David W. Weisgerber, M.D., P.A.

Internal Medicine

307 10th Avenue N.E.

Hickory, NC  28601

Board Certified Internal Medicine

Specializing in Preventive Medical Care and Diagnosis and Treatment of  Adult Diseases

Office visits by appointment  828-327-9898

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 What is High Blood Pressure?

High Blood Pressure or Hypertension (HTN) is an arbitrarily defined condition in which the systolic or highest pressure(SBP) in the blood vessel system or the diastolic or lowest pressure(DBP) in the blood vessel system regularly exceeds 
particular amounts while the person is at rest.  What has been defined as HTN has changed over time.  In the 1950s and 1960s it was commonly believed that the upper limit for the systolic pressure was determined by adding 120 to the person's age, thus suggesting the higher acceptable limit for someone 70 years of age as being 190 (units are mm of mercury or mmHg by convention).  We now understand that that was very wrong and no one's systolic pressure should exceed 140 and more conservative opinions hold that 130 should be considered the higher threshold for intervention.  Likewise, the lower blood pressure in the circulatory system or diastolic pressure has received similar attention suggesting that 90 is the uppermost tolerable value and more conservative opinions opt for the mid 80s as the threshold mandating treatment.

What causes High Blood Pressure?

There are many causes of HTN and some are to date unknown with speculation on the part of doctors continuing to be offered.  Those causes accepted for HTN include hormone imbalances associated with the adrenal glands, peripheral vascular disease affecting the blood supply to one or the other kidney, tumor produced chemicals which act like adrenalin, and something known as essential hypertension which has not had a cause identifed.

What should happen when I have been found to need treatment?

Once you are found to have HTN you qualify for treatment.  Unfortunately, there is little to be done by way of lifestyle adjustments to make the blood pressure normalize.  Elimination of the consumption of alcoholic beverages and moderation in salt intake represent two of the most potent non-medication treatments.  At the time of initial evaluation certain simple tests including blood testing and physical examination is performed.  If the blood pressure is exceedingly high or difficult to control, additional and special testing for the cause of the HTN is undertaken.  This is done because there are some treatable causes of HTN which, once corrected, will be associated with the normalization of the blood pressure.

  Testing for the various types of HTN can be performed by most doctors and treatment is straightforward although it still involves a trial and error approach as to which of the various medications will best control the patient's HTN.  Certain medications are generally believed to best serve certain patients depending on their co-existing medical diseases, but the effectiveness and tolerability of any particular drug is variable from one patient to the next.

 National Institute of Health  http://www.nhlbi.nih.gov/hbp/consumer/consumer.html

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