High Blood Pressure (Hypertension)

High blood pressure is one of the most common health problems in adults. Close to half of adults in the United States have it, and many of them don't know it.

It becomes more common with age, but younger adults can have it too.

• Primary (essential) hypertension: the most common kind. It builds slowly over years and has no single cause.
• Secondary hypertension: caused by another problem, such as kidney disease, sleep apnea, a hormone (gland) problem, or certain medicines.
• Uncontrolled hypertension: blood pressure that stays above your goal even though you've been diagnosed. Common reasons include missed doses, too much salt, or a plan that needs adjusting.
• Resistant hypertension: blood pressure that stays high even while taking three different types of blood pressure medicine (usually including a water pill) at good doses, or that needs four or more medicines to reach goal. It often needs a closer look for hidden causes.
• White coat hypertension: readings are high at the office but normal at home. Home or 24-hour monitoring helps sort this out.
• Severe high blood pressure: readings above 180/120. This needs quick attention. If you also have warning symptoms, it is an emergency (see When to call us or 911).

Many things can raise your blood pressure. Some you can change and some you can't:

• Getting older
• Family members with high blood pressure
• Eating a lot of salt (sodium), including in packaged and restaurant food
• Being overweight or not getting much physical activity
• Drinking a lot of alcohol, or smoking
• Diabetes, kidney disease or sleep apnea
• Long-term stress
• Some medicines and products, such as pain relievers like Advil (ibuprofen) or Aleve (naproxen), decongestants, some birth control pills and stimulants

Most people with high blood pressure feel completely fine. That's why it's sometimes called a "silent" condition. Headaches or nosebleeds are not reliable signs.

At your visit, your provider measures your blood pressure carefully, often more than once and sometimes in both arms. They check your pulse and weight, listen to your heart, lungs and the arteries in your neck and belly, check the pulses in your feet and look for swelling. They may also look at the back of your eyes.

High blood pressure is diagnosed from several readings on different days, not just one. Most of the time, we ask you to check your blood pressure at home and keep a blood pressure journal to bring to your visits. We also offer 24-hour ambulatory blood pressure monitoring when it's needed. An ECG, done in our office, may be used to check how high blood pressure is affecting your heart.

Lab tests your provider may order include: a basic or comprehensive metabolic panel (kidney function, sodium and potassium), a urine test for protein (urine albumin), blood sugar or A1C, a cholesterol (lipid) panel, a complete blood count (CBC), and thyroid tests. An ECG (heart tracing) is also common.

If your blood pressure is hard to control, extra tests may look for hidden causes, such as hormone blood tests or a sleep study. We don't do X-rays or other imaging at our office. If you need an ultrasound or other imaging, we refer you to a trusted outside center and review the results with you.

These tools are used by clinicians. Bring your results to your visit; they don't replace a medical evaluation.

• PREVENT™ Calculator (AHA) ↗ (opens in a new tab)Estimates your chance of heart attack, stroke or heart failure over the next 10 and 30 years.
• ASCVD 2013 Risk Calculator (AHA/ACC) ↗ (opens in a new tab)An older tool that estimates your 10-year chance of heart attack or stroke.

Most people need a mix of healthy habits and, often, medicine. Your provider will set a blood pressure goal with you. Common steps:

• Eat less salt. Read labels and cook more at home.
• Fill your plate with vegetables, fruits, whole grains, beans and low-fat dairy (the "DASH" eating style).
• Move more. Aim for about 30 minutes of activity most days, if your provider says it's safe.
• Lose weight if you need to. Even a few pounds can help.
• Limit alcohol and stop smoking.
• Take your medicine every day, even when you feel fine. Many people need two or more medicines to reach goal.
• Check your blood pressure at home: sit quietly for 5 minutes, feet flat, arm resting at heart level, and write down the numbers.
• If your blood pressure stays high (uncontrolled or resistant), your provider may check how you take your medicines, review other medicines and supplements, change doses, add a different type of medicine, look for causes like sleep apnea or a hormone problem, or refer you to a specialist.

High blood pressure is usually a lifelong condition, but it can often be controlled. Many people reach their goal with steady habits and the right medicines.

Keeping your numbers in range lowers your risk of heart attack, stroke, heart failure and kidney disease. Results are different for everyone, and your plan may need changes over time.

Your primary care team at Moaddel Medical checks your blood pressure, orders the tests you need and builds a plan that fits your life.

We review your home readings, adjust medicines when needed and look for causes when blood pressure is hard to control. When you need a heart specialist or imaging, we refer you to a trusted partner and keep your care connected.

We're at 7230 Medical Center Dr, Suite 100, West Hills, CA 91307.