High Blood Pressure (Hypertension)
MEDICAL ANIMATION TRANSCRIPT: High blood pressure or hypertension is a common condition in which the force of blood on the walls of your arteries is often too high, arteries or the blood vessels that carry blood away from your heart to supply your tissues with oxygen and nutrients. In your heart, two chambers called ventricles contract with each heartbeat to push blood to your lungs and through your arteries to your body. As blood flows through them, three main factors affect the pressure on your artery walls. The first is cardiac output or the amount of blood your ventricles push out of your heart each minute. Your blood pressure goes up as cardiac output increases. The second factor affecting your blood pressure is blood volume or the total amount of blood in your body. Blood pressure also goes up as blood volume increases. The third factor that affects your blood pressure is resistance, which is anything working against the blood flow through your arteries. Several factors contribute to resistance. One resistance factor is the flexibility of your artery wall. Healthy arteries expand with each heartbeat to help reduce blood pressure on the wall. Another resistance factor is the diameter of your arteries. Your body is able to increase the diameter of your arteries to lower your blood pressure, or reduce the diameter to raise your blood pressure. A third resistance factor is blood viscosity or thickness. In your blood, more particles such as proteins and fat, increase viscosity. If your blood is thicker, your blood pressure goes up as your heart works harder to push it through your arteries. Your blood pressure can be measured with a device called a sphygmomanometer or blood pressure cuff. When your heart beats, the pressure of blood on the walls of your arteries is called systolic pressure. When your heart relaxes between beats, pressure on the artery wall is called diastolic pressure. While your blood pressure may change throughout the day, it should optimally be less than 120 millimeters of mercury for systolic pressure, and less than 80 millimeters of mercury for diastolic pressure. If your systolic pressure frequently stays above 130 or your diastolic pressure frequently stays above 80, you have high blood pressure. Over time, high blood pressure will damage the walls of your arteries. Your artery wall may become weak and form an enlargement called an aneurysm or the wall may burst and bleed into the surrounding tissue. Small tears in your artery wall may attract certain substances in your blood such as cholesterol, fat, and calcium to form a buildup called a plaque. Blood flow through your artery decreases as the plaque enlarges. Blood cells can stick to the plaque and form solid clumps called clots, further reducing or completely blocking your blood flow. Damage to your arteries raises your blood pressure even more by making your heart beat more forcefully. Artery damage and reduced blood flow lead to conditions such as a stroke, heart attack, or kidney disease. In most cases, the cause of high blood pressure or hypertension is unknown. This type of high blood pressure is called primary or essential hypertension. Treatment for essential hypertension includes lifestyle changes, such as eating a healthy diet. If you are sensitive to the sodium in salt, your doctor may recommend limiting your intake of salt and highly processed foods. Sodium may cause your body to retain water, which increases both your blood volume and your blood pressure. Other lifestyle changes that can reduce blood pressure include avoiding excessive alcohol intake, getting regular exercise, losing weight if you are overweight, and quitting smoking. Your doctor may also recommend medications that act on your kidneys, blood vessels, or heart to help reduce your blood pressure. Diuretics, commonly called water pills, cause your kidneys to move more salt and water from your blood into your urine, which reduces your blood volume and pressure. Beta blockers reduce the workload on your heart by decreasing both the rate of your heartbeat and the strength of your heart's contractions. Several types of drugs act directly or indirectly to reduce your blood pressure by relaxing your blood vessels, which increases their diameter. These drugs include ACE inhibitors, Angiotensin 2 receptor blockers, calcium channel blockers, and direct-acting vasodilators.