How do you treat hypertension, or as it is also known, high blood pressure? Who is at risk of developing hypertension? Is it a disease in its own right? I sat down with Dr Jason Kaplan from Macquarie University to ask him these and other questions on how to treat hypertension. Watch the video to get all the details.
Is hypertension, or high blood pressure, a disease in its own right?
Jason says hypertension is a disease in its own right, and the most common form is called ‘essential hypertension’. This accounts for 95% of cases where blood pressure is high.
In about 5% of cases, high blood pressure is a result of secondary causes – where someone may have diseased organ systems, for example. Often the cause is either related to our kidneys or to the endocrine system.
Sometimes certain drugs can affect blood pressure. As we age, many of us are on arthritis drugs, such as Celebrex, Voltaren and Nurofen, all of which can raise blood pressure.
Certain hormone overproduction, such as the thyroid hormone and adrenal gland hormone, often causes hypertension.
The kidneys have a role in the regulation of blood pressure. Therefore if someone has kidney disease, then their blood pressure can become elevated.
If you are under the age of 30 or over the age of 55 and are diagnosed with high blood pressure, then your doctor will likely look for secondary causes. But for the majority of the population between the ages of 30-55, this will be typically diagnosed as essential hypertension, which is especially prevalent if there is a family history of heart disease.
How to identify and treat hypertension
A quarter of all men over the age of 50 in Australia have high blood pressure, and a very large proportion of them will be on medication to treat hypertension. Medications are one of the most common drugs prescribed in cardiology and general practice today.
Most high blood pressure is related to a gradual stiffening or hardening of the aging arteries. The good news is that a healthy lifestyle can go a long way to reducing the risk of developing it.
Unfortunately though, some people can’t reduce their high blood pressure by maintaining a healthy weight, engaging in regular exercise and limiting alcohol consumption. Sometimes there’s a need for medication.
Interestingly, many medical societies disagree on the specific numbers blood pressure should reach before treatment. Generally Jason will treat blood pressure if it’s above 140 or 90. For example, if the top number is consistently above 140 or the bottom number is above 90, then he recommends treatment.
Some doctors won’t diagnose hypertension on only one reading, and will take a few readings, including when outside their clinic. This is because sometimes people will get ‘white coat hypertension’, which is when the blood pressure goes up due to visiting the doctor.
In order to get an accurate blood pressure reading, it is useful to do multiple readings over a 24-hour period. Take-home monitors are typically available through your local medical centre.
If you have other cardiovascular risk factors, doctors like to treat to a target of 120 on 90.
A large American study called the Spring Trial had to stop early because people with low blood pressure were having less heart attacks and strokes. So while doctors typically only treat when blood pressure is above 140 on 90, they promote that you aim to have your blood pressure sitting at around 120 on 80 (120/80).
Lastly, if you suspect you have sleep apnoea or you snore, it’s worthwhile asking your doctor to test you, because if you treat the sleep apnoea, you also treat the blood pressure.