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Hypertension causes inflammation and remodeling of vessels, therefore effecting and harming organs (brain, kidney, heart, eye/retina). Untreated hypertension is a major cause of strokes, heart attack, kidney disease, heart failure. Hypertension usually does not give any symptom until major organ damage.

Brain bleed, most likely due to hypertension. Distributed under CC license: James Heilman, MD, CC BY-SA 3.0 https://creativecommons.org/licenses/by-sa/3.0, via Wikimedia Commons

Dialysis machine. Hypertension is one of the most common reason for chronic kidney disease and dialysis. Distributed under CC license: Jonas@sodratornet.se, CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0, via Wikimedia Commons

Hypertension is one of the modifiable factor to prevent heart attacks. License under CC: https://www.myupchar.com/en, CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0, via Wikimedia Commons

Hypertension is easily diagnosed with blood pressure cuff. There are two values to know. Systolic blood pressure is measured when blood flow in your arm completely stopped by blood pressure cuff in certain pressure. Diastolic blood pressure on the other hand, is measured the sound of flow is inaudible. Blood pressure cuff is an unexpensive device and is also used for follow up of effectiveness of treatment. Therefore it is critical for a hypertensive patient to know how to properly measure blood pressure.

How to measure blood pressure appropriately, by American Medical Association

Treatment of hypertension is important. To give an example and estimate, each 20 mmHg systolic blood pressure increase after 115 systolic blood pressure, doubles patients risk of dying from vascular disease (stroke, heart attack, kidney failure). Even 10 mmHg decrease of systolic blood pressure decreases early death by more than 10%.

Some medical conditions contribute greatly to hypertension. These include obesity, sleep apnea, hormonal conditions, medications

Treatment before medications:
0) Take hypertension seriously.
1) Every 1 kg weight loss decreases 1 mmHg of systolic blood pressure (SBP)
2) Eating veggies, avoiding fat, sugar and salt decreases almost 15 mmHg systolic blood pressure (SBP). Maximum salt intake should be less than 1 teaspoon a day (about 2 grams, check salt content of packaged foods, ask about salt content in restaurants).
3) Exercising 30 minutes per day (this is brisk walking, not a heavy exercise) decreases around 5 mmHg SBP.
4) Decreasing alcohol intake <2 drinks/day for males, <1 drinks/day for females decreases around 5 mmHg SBP
5) Seeking treatment for sleep apnea especially if poor sleep, day-time sleeping, fatigue, snoring, and big neck circumference.

As you can imagine, hypertension is treatable with only lifestyle changes. However this is not easy and sometimes not effective. Therefore there are many blood pressure medication options. You will need to talk to your primary care physician to select .

To help your physician to treat hypertension, monitoring and recording blood pressure 3-7 days 3 times a day prior to visit greatly effect treatment decisions.

Sometimes we find uncommon reasons for hypertension. This is usually suspected when you follow lifestyle changes and require 3 or more blood pressure medications to control, or admitted to the hospital because of hypertension in severe condition.

Educational video from CDC

Video about salt intake from CDC

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The information, including text, graphics, images and other material contained on this website are for informational purposes only. None of the material on this website is intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read on this website.

Tobacco causes harm by causing chronic inflammation and releasing toxic substances.

Quitting tobacco, by far, is effective than any other medication or intervention to prevent early death from heart attack, stroke, COPD, pneumonia, lung cancers, bladder cancer, bladder cancer, pancreatic cancer. It decreases risk of early death by half from all causes. The longer a patient smokes, the more risk of diseases. Patients’ genetics and other medical conditions also contribute to risk of early death.

Patients usually can’t quit tobacco by themselves, since it is a complicated addiction. The addiction has behavioral / mental, physical, economical, social components that needs to be addressed.

Role of physician: Addressing mental and behavioral factors of addiction, decreasing physical dependence with scientifically approved medications including varenicline, bupropion, nicotine supplements and treating the side effects and risks of tobacco to prevent life-threatening diseases.

Medications used in tobacco cessation have distinctive side effect profile. However none of them is as harmful as smoking tobacco. Benefits are almost always more than risks of using medications.

Chewing tobacco is not safe either. It usually causes oral cancers.

Vaping tobacco is less riskier than smoking it, however it is never a replacement of quitting tobacco.

Role of patients: Understanding the real risks of tobacco, attempting or willing to attempt treatment, having a good social support system or creating such environment, understanding behaviors that increases cravings of smoking greatly helps physicians to become successful of treatment.