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High Blood Pressure (Hypertension)

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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).

Nearly half of the adults in the U.S. are grappling with high blood pressure, or hypertension. Less than half have their blood pressure under control, underlining the urgency of both diagnosis and effective management.

High blood pressure is managed at our University of Miami Comprehensive Hypertension Center. The Comprehensive Hypertension Center, part of UHealth and the University of Miami Miller School of Medicine, has received the Gold Plus distinction from the American Heart Association (AHA).

American Heart Association Target BP Gold logo

The AHA awarded the distinction as part of its Target: BP™ initiative, a collaboration with the American Medical Association in response to the high prevalence of uncontrolled blood pressure. Gold Plus distinction is awarded to health care organizations that attest to at least four of six evidence-based blood pressure activities in the categories of equipment calibration and validation, staff knowledge and skills and systems of care.



What is Your Risk of Hypertension?

As a patient at the Comprehensive Hypertension Center, you will personalized care that helps determine factors that contribute to your blood pressure phenotype, risk, and therapeutic profile.

  • Genetic and family history assessment: We delve deep into your genetic and family history, recognizing the significance of inherited risk factors.
  • Biochemical analysis: Salt sensitivity and abnormal potassium level identification provides a holistic view of your biochemistry.
  • Physiological study of blood pressure variability: Our understanding of the physiological aspects of blood pressure variation is key to a comprehensive assessment of your cardiovascular health.
  • Environmental and epigenetic risk factors: Understanding how your environment and behavior affect your genes is vital in determining your cardiovascular risk.

By evaluating these pillars, we can provide you with personalized treatments and introduce you to self-care strategies that can aid in the prevention of advanced heart-related conditions.

We also serve younger patients, who may be unaware of their hypertension and cardiovascular disease risks. We also address the unique challenges of female patients whose cardiovascular needs change during childbearing, pregnancy, pre-menopause, and menopause.


Tests

Cuffless Blood Pressure Reading
To measure your blood pressure, your doctor or a specialist will usually place an inflatable patch. 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.

AHA BP chart

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.


Hypertension 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. By completing your hypetensive profile, we can evaluate what medications will work better for you. 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.

Procedure Treatments
Our interventions include:

  • Renal angioplasty with/without stenting
  • Renal denervation
  • Laparoscopic adrenalectomy
  • Sleep lab

Why Choose UHealth?

The University of Miami Comprehensive Hypertension Center is the the only American Heart Association certified comprehensive center in South Florida. Nearly one in two adults have hypertension, and only one in four people have controlled blood pressure. Our team offers a highly effective process to evaluate our patients for cardiovascular risk and establish a timely and specific diagnosis and treatment plan.

Advanced cardiovascular therapies for hypertension. Leading-edge treatments include ventricular assist devices and heart transplant. For advanced heart disease, options for treatment go beyond what is available in the community to prolong life and give you or your loved one a second chance.

Multidisciplinary care by recognized specialists in their field.  In complex cases, heart disease care may require the services of a cardiothoracic surgeon, an interventional cardiologist, a lung specialist, a diabetes specialist and a geneticist. Your doctors talk to each other and make sure all specialties involved in your care are on-board with a unified treatment plan.


HeartAware: Free on-line health risk assessments that may save your life

Female doctor talking to a femail patient

Over 80 million American adults (more than one in three) have cardiovascular disease (CVD). Nearly 2,300 Americans die of CVD every day — that’s one death every 38 seconds. This number can be significantly reduced through education and early detection.


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