By Noor Albashir, Gulf Coast Immediate Care Center, Fort Walton Beach, FL
Rose is a 49-year-old female woman who went to her primary care office for a yearly wellness exam. While the nurse was taking her vitals, she informed Rose that her blood pressure was elevated at 147/88. Rose was surprised as she has never had high blood pressure or any medical problems in the past and she feels completely fine.
Your arteries are specialized muscles that carry blood from the heart and deliver it to the rest of the body. Blood pressure is the pressure needed to push that blood against the arteries. When the pressure is high, it is known as hypertension.
There are two causes of hypertension. The most common cause is idiopathic, meaning the cause is unknown, this is known as Benign Essential Hypertension. The second cause of hypertension is due to underlying diseases of the kidney or endocrine system.
Blood pressure is presented as a ratio of two numbers. The top number is known as systolic blood pressure, this number represents the pressure when the heart is pumping blood out to the rest of the body. The bottom number is known as diastolic blood pressure, this number represents the pressure when the heart is resting and refilling with blood.
To be diagnosed with hypertension, a patient must present with TWO elevated blood pressure readings at TWO different visits. The stages of different blood pressures are the following:
| Blood Pressure Classification | |
| Normal Blood Pressure | Systolic <120 and Diastolic <80 |
| Elevated Blood Pressure | Systolic 120-129 and diastolic <80 |
| Stage I hypertension | Systolic 130-139 or diastolic 80-89 |
| Stage II hypertension | Systolic ≥ 140 or diastolic ≥ 90 |
Many patients, like Rose, are unaware they have high blood pressure because it does not usually present with symptoms. Patients may not show any symptoms at all and that is why hypertension can be known as the “silent killer.” However, patients with hypertension can present with headaches, vision changes, chest pain or swelling in the lower legs. Because high blood pressure can present without symptoms, it is important for people to check their blood pressure at local pharmacies or groceries if they do not have a blood pressure machine at home.
Hypertension may lead to complications that include, but are not limited to stroke, life-threatening arrythmias, heart failure, heart attack, or other heart disease, blindness, and kidney damage.
There are many lifestyle modifications one can make to improve their blood pressure. These include limiting salt intake and exercising for at least 30 minutes per day, 5 days per week. Smoking cessation and limiting the number of alcoholic drinks also helps to reduce blood pressure. If lifestyle modifications alone cannot reduce blood pressure to adequate values, there are several safe and effective medications, known as anti-hypertensive agents, proven to clinically reduce blood pressure and reduce cardiovascular damage. These medications are usually taken daily, and you may need more than one to achieve good blood pressure control.
About Noor: Noor is a 26-year-old Palestinian-American Physician Assistant. She graduated from the University of South Florida in 2020 and is licensed in the State of Florida. She works full-time at Gulf Coast Immediate Care and is passionate about pediatric medicine. She recently moved from Tampa to Pensacola and lives with her husband. Noor enjoys traveling, reading, and watching the sunset.
