Written by John M. Flack, MD, MPH, hypertension specialist at SIU School of Medicine

Hypertension, or high blood pressure, is very common: it affects nearly 80 million adults in the United States. Hypertension has been labeled the “silent killer” due to the absence of symptoms linked to this life-shortening condition. However, this label is unfortunate because many, though not all, individuals with hypertension have symptoms linked to their elevated blood pressure, including fatigue, headaches and chest pain.

What is hypertension?

Hypertension is the result of elevated pressure inside the arterial blood vessels. We estimate how high the pressure is inside the blood vessels by inflating a blood pressure cuff over the brachial artery in the arm and listening with a stethoscope.

Why is it important to know if I have high blood pressure?

Many adult Americans have high blood pressure, which contributes to a shorter than normal life-span, heart failure, heart attacks, stroke, kidney failure, peripheral vascular disease and dementia. In men, elevations in blood pressure can increase the chance of having erectile dysfunction. The risk of these problems relates both to how high the blood pressure is, particularly the systolic blood pressure (top number), and how long the blood pressure has been elevated. In persons with diabetes, hypertension is the major cause of bleeding in the eyes.

How do I know if I have hypertension?

A doctor or nurse can measure your blood pressure with a cuff and listening device, such as a stethoscope. Blood pressure is considered to be elevated when the systolic blood pressure (top number) exceeds 120 mm Hg and/or the diastolic blood pressure (bottom number) exceeds 80 mm Hg. Check out this blog to learn what the numbers mean. Patients with hypertension may have one or more symptoms – headache, sleep disturbance, weakness, fatigue, poor exercise tolerance, nervousness or chest pain. However, these symptoms are not specific enough to diagnose hypertension. These symptoms typically improve when the blood pressure level is lowered.

Who is at risk for hypertension?

Hypertension is an age-related condition. However, given the high levels of obesity and lack of physical activity in children and adolescents, hypertension is increasing in younger people. Hypertension is not inevitable with advancing age. Diet, exercise and weight affect our chances of developing hypertension.

Major dietary influences include the amount of sodium (salt) in our diets; the higher one’s salt intake, the greater the risk for hypertension. About 70% of the salt in our diets comes from the processed foods we eat. Potassium intake from fruits and leafy, green vegetables protects against developing high blood pressure. Too much alcohol intake (more than two drinks per day in men and one drink per day in women) will raise blood pressure. Recent studies have suggested that the risk of hypertension increases in persons with vitamin D deficiency. African Americans tend to develop more severe hypertension at earlier ages than whites.

How do I treat my hypertension?

The same things that prevent the development of hypertension – weight loss, a low sodium diet, exercise and avoiding excess alcohol – will also lower your blood pressure. However, in many patients, this will not be enough to keep the blood pressure below 140/90 mm Hg and medication may be necessary. Most patients will ultimately need more than one drug to keep the blood pressure controlled, but blood pressure medications do not “cure” hypertension.

When might I need to see a hypertension specialist?

• If your blood pressure is difficulty to control despite medication
• If you are experiencing significant side effects from your blood pressure medications
• If your doctor thinks you might have a secondary cause for your hypertension, such as a problem in your adrenal gland
• If your doctor thinks you might need specialized testing, such as 24-hour ambulatory blood pressure monitoring.

If you or a loved one is struggling to control high blood pressure, make an appointment with Dr. Flack or another specialist at SIU HealthCare’s new hypertension clinic by calling 217-545-8000. Appointments are available on Wednesdays and Thursdays.

Dr. Flack, MD, MPH, FAHA, FASH, FACP, is a professor of medicine and chair of the Department of Internal Medicine at SIU School of Medicine.