What is high blood pressure?

Having high blood pressure, which doctors call hypertension, and not knowing it, or knowing it and not taking control, is like walking around with a time bomb ticking inside your body: You never know when it will explode.

Unfortunately, there are no symptoms to warn you that your blood pressure is spiraling out of control until it has already caused damage such as heart disease, stroke and kidney disease. This absence of early warning symptoms is why high blood pressure is called the "silent killer."

Although about 50 million American adults have high blood pressure, a higher percentage of African Americans--nearly 40 percent higher than whites--suffers from it. That's about six million African Americans. But the problem is even more serious because African Americans develop high blood pressure earlier in life than do whites and our average blood pressures are much higher. What's more, compared to whites, African Americans suffer from higher rates of the deadly complications of high blood pressure--50 percent higher heart disease death rates, 80 percent higher stroke death rates and six nines greater death rates from kidney disease.

Unfortunately, more than 30 percent of American adults with high blood pressure don't even know they have it. And, of those people who know they have high blood pressure, many do not get treatment. These people are a medical crisis waiting to happen. In fact, African Americans often don't get treatment until they have had high blood pressure for a long time and some vital organs are damaged.

But it doesn't have to be this way, because there is good news, too. High blood pressure is treatable and controllable. And, you can lower and control your high blood pressure with faithful use of medication and lifestyle changes, such as diet and exercise. These approaches can help reduce your risks of heart disease, stroke and kidney disease. You can supplement these efforts with spiritual and psychological stress-busting techniques, such as meditation. You do not have to be a passive victim of high blood pressure and you do not have to become a victim of its complications. With your doctor's help, you can take control of your health and defuse the high blood pressure time bomb: This supplement can help to show you how.

The pressure's on

First, you should understand what you are up against. When your heart beats, it squeezes blood through your arteries, blood that exerts pressure against the walls of your arteries. Between beats, your heart rests. Blood pressure is the amount of force exerted against the walls of your arteries when your heart beats, and the amount of force exerted when your heart rests. Most high blood pressure is not the result of another disease and is called essential hypertension or primary hypertension. This most common form of high blood pressure is usually a result of hardening of the arteries, which can be the result of such things as an unhealthy diet and physical inactivity. Although hardening of the arteries is a natural process as a person ages, high blood pressure can speed up the process. There are some people whose blood pressure rises only in the doctor's office--a condition called white-coat hypertension, which puts a person at future risk for the real thing.

The numbers game

Blood pressure is measured in millimeters of mercury, written "mm Hg." The higher pressure records the pressure when your heart beats, for example, 130 mm Hg; this is called the systolic blood pressure. Recent data show that your systolic blood pressure, or first number, is more important to control because it is a greater predictor of adverse cardiovascular events. The "resting" pressure in between beats is called the diastolic blood pressure, or the second number. Let's say your diastolic blood pressure is 74 mm Hg. You would then record your blood pressure by writing the systolic over the diastolic, like this: 130/74 mm Hg.

A "normal" blood pressure is not a single number, but a range. A normal blood pressure is 139/89 and lower. So if yours is lower than 140/90, make plans to keep it there. If your blood pressure is higher than 140/90 mm Hg, it is important to talk to your doctor about ways you can lower it.

It is very important to know your numbers and be guided by your doctor--who can offer an individualized examination--in setting your blood pressure goal, because you or your doctor may have other medical concerns that affect your goal. People with diabetes, for example, should strive for a lower blood pressure reading, one below 130/85 mm Hg. In most cases, it is more beneficial to focus on getting your first number (systolic blood pressure) to goal.

BLOOD PRESSURE CATEGORIES(*) FOR ADULTS
(AGE 18 AND OLDER)([dagger])

CATEGORY              SYSTOLIC PRESSURE   DIASTOLIC PRESSURE
                          (IN MM Hg)          (in mm Hg)

Normal                Lower than 130   Lower than 85
High normal           130 - 139        85 - 89
High blood pressure   140 and higher   90 and higher

(*) From the Sixth Report of the Joint National Committee on
Prevention, Detection, Evaluation and Treatment of High Blood
Pressure (JNC-VI) guidelines.

([dagger]) Not taking high blood pressure medication and not
acutely ill.

THE TRUTH ABOUT HIGH BLOOD PRESSURE?

Myths about high blood pressure abound. Which of the statements below are true and which are false? See how many you can answer now; then take this quiz again after you have finished reading the supplement.

1.   T   F   Uncontrolled high blood pressure can
             cause a stroke.

2.   T   F   If there is high blood pressure in your
             family, you will get it no matter what.

3.   T   F   You should take your medication only
             when you feel sick.

4.   T   F   Exercise can help control your high
             blood pressure.

5.   T   F   If you exercise and watch your diet,
             you don't have to take your high blood
             pressure medication.

6.   T   F   It is more important to control your
             systolic blood pressure.

7.   T   F   It is important to follow your medication
             schedule and not skip a dose.

ANSWERS TO QUIZ

1. True; 2. False; 3. False; 4. True; 5. False; 6. True; 7. True

RISK FACTORS

Risk factors can raise the likelihood that you will develop high blood pressure. Some are uncontrollable, such as your age. But you can control other risks, such as excess weight.

Uncontrollable

Genetics * African Americans are at higher risk for high blood pressure than are whites and if you have people with high blood pressure in your family, your risk of developing it is higher. But the high blood pressure that plagues African Americans is no longer thought to be only the product of genetics. Lifestyle differences, environment and poorer access to quality health care are also factors.

Aging * Your risk for high blood pressure tends to rise as you age. It generally begins in people between the ages of 35 and 50, and occurs in over 50 percent of people over the age of 65.

Controllable

Weight * Carrying too much weight around is not only physically and emotionally difficult--it can be life threatening. Being overweight is a major risk factor in developing high blood pressure.

Smoking * A significant rise in blood pressure goes with the smoking of each cigarette.

Inactive lifestyle * Not participating in any form of regular exercise can increase your risk for high blood pressure.

Nutrition * A diet high in fat increases your risk for high blood pressure.

Salt * Eating salt drives up blood pressure, and African Americans tend to be more sensitive to sodium than whites.

Stress * Emotional stress, including the stress brought on by acts of racial prejudice, encourages high blood pressure.

Alcohol * Excessive alcohol intake is an important risk factor for high blood pressure.