Blood pressure is the force of your blood pushing against your artery walls generated with each heartbeat as blood is pumped from your heart into your blood vessels. The size and elasticity of the artery walls also affect blood pressure. Each time the heart beats, the pressure is created inside the arteries. It is greatest when blood is pumped out of the heart into the arteries (systole). When the heart relaxes between beats to refill, the pressure falls in the arteries (the diastole).

High blood pressure is managed at our University of Miami Comprehensive Hypertension Center.

Tests

Blood Pressure Reading
To measure your blood pressure, your doctor or a specialist will usually place an inflatable cuff around your arm and measure your blood pressure using a pressure-measuring gauge. Given in millimeters of mercury (mm Hg), it measures two numbers: the systolic and diastolic pressures. Normal blood pressure is considered to be below 120/80 mm Hg. Stage 1 hypertension is defined as a systolic pressure of 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg. Stage 2 hypertension, more severe, is a systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher. It’s important to verify any readings with repeat measurements over time and in both arms.

Ambulatory Blood Pressure Monitoring
Your doctor may suggest this 24-hour blood pressure monitoring to provide a more accurate picture of blood pressure changes over an average day and night.

Urinalysis
A urine test can detect substances in your body that indicate heart disease.

Blood Tests
A cholesterol test and other blood tests can indicate heart problems and problems with kidneys, organs that can take the brunt of prolonged high blood pressure.

Electrocardiogram (ECG)
This test measures your heart's electrical activity. Your doctor may also recommend additional tests, such as an echocardiogram, to check for more signs of heart disease.

Treatments

Lifestyle Modification
Research has shown that factors like being overweight, smoking, eating a high salt and high fat diet, and stress all contribute to high blood pressure. Along with other types of management, changing those habits can help bring blood pressure down and prevent further heart problems.

Medications
Several different types of medication may be helpful in controlling high blood pressure. Often more than one type is needed to get effective control:

• Calcium channel blockers work by slowing the movement of calcium into the cells of the heart and blood vessel walls, which makes it easier for the heart to pump and widens blood vessels.
• Similarly, Angiotensin converting enzyme (ACE) inhibitors widen or dilate your blood vessels to improve the amount of blood your heart pumps and lower blood pressure.
• Angiotensin II receptor blockers (ARBs) have the same effects as ACE inhibitors, but works by a different mechanism.
• Diuretics (water pills) help your body get rid of unneeded water and salt through the urine to lower blood pressure and can make it easier for your heart to pump.
• Beta-Blockers block the effects of the sympathetic nervous system on the heart.
• Finally, Omega-3 fish oil supplements have benefits for healthy people and people with high blood pressure and heart disease alike.