Hypertension - High Blood Pressure
Hypertension is sustained elevation of blood pressure above normal levels. It is a common occurrence in the elderly, but it is not a consequence of the aging process. It has many possible causes. Not all are known. On occasion, for brief intervals, there may be elevations in blood pressure that are not part of hypertension.
Clearly, sustained elevation in blood pressure may lead to heart disease, stroke, and kidney failure. Treatment to lower blood pressure to normal levels reduces these risks even in elderly patients.
The measurement of blood pressure with the commonly used blood pressure cuff involves many possible sources of error. Physicians are unlikely to make a diagnosis of hypertension from one or even several blood pressure measurements unless the pressures measured are very high. They may ask you to return for repeated blood pressure checks for several days to decide if you have true sustained high blood pressure.
Important Points in Treatment
If a cause for the elevated blood pressure can be found, it is best to try to lower the pressure to normal by treating the cause. In many patients no cause can be found (this is essential hypertension), and in some people treatment of the cause might have begun too late to permit the blood pressure to return to normal. Your physician may choose to start treatment to lower your blood pressure directly.
Besides drugs, other forms of treatment are effective in reducing blood pressure in some patients. These include weight loss, exercise, stopping smoking, low salt diet, calcium supplements, and stress management. These other forms of therapy may not be completely successful in lowering your blood pressure to normal, but they can reduce the amount of medication needed and thus reduce the possibility or severity of drug-related side effects.
Many kinds of blood pressure-reducing drugs are available. These include diuretics, vasodilators, adrenergic inhibitors, calcium channel blocking drugs, and enzyme inhibitors (ACE inhibitors). You may hear from family or friends that they know of someone taking one or several of these different classes of drugs. The selection of the proper drug depends on your degree of high blood pressure and on your other medical problems. Some of the medications used to treat high blood pressure can bring out or worsen other diseases. The selection of the drug and the dosage are individualized for each patient.
The treatment of high blood pressure often involves a complex program that includes several elements. Do not hesitate to discuss the program with your physician so that you understand the function of each element in your antihypertension program lest an important element be omitted.
Changes in blood pressure with treatment occur slowly. Rapid changes may be harmful or cause side effects. In some patients, careful monitoring of blood pressure at home with a blood pressure cuff is helpful. You should be aware that there may be differences in the blood pressure measured by different observers using different cuffs. It is best to have blood pressure checks done at the same location. Coin-operated blood pressure cuffs found in stores are notoriously inaccurate and are not reliable to monitor blood pressure.