against the walls of arteries. Blood pressure rises and falls during the day, but blood pressure that remains abnormally high is known as high blood pressure (or hypertension). About 90-95 percent of all high blood pressure cases are referred to as primary or essential hypertension, which means that the real cause of the high blood pressure is unknown.

The remaining cases are referred to as secondary hypertension, which means that the high blood pressure is the result of another illness or health condition. High blood pressure often has no symptoms and is dangerous because if left untreated, it significantly increases the risk of heart attack, congestive heart failure, stroke, kidney failure, and eye damage that can lead to blindness.

You may be at increased risk for having high blood pressure if you:

• Are overweight or obese.
• Are male.
• Are a woman over the age of 55.
• Have diabetes.
• Have a family history of hypertension.
• Have prehypertension.

Other factors that can raise blood pressure include physical inactivity, tobacco use, a diet high in saturated fat and sodium and low in potassium, alcohol consumption (exceeding the guidelines for moderation), inadequate stress and anger management, certain medications, and pregnancy, oral contraceptives, and hormone replacement therapy.

Healthy adults should have their blood pressure checked at least once a year. Using a blood pressure cuff and stethoscope or electric sensor, a nurse or physician can assess your blood pressure and tell you whether it is high. Although many stores have blood pressure machines that you can use free of charge, keep in mind that these machines may not give you a correct reading.

Blood pressure is measured in millimeters of mercury and expressed as two numbers (e.g., 120 over 80). The first number--which will be the highest number and is considered the “top” number--is the systolic blood pressure, which is the force of the blood in the arteries as the heart beats. The second, or “bottom,” number, is lower and is the diastolic blood pressure, which is the force of blood in the arteries as the heart relaxes between beats.

Both numbers are important; a rise in either one indicates a potential problem that needs attention--either through lifestyle changes and/or medical treatment. According to new guidelines released by the National Heart, Lung, and Blood Institute, a reading below 120/80 is classified as normal. People with a blood pressure reading between 120/80 and 139/89 are now classified in the category called prehypertension. Individuals in this category are at twice the risk of developing high blood pressure later in life. Those with a blood pressure reading of 140/90 or higher are in the category of hypertension.

To prevent and control high blood pressure, the first step involves important changes in your lifestyle. You should:

• Maintain a healthy weight.
• Get regular physical activity (30-60 minutes daily or on most days of the week).
• Use the federal government’s Dietary Guidelines for Americans 2005 and the new Food Pyramid as guides to healthier eating.
• Learn to control/manage stress and anger.
• Avoid tobacco products and environmental tobacco smoke.

If these changes do not help control blood pressure within three-six months, several different types of prescription medications are available. Although these medications work differently, their overall effect is to help relax and widen arteries and reduce the pressure inside their walls. Even if a physician prescribes blood pressure medicine, it is still important to follow the lifestyle guidelines cited above.

Marilyn Massey-Stokes, EdD, CHES
Associate Professor of Health, Texas Tech University, Lubbock, TX

American Heart Association, 7272 Greenville Ave., Dallas, TX 75231; 00-AHA-USA-1; www.americanheart.org

Centers for Disease Control & Prevention, 1600 Clifton Rd., Atlanta, GA 30333;
404-639-3311; www.cdc.gov

National Heart, Lung, & Blood Institute, PO Box 30105, Bethesda, MD 20824-0105;
301- 592-8573; www.nhlbi.nih.gov

MedlinePlus, www.nlm.nih.gov/medlineplus/highbloodpressure.html