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Hypertension, or high blood pressure, is a very common disease in society and studies indicate that this will only become more problematic in the next generations as obesity and diabetes levels are expected to rise. To start from the very basics, blood pressure is a term describing the pressure that blood has on the arteries as it is pumped through the body. There are two numbers essential to every blood pressure reading; the systolic and diastolic measures. Systolic blood pressure is the pressure seen when the heart is contracting and is the highest pressure that will be seen in the body. Diastolic blood pressure, on the other hand, is the natural pressure on the blood vessels when the heart is between beats. This is the time when the heart is relaxed. In an ideal patient, this read-out should be close to 120/80 but even up to 130/85 is deemed fine by physicians. 

Patients that suffer from hypertension have systemic diseases that cause the pressure on their blood vessels to be higher. The clinical definition of hypertension is a blood pressure of over 140/90. Pressure levels increase when the heart has to work harder to get blood moving throughout the body. This can occur after atherosclerosis builds in the arteries, patients suffer from damage secondary to diabetes or due to chronic smoking or alcohol consumption. 

Patients need to routinely be screened for hypertension because it is termed "the silent killer," in medicine. Patients rarely will notice physical manifestations in higher pressures because our bodies are naturally able to adjust to it, up to a point. It makes living day to day easier for us but also increases our risks for serious complications if we do not proactively stop the disease. Some of the earliest signs that you may notice when you have pressure problems would be having chronic headaches located at the back of your head. The blood vessels in the head are more sensitive to small pressure changes and pounding headaches generally point in the direction of hypertension. 

It takes some time for a doctor to be able to diagnose you with hypertension because your blood pressure can change multiple times a day based on the time of the day and the work demand you have throughout the day. Patients can also have artificially elevated blood pressure values when they visit the medical doctor due to stress to it is for that reason that physicians need to see high-pressure values on at least two separate occasions and patients should measure their blood pressure also at home to see if pressure levels normalize when they are not around doctors. 

The first steps to take when you are ultimately diagnosed with hypertension is to try to make lifestyle changes to avoid medications. Losing roughly 1 kg of weight equates to a drop in 1 mmHg of blood pressure so weight loss is your best option to try to avoid blood pressure medications and reduce your risk of vascular diseases like heart attacks and stroke.  

If you are unsuccessful at losing weight, medications become essential to try to lower your pressure as much as possible. Diuretics will be the first medication that doctors will try just to remove extra fluid from your body to lower pressures. They are safe and in most cases, patients will only need this medication to reduce their blood pressures back to safer levels. Patients do risk side effects like dizziness and headaches because diuretics also remove electrolytes like sodium and potassium from our bodies so it is important that you supplement your electrolytes to avoid side effects. 

If this doesn't work, the next step is to add another medication in addition to your diuretic like a B-blocker or ACE inhibitor. These medications attack different pathways in your body to prevent blood vessels from tightening further. 

What you need to realize if you have hypertension is that medications are only effective up to a certain point. Even in ideal conditions, medications may only be able to lower your blood pressure by 15 mmHg so it is far more effective for patients to try to increase their aerobic exercises, alter their diets and try to lose weight so there will be a more noticeable difference. [1]

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