Hypertension

Blood pressure is the force exerted by your flowing blood on the walls of your arteries, which are tubular structures that carry blood to the different parts of your body. This means that your blood pressure is determined by both the amount of blood your heart pumps through your body’s arteries as well as the amount of resistance to this blood flow.

When your arteries are healthy and dilated, the resistance to blood flow is low, and blood flows easily through your body. But when your arteries are too narrow or stiff, resistance to blood flow increases, and therefore your blood pressure rises. This causes your heart to work harder than normal to pump blood through the body. The extra work thickens the muscles of your heart and further hardens or damages artery walls. The condition can also cause damage to your other organs, especially the brain, eyes, and kidneys.

Some people with high blood pressure may have a pounding feeling in their chest or head, or feel some lightheadedness or dizziness. However, for most people with hypertension, there are no obvious signs or symptoms. This is why hypertension can go undetected for years if people do not have their blood pressure checked. In fact, 17% of Americans with hypertension are undiagnosed.

Unfortunately, the first sign that you have high blood pressure may be when you are already having signs of cardiovascular disease or have suffered a heart attack or stroke. This is why hypertension is known in the medical world as “the silent killer.” Blood pressure tests are simple and quick to perform, so don’t delay in getting yourself checked.

Nearly one in two people with high blood pressure do not have it controlled, which likely contributes to the high rates of cardiovascular disease in America. In order to treat your hypertension, your doctor may prescribe medications to bring your blood pressure down. It is important that you take any prescribed drugs regularly and do not stop taking them, even after your blood pressure comes down, without talking to your doctor.

Your doctor will likely prescribe one or more of the following medications to treat high blood pressure:

• Thiazide diuretics: These ‘water pills’ work by helping your kidneys get rid of sodium and water through urination.
• Angiotensin-converting enzyme (ACE) inhibitors: These act to help relax your blood vessels by blocking the formation of a natural chemical (angiotensin) that narrows blood vessels.
• Angiotensin II receptor blockers (ARBs): These work by helping to relax your blood vessels by blocking the action of angiotensin that narrows blood vessels.
• Calcium channel blockers: These function by relaxing the muscles of your blood vessels and may also slow your heart rate.

If you are still not reaching your blood pressure goal with the above medications, your doctor may prescribe other medications. These include alpha blockers, alpha-beta blockers, and beta blockers. They work by reducing the nerve impulses to your blood vessels and/or heart to prevent your blood vessels narrowing and your heart overworking.

Your doctor may also consider aldosterone antagonists to prevent salt and fluid retention, or vasodilators which work directly on the muscles in the walls of your arteries, preventing the muscles from tightening and your arteries from narrowing.

You can chat with one of our doctors on Cedars-Sinai Connect to learn more about treatment and same-day prescriptions.