Definition
Blood pressure is measured in millimeters of mercury (mm Hg). Hypertension (high blood pressure) is when your blood pressure frequently goes over 140/90 mm Hg.

A patient is considered "pre-hypertensive" if the top (systolic) number of the blood pressure reading is 120-139 mm Hg and if the bottom (diastolic) number is over 80-89 mm Hg on most measurements.

People with pre-hypertension are likely to develop high blood pressure at some point, unless lifestyle changes to lower blood pressure to normal are made.

Considerations
About 1 in every 5 adults in the U.S. has high blood pressure. High blood pressure occurs more often in men than in women, and in African Americans almost twice as often as in Caucasians.

Most people feel no symptoms with uncomplicated high blood pressure. Essential hypertension (hypertension with no known cause) is not fully understood, but accounts for between 80-85% of all hypertension cases in people over 45 years of age.

Even though many times high blood pressure does not have a known cause, the condition can still be treated effectively with both lifestyle changes and medications.

Lifestyle changes include following a low sodium diet, exercising, quitting smoking, losing weight, and avoiding excessive alcohol intake. There are dozens of different medications available for the management of high blood pressure.

Common Causes
Most of the time, no cause is identified. This is called essential hypertension. High blood pressure that results from a specific condition, habit, or medication is called secondary hypertension. Some reasons for secondary hypertension include:

Use of certain medications (such as appetite suppressants, cold preparations, and migraine medications)

• Habitual alcohol use
  
• Excess sodium (salt) in your diet
  
• Obesity
  
• Anxiety or stress
  
• Arteriosclerosis
  
• Coarctation of the aorta
  
• Pain
  
• Renal artery stenosis
  
• Diabetes
  
• Drugs such as alcohol toxicity or cocaine
  
• Renal disease
  

Treatment
The goal of treatment is to reduce blood pressure, which will lower the risk of complications. The goal is blood pressure at least below 140/90 and below 130/80 for those with diabetes or kidney disease.

A proper diet, weight loss, exercise, and salt and alcohol reduction are often recommended for patients with hypertension or pre-hypertension.

For those with a blood pressure reading consistently above 140/90 mmHg, phsicians may prescribe medication. For those with other risk factors for heart disease, especially diabetes, doctors will consider starting medications sooner rather than later.

Regular blood pressure checks, as recommended by a health care provider, are recommended to monitor overall condition and response to treatment.

Diagnostic tests that may be performed include:

• Blood tests, such as a chem-20
• Urinalysis
  
• X-rays of the kidneys
  
• EKG or echocardiogram
  

Prevention
In people with hypertension, modification of sodium intake may be recommended.

Products containing sodium (e.g., salt, MSG, and baking soda) often have little effect in people without hypertension, but may have a profound effect in those with hypertension.