Conditions We Treat: Blood Pressure Disorders

Blood Pressure Disorders

Blood pressure is the pressure exerted on walls of the blood vessels by circulating blood. Along with body temperature, respiratory rate, and pulse rate, blood pressure is one of the four main vital signs monitored by medical professionals.

Regulated by the nervous and endocrine systems, blood pressure fluctuates somewhat throughout the day depending on factors such as activity level, the body's circadian rhythm, stress and other emotional reactions, sleep, and digestion.

The body has many mechanisms to control blood pressure, including changing the amount of blood the heart pumps, the diameter of the arteries, and the volume of blood in the bloodstream.

When a disease state causes blood pressure to stay persistently high, low, or erratic, problems can arise. The most common blood pressure disorders are high blood pressure (hypertension) and low blood pressure (hypotension). Both have many causes and can range in severity from mild to dangerous.

Hypertension

Hypertension occurs when blood pressure within the arteries puts too much mechanical stress on the artery walls. This causes the heart to work harder. It also leads to unhealthy tissue growth within the walls of the arteries, and thickening and weakening of the heart muscle.

A blood pressure reading of 140/90 mm Hg is generally considered to be hypertensive.

Unless long-standing and untreated, hypertension doesn't usually cause any noticeable symptoms.

Contributing factors

Often no cause for chronic high blood pressure can be identified, but sometimes it occurs as a result of an underlying disorder of the kidneys or  hormones. Other risk factors include:

  • Obesity.
  • A sedentary lifestyle.
  • Stress.
  • Smoking.
  • Excessive amount of alcohol or salt in the diet.

Complications of hypertension

Over time, even mild hypertension can increase the risk of atherosclerosis, stroke, aneurysm, heart failure, heart attack, and kidney damage. Left untreated, chronic high blood pressure can cause progressive damage to one or more vital organs.

Treatment

To treat mild and moderate hypertension, doctors typically begin by recommending that patients reduce alcohol and sodium intake, eat a diet rich in fruits and vegetables, exercise regularly, and lose weight if they're overweight.

If drugs are prescribed, a variety of options are available. Many patients require more than one type of drug to reach their blood pressure goal.

Hypotension

When arterial pressure and blood flow decrease far enough, low blood pressure can occur. Although blood pressure varies from person to person, a blood pressure reading of 90/60 mm Hg is generally considered low. Hypotension is a medical concern if it causes symptoms such as the following:

  • Dizziness or lightheadedness.
  • Fainting.
  • Lack of concentration.
  • Blurred vision.
  • Nausea.
  • Cold, clammy, pale skin.
  • Rapid, shallow breathing.
  • Fatigue.
  • Depression.
  • Thirst.

Severely low blood pressure can deprive your body of oxygen, leading to damage to your heart and brain.

Contributing factors

The causes of low blood pressure range from minor to serious. They include:

  • Pregnancy.
  • Heart problems such as low heart rate (bradycardia), heart valve problems, heart attack, and heart failure.
  • Endocrine problems.
  • Dehydration.
  • A lack of nutrients in your diet.
  • Sepsis.
  • Shock.
  • Hemorrhage.
  • Toxins, including toxic doses of blood pressure medicine.
  • Certain medications.
  • Eating disorders, particularly anorexia nervosa and bulimia.

Treatment

If you're experiencing symptoms of low blood pressure, doctors usually try to identify and address the underlying health problem rather than the low blood pressure itself. If no underlying condition can be found, the goal becomes raising your blood pressure. This can often be done by:

  • Consuming more salt.
  • Drinking more water.
  • Wearing compression stockings.
  • Taking medications such as fludrocortisone and midodrine.