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Hypertension Management for Adults

Hypertension Management for Adults

Millions of people around the world have some degree of hypertension. In fact, over 20% of Filipinos are reported to have it. With these statistics, it is likely that you or someone you know is being treated for hypertension. Learn more about hypertension management for adults today.

Hypertension management for adults

Generally, hypertension is when the blood pressure goes over the normal reading of 120/80 mmHg. However, a single reading over this number doesn’t automatically mean you have hypertension.

There are several categories or stages of hypertension, each with its own management. Therefore, the first step to managing hypertension is to get evaluated and diagnosed by a doctor.

Elevated blood pressure management (prehypertension)

While slightly elevated blood pressure doesn’t automatically mean you have hypertension, it can be an early sign. At this stage, blood pressure is between 120/80 to 129/80 mmHg. Most people do not feel any symptoms at this stage, so it often goes undetected until it reaches stage 1 or stage 2.

Fortunately, this stage does not require any special medications yet. Diet and cardiovascular exercise are encouraged to improve heart health. Watch out for fatty, salty, or overly sweet food. Instead, include more heart-healthy whole grains, fiber, and lean protein in your diet.

Stage 1 hypertension management

This stage is the first “official” stage of hypertension. If your blood pressure falls between 130/80 to 139/80 mmHg, you have stage 1 hypertension according to the American College of Cardiology and American Heart Association.

Diet and exercise may no longer be enough, therefore, your doctor might prescribe blood pressure medications. Patients with pre-existing diabetes, CKD, or high risk of heart attack or stroke will be given multiple medications.

Stage 2 hypertension management

Lastly, stage 2 hypertension management requires initiation of medications. Without other co-morbidities or previous history of diabetes or heart disease, you will likely be prescribed one or two blood pressure-lowering agents.

Your doctor will assess your status and determine your goal BP. Diet and exercise are still a must, even if you are taking medications. Missing out on your doses can cause problems or lead to higher blood pressure.

Talk to your doctor or a pharmacist if you experience any side effects while taking your medications.

Measuring blood pressure correctlyhypertension managment

Additionally, regular blood pressure taking is a must for both stage 1 and stage 2 hypertension management. Knowing how to properly take your blood pressure is essential for accurate readings.

Even the simplest things can affect your blood pressure, including whether you are sitting or standing and if you are at home or at a clinic.

Interestingly, many people tend to have higher blood pressure readings when they are in a doctor’s clinic or hospital. This is known as “white coat hypertension”.

Here are some tips on how to get an accurate blood pressure reading:

  • Make sure you are well-rested and not stressed or anxious.
  • Double-check your BP apparatus before taking your blood pressure. If the pump or cuff is defective, you will not get a good reading.
  • Sit straight with your arm resting comfortably on a table, keeping your elbow at chest level.
  • Avoid drinking caffeinated beverages or certain medications right before measuring your BP.
  • Empty your bladder before checking your BP.

Hypertension management for emergency situations

Hypertensive crisis

When a person’s blood pressure reaches an extremely high number over 180/120 mmHg, it is now a hypertensive crisis.

Hypertensive crisis is a medical emergency as it can result in permanent injury or even death.

What can happen during a hypertensive crisis:

  • Organ damage
  • Severe headache
  • Chest or back pain
  • Trouble breathing
  • Weakness
  • Slurred speech
  • Seizure

Management involves quickly administering blood pressure-lowering medications. Generally, IV injection is done. Then, your blood pressure will be monitored frequently to ensure the medications are working.

For hypertensive crises that also involve other conditions like myocardial infarction (MI), stroke, or pulmonary edema, these conditions will also be treated. Hypertensive crisis is not a condition that can be treated at home, therefore a trip to the emergency room is necessary.

Gestational hypertension

Another emergency caused by high blood pressure is gestational hypertension. A woman may experience a spike in her blood pressure sometime after 20 weeks of pregnancy. Preeclampsia is a disorder that includes high blood pressure, protein in her urine, and edema.

When left untreated, preeclampsia can progress into eclampsia which results in seizures due to high blood pressure. Eclampsia is a type of hypertensive crisis during pregnancy. Although it is rare, eclampsia puts both the mother and child’s life at risk.

Management of gestational hypertension is different from other types of hypertensive disorders because many of the medications can harm the fetus.

Some medications used to reduce blood pressure include vasodilators, beta-blockers, and calcium channel blockers. For women who have already had hypertension prior to pregnancy, their medications may be different.

Key takeaways

In summary, hypertension management centers around one main goal: to lower blood pressure. Each stage of hypertension requires a different approach and target blood pressure.

As usual, prevention is better than cure, especially with conditions like hypertension. Therefore, maintaining a healthy diet, active lifestyle, and regularly taking your prescribed medications will help keep your blood pressure under control.

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Sources

ACC/AHA Hypertension Guideline https://www.aafp.org/afp/2018/0315/p372.html Accessed March 29, 2021

2020 International Society of Hypertension Global Hypertension Practice Guidelines https://www.ahajournals.org/doi/10.1161/HYPERTENSIONAHA.120.15026 Accessed March 29, 2021

Prevalence of hypertension among Filipinos increasing – PSH https://www.pchrd.dost.gov.ph/index.php/news/ Accessed March 29, 2021

New ACC/AHA High Blood Pressure Guidelines Lower Definition of Hypertension https://www.acc.org/latest-in-cardiology/articles/2017/11/08/11/47/mon-5pm-bp-guideline-aha-2017 Accessed March 29, 2021

Treatment of hypertensive emergencies https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5440310/ Accessed March 29, 2021

Hypertensive Disorders of Pregnancy https://www.aafp.org/afp/2016/0115/p121.html Accessed March 29, 2021

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Written by Stephanie Nicole Nera, RPh, PharmD Updated 4 weeks ago
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