Hypertension

What causes hypertension ?

The root causes of high blood pressure are not entirely understood. But there are certain things that increase your risk of hypertension. These include:

• being a man over 64 or a woman over 65
• a family history of high blood pressure
• being of African origin

Some features of your lifestyle might make you more susceptible to hypertension, too. These are:

• tobacco use, either smoking or chewing
• drinking alcohol to excess
• too much salt in your diet
• too little potassium in your diet
• being obese or overweight
• high levels of stress
• inactivity

Sometimes hypertension is caused by an underlying condition. This can make your blood pressure rise very suddenly. Conditions that may cause hypertension include:

• adrenal gland tumours
• kidney problems
• obstructive sleep apnea
• thyroid problems

Certain medications may cause hypertension, too, for example:

• cold remedies
• decongestants
• over-the-counter pain relief
• some birth control pills
• some prescription drugs

What are the symptoms of hypertension ?

It is common for people with high blood pressure to not know they have it as it does not have obvious symptoms. It’s easy to detect high blood pressure with a simple measurement in a healthcare setting, but hypertension does not have symptoms that you can detect day to day.

It is more likely that your high blood pressure will be picked up when you have your blood pressure measured during a routine health-check.

But if you develop the following symptoms, seek medical attention:

• blurring of the vision
• headaches
• nausea and dizziness
• pulsations in head and neck
• short breath

These are symptoms of malignant high blood pressure, which is a medical emergency.

Complications of high blood pressure

If your blood pressure is consistently high, it may damage your arteries and speed up atherosclerosis, or hardening of the arteries. This can result in:

• stroke
• ischemic heart disease
• peripheral vascular disease
• heart failure
• aneurysms
• kidney failure
• sight damage
• reduced blood supply to the brain leading to dementia

How does a doctor diagnose hypertension ?

Blood pressure varies throughout the day. This table gives an idea of the range for blood pressure measured in a healthcare setting like your doctor’s office:

Because being in a healthcare setting can raise your blood pressure (white coat hypertension), the range is slightly different for blood pressure measured at home. If you have a consistent blood pressure measured at home of above 135 mmHg systolic and/or 85 mmHg diastolic, that is considered high.

People with diabetes and long-term kidney disease need to keep an eye on their blood pressure as their condition makes them more vulnerable to the damaging effects of hypertension. The boundary line for high blood pressure when you have diabetes or kidney disease is over 130 mmHg systolic or over 80 mmHg diastolic.

What to do if you think you have hypertension

If you are worried you may have hypertension, get your blood pressure checked. This will confirm whether or not your blood pressure falls within a healthy range. You can get your blood pressure checked at your doctor’s office, or there a surprising number of places near you where you can get your blood pressure measured:

• ambulance stations
• community centres
• drugstores
• fire stations
• fitness centres
• health fairs

How is hypertension treated?

Your doctor may give you a blood pressure goal to work toward. You may be able to meet this goal without medication, just by making lifestyle changes.

Treatment of hypertension is all about maintaining healthy behaviours and supporting these lifestyle changes with medication. You will have to maintain a healthy lifestyle, but if your blood pressure stays under control for several years, you may be able to stop taking medication. However, some people need to take hypertension meds for the rest of their lives.

Medications that may be prescribed for hypertension

There are several types of medication used to control blood pressure. They include:

• ACE inhibitors
• angiotensin-2 receptor blockers (ARBs)
• calcium channel blockers
• diuretics
• beta blockers
• alpha blockers

Your doctor may try a combination of different types of drugs to treat your hypertension. It is common to have your blood pressure prescription change a few times as you and your doctor work out the best meds with the fewest side-effects.

ACE inhibitors and angiotensin-2 receptor blockers

Angiotensin-converting enzyme (ACE) inhibitors and angiotensin-2 receptor blockers (ARBs) relax your blood vessels. Examples of ACE inhibitors that your doctor might prescribe for hypertension include: enalapril, lisinopril, perindopril and ramipril. Your doctor might prescribe ARBs such as candesartan, irbesartan, losartan, valsartan and Olmesartan.

Calcium channel blockers

Calcium channel blockers widen your blood vessels. Examples of calcium channel blockers are amlodipine, felodipine and nifedipine or diltiazem and verapamil.

Diuretics

Diuretics flush water and salt from your body in your urine. They are sometimes called water pills.

Diuretics that might be prescribed for hypertension include: indapamide and Bendroflumethiazide, amiloride and spironolactone.

Beta blockers

Beta blockers such as atenolol and bisoprolol treat hypertension by reducing the speed and force of your heartbeat.

Alpha blockers

Alpha blockers are prescribed for hypertension because they prevent the hormone norepinephrine from tightening the walls of your blood vessels. Doxazosin is an alpha blocker.

How do I get medications for hypertension ?

In Canada you can depend on NX Pharmacies for your hypertension meds. We serve all areas of Canada and can fill your prescription of hypertension medication. We can help with renewals and refills. Our discretion is assured, and you can depend on us for authentic Health Canada-approved medications.

Even if you’ve been successfully managing your hypertension for years, you can still benefit from the support of a doctor or pharmacist.

If something changes with your hypertension , talk to your GP. And if your meds stop working, or you start to get uncomfortable side-effects, ask for a medicines review. Your pharmacist may also be able to advise on managing side-effects of your hypertension meds.

How will I know if my hypertension meds are working?

It can be difficult to tell whether your hypertension meds are working, as you won’t feel any different. It’s important to keep taking them, though. Talk to your doctor if you have questions about whether your meds are working. You will have regular check-ups to keep an eye on your blood pressure, and this is an opportunity to ask any questions you might have.

Do hypertension drugs have any side-effects?

Most people take hypertension drugs without any ill-effects. It’s really important that you do not stop taking your meds without talking to your doctor. They can advise on changing your medication. You can also speak with a pharmacist, who can tell you if there are any adjustments you can make to your regime.

Is it safe to take hypertension meds with drugs I’m taking for another condition?

All your prescribed medications should be on your medical record so your doctor should know about them and take them into account when prescribing. If you are taking anything else, such as over-the-counter remedies, recreational drugs, herbal preparations or nutritional supplements, tell your doctor.

Remember that you can always ask your pharmacist about interactions between your medications and supplements.

What if my hypertension is caused by medication for another condition?

Some meds commonly taken for other conditions are linked to hypertension. These include certain birth control pills and some prescription drugs. If your prescribed drug is linked to hypertension, then part of your care plan will be regular blood pressure checks.

There are also some cold remedies, pain relievers and decongestants available over the counter that can cause raised blood pressure. It’s not a good idea to take these long-term. Ask your pharmacist for alternative ways to manage your symptoms.

How to manage hypertension with lifestyle changes

Your GP may recommend some lifestyle changes to alleviate your hypertension symptoms. Ask for support if you need help with implementing any of these lifestyle changes.

Eat less salt and fat to keep your blood pressure within healthy limits

If you are managing hypertension, take extra care to eat a healthy, low-fat balanced diet. It’s important to eat less than 2,000 mg of sodium (that’s not quite a teaspoon of salt). Other sources of sodium include sodium bicarbonate, monosodium glutamate (MSG) and sodium citrate. Soy sauce is also high in sodium. This may mean cutting out processed food and prepared meals.

Aim for a diet that is rich in nutrients, particularly potassium, calcium and magnesium. Heart and Stroke Canada has some information about the DASH diet, which has been specially designed for people trying to reduce their blood pressure.

Take appropriate exercise to manage hypertension

Leading an active life has many wellbeing benefits. It can also help with hypertension. An active lifestyle also helps with managing stress, which can contribute to high blood pressure; and alongside a healthy diet, it can help you lose weight. Two and a half hours of moderate to vigorous exercise every week is a good target to aim for.

Track your own blood pressure

You can get a home blood pressure monitor to keep an eye on your numbers so you stay motivated as you work toward your blood pressure goal. Ask your healthcare provider to recommend a good blood pressure monitor to use at home. You can bring it to your appointment to make sure it is accurate, to check the cuff fits and to ensure you are using it correctly.

Keep your weight within healthy limits to manage hypertension

Healthy diet and regular exercise will help with weight loss. Losing just 10 lb can reduce your blood pressure, and this may mean you can stop taking blood pressure meds.

Drink less caffeine to reduce your blood pressure

Caffeine, the stimulant found in cola, coffee and tea, can increase your blood pressure. Cut back if you drink a lot of caffeinated beverages. Caffeine is found in some over-the-counter cold remedies. If you are trying to reduce your caffeine intake, let the pharmacist know and they will help you to select caffeine-free cold and flu pills.

Drink less alcohol to control blood pressure

Cutting back on how much alcohol you consume may help you manage your blood pressure. Talk with your doctor about how much you drink, even if you don’t think you are drinking to excess. Try to limit alcohol to no more than two drinks in one day, and 14 in a week for men and nine a week for women. If you need help with quitting drink, or cutting back, ask your doctor or a pharmacist.

Stop tobacco use to alleviate hypertension

Stopping nicotine use will help you lower your blood pressure. This includes use of:

• chewing tobacco
• cigarettes
• cigars
• nicotine gum
• pipes
• snuff

Ask for help if quitting tobacco and nicotine is difficult for you. Your pharmacist can advise on reliable nicotine cessation methods.

Manage stress in your life to reduce hypertension

Reducing stress in your life will help keep your blood pressure low. Do what you enjoy, with people you like spending time with. There are also relaxation techniques you can learn, such as meditation, which can help manage stress and lower blood pressure.