High Blood Pressure: ‘The Silent Killer’

By Abdelhadi Rifai, MD, Cardiologist 
Cheyenne Regional Medical Group
Heart & Vascular Institute 

What is high blood pressure?
High blood pressure (also known as hypertension) is when the force of blood flowing through the blood vessels is consistently too high.

How can you tell if you have this condition?
Most of the time hypertension has no obvious symptoms. The best way to find out is to have your blood pressure checked regularly.

What is the best way to get an accurate blood pressure measurement?
Below are recommendations to ensure an accurate measurement:

• Don’t smoke, exercise, drink caffeinated beverages or alcohol within 30 minutes of the measurement.
• Sit in a chair for at least five minutes with your left arm resting comfortably on a flat surface at heart level. Sit calmly and don’t talk.
• Place the bottom of the cuff above the bend of the elbow.
• Take at least two readings one minute apart in the morning before taking medications and in the evening before dinner. Record the results. 

Is high blood pressure a problem in the United States? 
High blood pressure is a major concern, as the following statistics show:

• Nearly half of adults in the United States (47 percent, or 116 million) have hypertension or are taking medication to control it. Unfortunately, many people don’t know they have high blood pressure because there are often no symptoms.
• Approximately one in four adults (24 percent) with hypertension has the condition under control.
• In 2019, more than half a million deaths in the United States had hypertension as a primary or contributing cause.
• A greater percentage of men (50 percent) has high blood pressure than women (44 percent).

What does it mean to have normal vs. high blood pressure?
Blood pressure is measured using two numbers. Systolic pressure (the first number) measures the pressure in the arteries when the heart beats. Diastolic pressure (the second number) measures the pressure in the arteries when the heart rests between beats. 

In 2017, the American College of Cardiology and the American Heart Association published new guidelines for the definition and management of hypertension in adults.

• Normal: Readings are consistently less than 120/80 mm Hg.
• Elevated: Readings consistently range from 120 to 129 mm Hg systolic and less than 80 mm Hg diastolic. People with elevated blood pressure are likely to develop high blood pressure unless steps are taken to control the condition.
• Hypertension stage 1: Blood pressure consistently ranges from 130 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic. At this stage doctors are likely to prescribe lifestyle changes and may consider adding blood pressure medication based on the individual’s risks.
• Hypertension stage 2: Blood pressure is consistently 140/90 mm Hg or higher. At this stage a provider is likely to prescribe a combination of blood pressure medications and lifestyle changes.
• Hypertensive crisis (a medical emergency): If your blood pressure is higher than 180/120 mm Hg and you are experiencing chest pain, shortness of breath, back pain, numbness or weakness, change in vision or difficulty speaking, do not wait to see if your pressure comes down on its own. Call 9-1-1 immediately.

What are the consequences of high blood pressure?
After a prolonged period, untreated high blood pressure can cause multiple cardiovascular complications that can include damage to the heart, arteries and multiple organs. It can also lead to stroke, heart attack, heart failure, vision loss, kidney failure and sexual dysfunction.

How can I lower my blood pressure?
There is not a cure for high blood pressure, but you can get your blood pressure under control and therefore reduce the associated health risks by taking the following steps:

• Lower your sodium intake by limiting packaged and restaurant food.
• Limit your alcohol consumption to no more than two drinks per day for men and no more than one drink per day for women.
• Increase your physical activity.
• Manage your stress by relaxing for short periods during your workday, at night and on weekends.
• Maintain a healthy weight. Losing as little as 5 to 10 pounds may help lower your blood pressure.
• Quit smoking. 
• Take prescribed medication.

It is important to know that managing blood pressure is not a short-term effort but a lifelong commitment.

If you think you may be at risk for high blood pressure, please talk to your provider. You can also talk to a provider at the CRMG Heart & Vascular Institute by scheduling an appointment at (307) 637-1600.

Bio: Dr. Abdelhadi Rifai joined the Cheyenne Regional Medical Group (CRMG) Heart & Vascular Institute from Chicago, IL, where he completed his cardiovascular medicine fellowship at Advocate Lutheran General Hospital. Dr. Rifai is passionate about caring for patients diagnosed with heart failure, having trained in the biggest heart failure center in the Midwest. Given his training and experience, Dr. Rifai has been appointed as the medical director of the CRMG Heart & Vascular Institute’s heart failure treatment program.