Silent Pressure: Diagnosing and Managing Hypertension


Physicians and patients with high blood pressure must work together to prevent the “dam from breaking,” which is a tall order when hypertension can be a silent disease with few symptoms. While approximately one out of every three American adults struggle with hypertension, roughly one out of every 10 adults in the United States do not know they have chronic high blood pressure.

When you consider that the long-term blood pressure elevations of hypertension can lead to remodeling of the heart leading to heart failure, heart attack, stroke and kidney failure, it’s critical for patients to work with physicians to diagnose and manage abnormal blood pressure. 

Hypertension by the numbers

To begin, physicians will screen for hypertension at regular physical exams. Hypertension, or high blood pressure, is measured by looking at the systolic blood pressure (the top number in your blood pressure reading) and the diastolic blood pressure (the bottom number). Systolic blood pressure is a reflection of the amount of pressure placed on the heart muscle during contraction to pump blood out. Diastolic blood pressure reflects the amount of pressure the heart is experiencing during relaxation as it fills with blood.

Typically, healthy blood pressures are between 90/60 mmHg and 120/80 mmHg. It is important to know what your normal blood pressure is so that you can help your doctors identify abnormalities from your normal baseline, especially in the event that you become sick and admitted to the hospital. 

Hypertension occurs when the systolic blood pressure reaches around 140mmHg or the diastolic blood pressure reaches 90mmHg. However, your doctor may start watching closely for high blood pressure if your numbers reach 130mmHg (systolic) and/or 80mmHg (diastolic). This is called prehypertension. However, one elevated reading does not mean you have chronic high blood pressure. True hypertension requires these numbers to remain elevated over a sustained period of time.


Hypertension Factors


There are many factors that can contribute to the development of hypertension. These include:

- genetics

- race (African Americans are at a higher risk)

- being overweight or obese

- a sedentary lifestyle

- drinking too much alcohol over a long period of time

- smoking

- having other chronic conditions such as diabetes or kidney problems


However, there are also things you can do to help control your blood pressure and reduce your risk of heart disease, stroke, or kidney problems:

- exercise regularly

- focus on weight loss through diet (talk to your doctor about what may be the best way for you to lose weight)

- manage stress 

- don’t smoke

- limit alcohol

-take your medications daily if prescribed by your doctor

Management of hypertension depends on proactive, aggressive treatment to avoid the negative outcomes associated with high blood pressure. It takes daily vigilance, persistence and patience to combat this disease that often remains a constant companion for life.


Talk to your doctor about how you can reduce your risk of developing high blood pressure. 






Written by:

Katherine Larson, MD

Internal Medicine, Intermountain Southridge Clinic






Eric Allen, DO

Internal Medicine, Intermountain Southridge Clinic