Know your blood pressure – and your options

By Pat Clarke, Office of Communications, CDER

High blood pressure is known as the silent killer. There are often no symptoms until the heart, arteries, and other organs are already damaged.
“Once you develop hypertension, you generally have it for life. If untreated, hypertension can worsen over time,” said Dr. Nancy Xu, medical officer, Division of Cardiovascular and Renal Products, in FDA’s Center for Drug Evaluation and Research
High blood pressure increases the risk for stroke, heart attack, heart failure, kidney failure and death, according to the National Institutes of Health’s Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure.

What do the numbers mean?

A blood pressure of less than 120/80 is normal

Readings between 120/80 and 139/89 are considered pre-hypertension.

A reading higher than 140/90 may indicate Hypertension

Blood pressure is the force of blood moving through your arteries, and is measured with two numbers. The first, or top number, is your pressure when your heart beats, called the systolic pressure.
The second, or bottom number, measures the force of blood in your arteries while your heart is relaxed (filling with blood between beats). This is called the diastolic pressure.
Blood pressure usually varies throughout the day. For adults, a blood pressure reading of lower than 120/80 is considered normal. Readings between 120/80 and 139/89 are considered pre-hypertension. People with pre-hypertension do not have blood pressure as low as it should be, but not are yet considered to have high blood pressure. Your doctor may tell you that you have high blood pressure if you have two measurements of blood pressure readings, on physician office visits at least one week apart, that are higher than 140/90.
The United States Preventive Services Task Force has issued guidelines that state people with blood pressure lower than 120/80 should be screened every two years. Your doctor may determine that your blood pressure should be screened more frequently.

Who has it

It is estimated that almost one in three adults in the United States has high blood pressure. And because of the obesity epidemic, more and more children are developing high blood pressure. High blood pressure occurs more frequently as people age. Many people develop high blood pressure when they are in their late 30’s or early 40’s, although high blood pressure can also be seen in children.

Healthy living choices

To protect your heart, arteries and other organs from strain and damage over time, controlling your blood pressure should be part of a healthy living plan that includes monitoring your lipids.
Treatment of high blood pressure often starts with lifestyle changes, including decreasing salt in your diet, losing weight if necessary, stopping smoking, cutting down on alcohol use, and regular exercise.

Many medication options

In addition to lifestyle changes, medications are often used to lower blood pressure. There are currently nine types of medications that treat high blood pressure. For example, beta blockers slow the heart rate; calcium channel blockers directly relax blood vessels. Each type of medication has pluses and minuses that must be carefully weighed by you and your doctor. The optimal medication depends on your other medical conditions and preferences. Most people take more than one medication in order to bring their blood pressure down to their treatment goal.
Blood pressure medication should begin to work within days. Once started, the medication should be used until your doctor tells you to stop. It is also a good idea to monitor your blood pressure at home.

Controlling your blood pressure is a lifelong task

Because hypertension is a chronic medical condition that often has little or no symptoms, remembering to take your medications can be a challenge. Combination therapy and long-acting, once-a-day medications have been used to decrease pill burden and help ensure use. Patients taking more than one high blood pressure medication should ask their doctor if a combination medication can be prescribed.
If cost is an issue, generic versions should be considered. Patients need to be proactive regarding high blood pressure medications, monitoring blood pressure, and taking medications as prescribed, says Xu. Patients should consider alternatives (combination therapy, long-acting, or generic medication) when appropriate, and talk to their doctor about any side effects. Speaking up and taking charge of your health can help control the silent killer.