About 30% of Americans have what was formerly called prehypertension or borderline
hypertension with blood pressure between 121/81 and 139/89. Systolic blood
pressures of 140 mm Hg or higher or diastolic pressures of 90 mm Hg or higher are
considered hypertension (now called stage 2 hypertension), but there is considerable
debate about the level of blood pressure that will benefit from treatment with
drugs and what the target BP level should be for drug treatment.

Blood pressure fluctuates throughout the day and is regulated by the interplay between
the strength of heart contractions, for example, during exercise compared to
at rest or during sleep. Blood pressure is also regulated by hormones and by the
nervous system in that stress raises blood pressure and relaxation and sleep lower
it. Other influences on blood pressure include how dilated your blood vessels are,
how elastic your blood vessels are—atherosclerosis makes them stiffer, so peak
pressures are higher, and how well your kidneys function to regulate sodium in the
body—more sodium means greater blood volume and higher blood pressure.

Five to 10% of hypertension is termed secondary hypertension because it is caused
by, or secondary to, a disease condition, a drug, or metabolic disorder. Kidney
disease, a narrowing of the arteries that supply blood to the kidneys, a variety of
adrenal gland tumors and other hormone disorders, sleep apnea, and certain drugs
can cause medically treatable forms of secondary hypertension. Blood pressures
should be measured after five minutes of rest, and they are often raised by the stress
of visiting a doctor—so-called “white coat hypertension.”

Ninety to 95% of high blood pressure in the U.S. is considered to be essential hypertension
because it is related to lifestyle, diet, and the condition of the body’s
vasculature and not caused by a single disease condition or factor. Family history,
genetics, and race influence the risk of hypertension, but an important factor is the
typical American diet that is high in salt (sodium) and also low in foods that are high
in potassium such as fruits and vegetables.

Physical inactivity, overweight, and obesity are lifestyle factors that make important
contributions to hypertension, and they too can be modified. For some people,
becoming physically active and losing weight can normalize blood pressure. But
among lifestyle interventions to prevent and treat hypertension, the most effective
is the adoption of a nutritional pattern that limits sodium in the diet. Essential hypertension
can often be controlled with these lifestyle interventions. If that fails,
hypertension is usually amenable to treatment with antihypertensive drugs that are
available through a prescription from a health care provider. Most antihypertensive
drugs are effective and have tolerable and often no noticeable side effects.

This blog presents opinions and ideas and is intended to provide helpful general information. I am not engaged in rendering advice or services to the individual reader. The ideas, procedures and suggestions in that are presented are not in any way a substitute for the advice and care of the reader’s own physician or other medical professional based on the reader’s own individual conditions, symptoms or concerns. If the reader needs personal medical, health, dietary, exercise or other assistance or advice the reader should consult a physician and/or other qualified health professionals. The author specifically disclaims all responsibility for any injury, damage or loss that the reader may incur as a direct or indirect consequence of following any directions or suggestions given in this blog or participating in any programs described in this blog or in the book, The Building Blocks of Health––How to Optimize Your Health with a Lifestyle Checklist (available in print or downloaded at Amazon, Apple, Barnes and Noble and elsewhere). Copyright 2021 by J. Joseph Speidel