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Diagnosis 101

How do you know if blood pressure is an issue?

The question: How do you determine if you should worry about high blood pressure?

The expert: Dr. Dmitry Tarasevich is a board certified internal medicine physician practicing with Monadnock Internists, a practice of Monadnock Community Hospital. He went to medical school at Kazan University in Russia and did his residency at Hospital of Saint Raphael, Yale University Affiliate, in Connecticut.

The diagnosis: It is very important for everyone to know what their blood pressure is and to monitor it regularly. Hypertension, or high blood pressure, is the most common chronic disorder in the United States, affecting more than 31 percent of the adult population. The prevalence increases with age: For a middle-aged person in the U.S., the lifetime risk of developing hypertension approaches 90 percent.

High blood pressure is a major risk factor for stroke, heart attack, heart failure, chronic kidney disease, progressive atherosclerosis and dementia. This is called target organ injury.

Normal blood pressure is less than 120/80 mm Hg (millimeters of mercury). The first number is the systolic, and second diastolic blood pressure. In general, hypertension is defined as blood pressure higher than 140/90. Each number being higher actually matters. High blood pressure may not cause initial symptoms at all. That’s why screening for it is so important. It matters how the blood pressure measurement is taken. It is certainly worth discussing your blood pressure with your primary care physician, as even within the acceptable range between 90/60 and 140/90, people live longer when they have lower blood pressure most of the time. Optimum blood pressure is defined as less than 115/75 mm Hg. The duration of time you ignore your high blood pressure certainly negatively impacts your health. Blood pressure in even prehypertensive range increases risk for progression to definite hypertension over time. It hardens your blood vessels. At least annual checks and discussion of strategies to lower your blood pressure and cardiovascular risk are recommended.

The treatment of hypertension is highly effective in reducing the negative consequences or outcomes, i.e. cardiovascular morbidity and mortality. Your physician should be able to help you set appropriate, patient-specific, evidence-based therapeutic goals, help you understand and use available options in an efficient and cost-effective manner. You should actively participate in the care process, asking for timely follow up and monitoring of your blood pressure, and adjusting treatment as necessary. Common treatment includes exercise, stress reduction, diet and lifestyle modifications, and in some cases, medications. Do not delay your initial evaluation and stay tuned if you are at risk, that is if your blood pressure is greater than 120/80.

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