Systolic Pressure And Pulse Pressure Are The Main Risk Factors
In 2036 subjects aged 5079 years in the Framingham heart study, only systolic pressure was independently associated with the development of coronary heart disease over the subsequent 20 years. In patients with systolic pressures of 120 mm Hg the coronary heart disease risk actually increased as diastolic pressures decreased, suggesting that a wider pulse pressure was an important component of coronary risk. A recent report from the Framingham investigators added to this cohort another 4506 subjects from the Framingham offspring study, so that the baseline ages of the combined cohort ranged from 20 to 79 years. Over 17 years, 12% of subjects developed coronary heart disease. In subjects whose baseline age was < 50 years, diastolic pressure was the strongest predictor of the subsequent development of fatal or non-fatal coronary disease, including myocardial infarction and angina pectoris. Between the ages of 50 and 59 years there was a transition period when all three blood pressure measures were comparable predictors of coronary risk. From the age of 60 years, diastolic pressure was inversely related to coronary risk so that the pulse pressure became superior to systolic pressure as a predictor.
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A Lot Of Diagnoses A Lot Of Misunderstanding
A June 2020 paper in the Journal of Atrial Fibrillation , describes the lesser-known diagnoses of a racing heart and the problem of heart rate messaging miscommunication in the autonomic nervous system.
The cardiovascular branch of the autonomic nervous system is responsible for the regulation of heart rate, blood pressure, and maintaining homeostasis during physiological stress such as exercise and standing upright. The autonomic nervous system constantly controls the rate and force of heart contractions and the vascular tone with the aim to maintain the sufficient tissue perfusion with oxygenated blood and secure venous return to the heart. .
- Dysautonomia problems of or dysfunction of the autonomic nervous system.
Dysautonomias, the result of an autonomic nervous system malfunction, is often found in patients with cardiovascular symptoms. Apart from the most prevalent one, arterial hypertension , the cardiovascular dysautonomic continuum encompasses other important although less known conditions: postural orthostatic tachycardia syndrome, inappropriate sinus tachycardia, orthostatic hypotension and reflex syncope . Moreover, heart diseases may evoke autonomic imbalance by themselves cardiac pump failure is usually associated with sympathetic hyperactivity , neuroendocrine vasopressor activation , higher heart rate, reduced heart rate variability and baroreflex hyposensitivity , all of which are predictors of adverse outcomes.
Heart Attack And Heart Disease
High blood pressure can damage your arteries by making them less elastic, which decreases the flow of blood and oxygen to your heart and leads to heart disease. In addition, decreased blood flow to the heart can cause:
- Chest pain, also called angina.
- Heart attack, which happens when the blood supply to your heart is blocked and heart muscle begins to die without enough oxygen. The longer the blood flow is blocked, the greater the damage to the heart.
- Heart failure, a condition that means your heart cant pump enough blood and oxygen to your other organs.
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Treatment Of High Blood Pressure
Treatment for HBP depends on its severity and associated risks of developing other diseases. Treatment options include:
Lifestyle changes
- Make and keep appointments to see your doctor for routine check-ups and follow-up tests.
Medications
- ACE inhibitors will help blood vessels relax and open up, leading to a lower blood pressure.
- Angiotensin II receptor blockers will help blood vessels open up, leading to a lower blood pressure.
- Beta blockers will help reduce your blood pressure.
- Alpha blockers will help reduce the arteries resistance, relaxing the muscle tone of the vascular walls.
- Alpha-2 receptor agonists will help reduce blood pressure by decreasing the activity of the sympathetic portion of the involuntary nervous system.
- Calcium channel blockers will help relax and open up narrowed blood vessels, reduce heart rate and lower blood pressure.
- Combined alpha and beta blockers are used as an IV drip for those patients experiencing a hypertensive crisis.
- Central agonists will help decrease the blood vessels ability to tense up or contract.
- Diuretics water pills will help reduce the amount of fluid retention in your body.
- Peripheral adrenergic inhibitors will help reduce blood pressure by blocking neurotransmitters in the brain.
- Vasodilators will help the muscle in the walls of the blood vessels to relax, allowing the vessel to dilate.
How Can High Blood Pressure Affect Your Blood Vessels And Heart
High blood pressure can affect your arteries and your heart in a number of ways which are all interlinked.
It can damage your blood vessels, reducing the blood flow around your body and back to your heart. Your heart then has to work harder to pump blood and can become enlarged or weak and cant work as well as it should.
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Q Are There Any Female
Q What Is Cardiac Arrest
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What Questions Should I Ask My Doctor
- What is my personal risk of hypertensive heart disease?
- Is there anything else I can do to reduce my risk of hypertensive heart disease?
A note from Cleveland Clinic
High blood pressure is a very common condition, but some people dont even know they have it. If you have been told you have high blood pressure, its very important to take the medicines your provider ordered for you. Keeping your blood pressure under control is a key factor in preventing hypertensive heart disease. You have the power to make healthy changes in your life for a healthy heart.
Last reviewed by a Cleveland Clinic medical professional on 09/21/2021.
References
If You Suspect Youre Having A Heart Attack
Pain or pressure in the chest is the most common symptom of a heart attack. Other symptoms include:
- Pain or discomfort in the arms, back, neck, jaw or stomach
- Shortness of breath with or without chest discomfort
- Nausea or light-headedness
If you experience one or more of these warning signs, call 911 immediately, even if youre not sure its a heart attack. EMS staff can begin treatment when they arrive up to an hour sooner than if someone gets to the hospital by a vehicle. People with chest pain who arrive by ambulance usually receive faster treatment at the hospital, too.
Dont let high blood pressure cause a heart attack:
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What If Your Doctor Assures You Its Just Stress Or Fatigue
If a young, healthy patient doesnt have other risk factors, the likelihood of having significant coronary artery disease is low. It may not be appropriate to jump into testing. But the important thing is to always keep coronary risks in mind. Anyone who is experiencing symptoms that dont go away or get worse should go back to a doctor for further evaluation.
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High Blood Pressure Increases Your Risk Of Heart Attack
Researchers estimate that each rise in systolic blood pressure of 10 mmHg, increases your risk of a heart attack by 20%. Similarly, your risk of a heart attack increases by 2% 3% for each 1mm Hg increase in diastolic BP .
So, if your blood pressure is 130/80 mmHg your risk of a heart attack is 20% greater than if it was 120/80 mmHg. If your blood pressure is 140/90 mmHg then your risk is at least 60% higher than if it were 120/80 mmHg and so on.
The good news is that early diagnosis, making diet and lifestyle changes, and taking antihypertensive medication can help to control your blood pressure so these increased risks return to normal.
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Regular Blood Pressure Checks If Diagnosed With High Blood Pressure
If you are diagnosed with high blood pressure, your blood pressure will need to be closely monitored until it is brought under control.
After your blood pressure has been controlled, your GP or practice nurse will measure your blood pressure at agreed regular intervals .
It is important you attend these appointments to ensure your blood pressure is being maintained within an acceptable range.
What Is A Silent Heart Attack
A silent heart attack, as the name suggests, may have few or no obvious symptoms. In some cases, people may feel tired or have flu-like symptoms, or they could experience indigestion or discomfort in their chest, back, arms, or jaw.
This type of heart attack can sometimes be worse than the regular kind, as people who have them may not receive any treatment.
A silent heart attack can only be diagnosed through an electrocardiogram or MRI scan.
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Cardiac Arrest Vs Heart Attack
Sometimes there is confusion between the terms cardiac arrest and heart attack. A heart attack, or myocardial infarction, is damage to the heart muscle that occurs due to reduced blood flow to the heart muscle, depriving the heart muscle of the oxygen it needs to function properly.
Cardiac arrest means that the heart stops beating and death is imminent. A heart attack, if severe, can lead to cardiac arrest, and this is what occurs when a heart attack is fatal. However, other conditions, such as serious arrhythmias or shock, can also cause cardiac arrest.
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Most People With Hypertension Feel Okay
Hypertension usually does not produce any symptoms, because the organs of the body can resist high blood pressure for a long time. Thats why its important to have regular medical examinations to make sure your blood pressure isnt creeping up as you grow older.High blood pressure over a period of time can contribute to many illnesses, including:
The effects of high blood pressure on the arteries are worsened by:
- cigarette smoking
- high levels of saturated fat in the diet
- high blood cholesterol
Responses to some types of stress may affect both blood pressure and changes in the arteries, but this remains scientifically uncertain.
How Are Heart Diseases Diagnosed
If you have high blood pressure or any signs or symptoms of heart disease, there are a number of tests that can be used to see if any damage has been done to the heart.
The tests include:
- to measure cholesterol, proteins, urine and hormones, as well as other signs of disease and damage
- an a type of ultrasound scan which gives a moving image of the heart. It shows the structure of the heart, including the valves, how well its working and signs of damage
- an ECG which measures electrical signals in the heart, using sensors attached to your skin, to show if the heart is working properly
- a treadmill test where your heart is monitored with an ECG to see how it responds to the physical stress of using the treadmill
- a radionuclide scan a type of scan that uses a radioactive chemical which collects in certain parts of the body
- a CT scan which is similar to an X-ray but more detailed and it gives a 3D image
- an MRI scan this gives a very detailed 3D image which is taken in a large tunnel-shaped scanner, these tend to be used in people with more complex symptoms
- a coronary angiography a type of scan where dye is injected into your blood vessels and the dye can be picked up on the scan, showing any blockages.
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Diagnosis Of High Blood Pressure
The best way to diagnose HBP is to have it measured. A blood pressure reading, given in millimeters of mercury , has two numbers.
- Systolic blood pressure indicates how much pressure your blood is exerting against your artery walls during heartbeats.
- Diastolic blood pressure indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.
Blood pressure measurements fall into four general categories. The American Heart Associations guidelines are as follow:
- Normal blood pressure: A reading of less than 120 and 80
- Elevated blood pressure: A reading ranging from 120 to 129 and below 80
- Stage 1 hypertension: A reading ranging from 130 to 139 or 80 to 89
- Stage 2 hypertension: A reading ranging from 140 or higher or 90
- Hypertensive crisis : A reading higher than 180 and/or 120
*If you have an electronic blood pressure machine and would like to measure your blood pressure at home, please follow The American Heart Associations guidelines:
Not A Minute Too Soon
When you are experiencing a heart attack, every second counts. As more time passes, the more your heart muscle dies.
If you or someone you know experiences these symptoms, call 9-1-1 immediately or get to an emergency room.
The Cardiovascular Institute of Carolina at Aiken Regional Medical Centers is always at the ready to treat heart attack patients 24/7.
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Why Is Your Blood Pressure Important
Your blood pressure is important because if it is too high, it affects the blood flow to your organs. Over the years, this increases your chances of developing heart disease, stroke, chronic kidney disease, eye disease, erectile dysfunction and other conditions.
Very occasionally, people with very high blood pressure are at serious risk of problems and need urgent treatment in hospital to reduce the risk of a stroke or heart attack.
Current Australian guidelines recommend that if you have persistent raised blood pressure over 160/100 mmHg, but are at low risk of having a stroke or heart attack, you should talk to your doctor or specialist about taking medication to lower your blood pressure.
For further information, visit the Choosing Wisely Australia website.
If youre over 18, you should have your blood pressure checked by your doctor at least every 2 years, or more often if advised.
What Is Normal And What Is High Blood Pressure
Normal systolic blood pressure should not rise above 120, and normal diastolic pressure should not rise above 80.
High blood pressure is classified as a reading of 140 over 90, or above.
If the systolic blood pressure rises above 180, or if the diastolic blood pressure rises above 110, emergency care is necessary.
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Lack Of Oxygen In The Blood
If levels of oxygen in the blood decrease due to carbon monoxide poisoning or a loss of normal lung function, the heart will receive un-oxygenated blood.
This will result in the heart muscles being damaged, triggering a heart attack.
Page last reviewed: 28 November 2019 Next review due: 28 November 2022
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What Not To Do
If you feel heart attack symptoms:
- Donât delay getting help.Women generally wait longer than men before going to the emergency room, says Rita F. Redberg, MD, MSc, FACC, director of Womens Cardiovascular Services for the UCSF Division of Cardiology in San Francisco. Even if you think your symptoms arenât that bad or will pass, the stakes are too high.
- Dont drive yourself to the hospital. You need an ambulance. If you drive, you could have a wreck on the way and possibly hurt yourself or someone else.
- Donât have a friend or relative drive you, either. You may not get there fast enough.
- Donât dismiss what you feel.Dont worry about feeling silly if youre wrong, Goldberg says. You have to get it checked out right away.
People dont want to spend hours in an emergency room if it isnt a heart attack, Bairey Merz says. But women are actually good at deciding what is typical for themselves and when to seek health care.
Nieca Goldberg, MD, medical director, Joan H. Tisch Center for Womenâs Health, NYU Langone Medical Center, New York.
C. Noel Bairey Merz, MD, FACC, FAHA, director, Barbra Streisand Womens Heart Center director, Preventive Cardiac Center professor of medicine, Cedars-Sinai Medical Center, Los Angeles.
Rita F. Redberg, MD, MSc, FACC, director, Womens Cardiovascular Services, UCSF division of cardiology professor of medicine, UCSF School of Medicine, San Francisco editor, JAMA Internal Medicine.
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