Hypertension, Part Two: A Patient Guide

By Jacqui O'Connell, RN

Complications

Left untreated, hypertension will cause complications. People with untreated high blood pressure will not live as long as people with well treated blood pressure. Medications make a major difference in longevity and reduction of disability. There are several reasons for this.

A consistently elevated blood pressure hastens the formation of plaque or fatty deposits within the blood vessels accelerating atherosclerosis (or hardening of the arteries) leading to an increased risk of heart attack or stroke. High blood pressure also puts a strain on both the blood vessels (they become thicker and more resistant to flow but also may have weak spots that cause them to dilate and for aneurysms) and the heart (it must thicken to deliver a harder flow, and requires more oxygen to do its job, eventually outstripping its supply and beginning to fail).

The kidneys, which filter waste from the body, are also vulnerable to damage as a result of high blood pressure. Hypertension can cause the arteries feeding the kidneys to become thickened and effectively constricted. This condition can lead to progressive kidney damage and ultimate failure.

Eyes, too, can suffer the ill-effects of hypertension. The retinas may be damaged because of increased pressure in blood vessels in the eyes. Loss of vision may result.

Screening

Consistent and accurate monitoring of blood pressure is important in the diagnosis, prevention and treatment of hypertension. Appropriate medical personnel can best determine how often blood pressure should be checked. If you do have hypertension and are put on a medicine, the blood pressure must be rechecked to make sure that it is working for you. Not every medicine works for every patient.

Blood pressure is measured with a device called a sphygmomanometer. The arm should be bare or clothing should be flat to avoid constriction and artificial blood pressure inflation. The arm should be positioned so the blood pressure cuff is at the level of the heart. An appropriate sized cuff is wrapped around the upper arm and inflated. A stethoscope is placed just below the cuff over the antecubital space (opposite to where the elbow bends). Pressure created by the cuff causes the blood flow to stop briefly in the arm. As the air is released from the cuff, blood starts to flow through the artery. The person listening with the stethoscope is listening for sounds made as the blood flows through the artery. The first number recorded is the systolic pressure. This sound measures the pressure generated when the heart beats. The second number recorded is the diastolic, which measures the pressure between heartbeats. This is the last sound heard by the blood pressure recorder.

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