HYPERTENSION

A Visual Guide to High Blood Pressure

What Is Hypertension?

Hypertension, or high blood pressure, is a common condition that will catch up with most people who live into older age. Blood pressure is the force of blood pressing against the walls of your arteries. When it's too high, it raises the heart's workload and can cause serious damage to the arteries. Over time, uncontrolled high blood pressure increases the risk of heart disease, stroke, and kidney disease.

Hypertension Symptoms

High blood pressure is sometimes called a silent killer because it may have no outward symptoms for years. In fact, one in five people with the condition don't know they have it. Internally, it can quietly damage the heart, lungs, blood vessels, brain, and kidneys if left untreated. It's a major risk factor for strokes and heart attacks in the U.S.

What Causes Hypertension?

Normal blood pressure readings will fall below 120/80, while higher results over time can indicate hypertension. In most cases, the underlying cause of hypertension is unknown. The top number (systolic) shows the pressure when your heart beats. The lower number (diastolic) measures pressure at rest between heartbeats, when the heart refills with blood. Occasionally, kidney or adrenal gland disease can lead to hypertension.

Prehypertension: A Warning Sign

Almost one-quarter of Americans have prehypertension. Their blood pressure is consistently just above the normal level -- falling anywhere between 120 and 139 for systolic pressure or 80 to 89 for the diastolic pressure. People in this range have twice the risk of developing heart disease than those with a lower reading. Your doctor may recommend lifestyle changes to help lower your blood pressure.

The Hypertension Danger Zone

You have high blood pressure if readings average140/90 or higher -- for either number -- though you may still have no symptoms. At 180/110 and higher, you may be having a hypertensive crisis. Rest for a few minutes and take your blood pressure again. If it is still very high, call 911. A hypertensive crisis can lead to a stroke, heart attack, kidney damage, or loss of consciousness. Symptoms of a hypertensive crisis can include a severe headache, anxiety, nosebleeds, and feeling short of breath

Who Gets High Blood Pressure?

Up to the age of 45, more men have high blood pressure than women. It becomes more common for both men and women as they age, and more women have hypertension by the time they reach 65. You have a greater risk if a close family member has high blood pressure or if you are diabetic. About 60% of people with diabetes have high blood pressure.

Hypertension and Race

African-Americans are more likely to develop hypertension -- and to develop it at a younger age. Genetic research suggests that African-Americans seem to be more sensitive to salt. In people who have a gene that makes them salt-sensitive, just a half-teaspoon of salt can raise blood pressure by 5 mm Hg. Diet and excessive weight can play a role, as well.

Hypertension and Sodium

Sodium, a major component of salt, can raise blood pressure by causing the body to retain fluid, which leads to a greater burden on the heart. The American Heart Association recommends eating less than 1,500 milligrams of sodium per day. You'll need to check food labels and menus carefully.  Processed foods contribute up to 75% of our sodium intake. Canned soups and lunch meats are prime suspects.

Hypertension and Stress

Stress can make your blood pressure spike, but there's no evidence that it causes high blood pressure as an ongoing condition. However, stress may affect risk factors for heart disease, so it may have an indirect connection to hypertension. Stress may lead to other unhealthy habits, such as a poor diet, alcohol use, or smoking, which can contribute to high blood pressure and heart disease.

Hypertension and Weight

Being overweight places a strain on your heart and increases your risk of high blood pressure. That is why diets to lower blood pressure are often also designed to control calories. They typically call for cutting fatty foods and added sugars, while increasing fruits, vegetables, lean protein, and fiber.  Even losing 10 pounds can make a difference

Hypertension and Alcohol

Drinking too much alcohol can increase your blood pressure. Guidelines from the American Heart Association state that if you drink alcohol, you should limit the amount to no more than two drinks a day for men, or one a day for women. They define a drink as one 12-ounce beer, four ounces of wine, 1.5 ounces of 80-proof spirits, or one ounce of 100-proof spirits.

Hypertension and Caffeine

If caffeine can make you jittery, can it also raise your blood pressure? It might have a temporary effect, but studies haven't shown any link between caffeine and the development of hypertension. You can safely drink one or two cups a day, according to the American Heart Association.

Hypertension and Pregnancy

Gestational hypertension is a kind of high blood pressure that occurs in the second half of pregnancy. Without treatment, it may lead to a serious condition called preeclampsia that endangers both the mother and baby. The condition can limit blood and oxygen flow to the baby and can affect  the mother's kidneys and brain. After the baby is born, the mother’s blood pressure usually returns to its normal level.

Hypertension and Medicine

Cold and flu medicines that contain decongestants are one of several classes of medicine that can cause your blood pressure to rise. Others include NSAID pain relievers, steroids, diet pills, birth control pills, and some antidepressants. If you have high blood pressure, talk to you doctor about what medicines and supplements you are taking that may affect blood pressure.

'White Coat' Hypertension

Some people only have a high reading in the doctor's office, perhaps because they're nervous. Some will only have high blood pressure readings sporadically. Those people may have a higher chance of developing high blood pressure, a recent study shows. To get a more accurate reading, take your blood pressure at home, chart your readings, and share them with your doctor. It is also a good idea to bring in your home monitor in for a check of the device and your technique

Hypertension and Children

While hypertension is more often a problem for older people, even children can have high blood pressure. "Normal" blood pressure varies based on a child’s age, height, and sex, so your doctor will need to tell you if there is a concern. Children are at greater risk if they are overweight, have a family history of the illness and if they're African-American.

Treatment: The DASH Diet

You may be able to lower your blood pressure by switching to a better diet. The DASH Diet -- Dietary Approaches to Stop Hypertension -- involves eating more fruits, vegetables, whole-grain foods, low-fat dairy, fish, poultry, and nuts. You should eat less red meat, saturated fats, and sweets. Reducing sodium in your diet can also have a significant effect.

Treatment: Exercise

Regular exercise helps lower your blood pressure. Adults should get about 150 minutes of moderate-intensity exercise every week. That could include gardening, walking briskly, bicycling, or other aerobic exercise. Muscle-strengthening activities are recommended at least two days a week and should work all major muscle groups.

Treatment: Diuretics

Diuretics are often the first choice if diet and exercise changes aren't enough. Also called "water pills," they help the body shed excess sodium and water to lower blood pressure. That means you'll urinate more often. Some diuretics may deplete your body's potassium, causing muscle weakness, leg cramps, and fatigue. Some can increase blood sugar levels in diabetics. Erectile dysfunction is a less common side effect.

Treatment: Beta-blockers

Beta-blockers work by slowing the heart rate, which means that the heart doesn't have to work as hard. They are also used to treat other heart conditions, such as an abnormal heart rate called arrhythmia. They may be prescribed along with other medications. Side effects can include insomnia, dizziness, fatigue, cold hands and feet, and erectile dysfunction.

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Treatment: ACE Inhibitors

ACE inhibitors reduce your body's supply of angiotensin II -- a substance that makes blood vessels contract and narrow. The result is more relaxed, open (dilated) arteries, as well as lower blood pressure and less effort for your heart. Side effects can include a dry cough, skin rash, or dizziness, and high levels of potassium. Women should not become pregnant while taking an ACE inhibitor.

Treatment: ARBs

Instead of reducing your body's supply of angiotensin II, these drugs block receptors for angiotensin -- as if placing a shield over a lock. This blockade prevents the chemical's artery-tightening effects, and lowers your blood pressure. ARBs can take several weeks to become fully effective. Possible side effects include dizziness, muscle cramps, insomnia, and high levels of potassium. Women should not become pregnant while taking this medication.

Treatment: Calcium Channel Blockers

Calcium channel blockers slow the movement of calcium into the cells of the heart and blood vessels. Since calcium causes stronger heart contractions, these medications ease the heart's contraction and relax the blood vessels. They can cause dizziness, heart palpitations, swelling of the ankles, and constipation. Take them with food or milk and avoid grapefruit juice and alcohol because of possible interactions.

Treatment: Other Medications

Other medications that relax the blood vessels include vasodilators, alpha blockers, and central agonists. Side effects can include dizziness, a fast heart beat or heart palpitations, headaches, or diarrhea. Your doctor may suggest them if other blood pressure medications are not working well enough or if you have another condition.

Treatment: Complementary Therapies

Meditation can put your body into a state of deep rest, which can lower your blood pressure. Yoga, tai chi, and deep breathing also help. These relaxation techniques should be combined with other lifestyle changes, such as diet and exercise. Be aware that herbal therapies may conflict with other medications you take, and some herbs actually raise blood pressure. Tell your doctor if you take herbal or other dietary supplements.

Living With High Blood Pressure

Hypertension is often a life-long condition. It's important to take your medications and continue to monitor your blood pressure. If you keep it under control, you can reduce your risk of stroke, heart disease, and kidney failure.

Jobs That Wreck Your Sleep

Air Traffic Controller

News of air traffic controllers falling asleep on the job shows the difficulty of shift work. Even when lives are at stake, it's a challenge for some people to stay alert throughout the night. That's because their internal body clock -- sometimes called circadian rhythms -- may be out of synch with their schedule. Shift work disrupts this cycle, and many people have trouble adapting.

Network Administrator

The Internet has also created a new demand for shift workers. Network administrators make sure that Web-based services are available to users 24/7 -- so you can buy books, download music, or browse WebMD any time you like. The downside to all this shift work is that the workforce is more sleep deprived than in decades past. And that has risks.

Factory Worker

The manufacturing industry relies on shift work to avoid factory downtime and to maximize productivity. But there are costs. Compared to non shift workers, shift workers are significantly more likely to get fewer than six hours of sleep on work days. Drowsy or tired workers can increase the risk of workplace injuries. Poor sleep has also been linked to high blood pressure, diabetes, and depression.

Senior Manager

If you have (or are) a cranky boss, too little sleep could be part of the problem. Senior managers deal with the stress of overseeing a team, and they often put in long hours. Studies show the more hours you work, the less you sleep. And one survey found a direct link between poor sleep and job dissatisfaction.

Cable News Reporter

The advent of 24-hour cable news created a whole new field of shift workers. Reporters, producers, and camera operators provide live news reports throughout the night. As more industries expand to 24-hour operations, the need for shift workers is growing. More than 15 million Americans now work evenings, nights, or other irregular shifts.

Nurse

Shift work is a time-honored tradition for hospital nurses. To provide continuous care to patients, many nurses also end up working long hours. Research suggests people tend to be less alert and focused during the last four hours of a 12-hour shift. This raises special concerns for jobs related to public health and safety

Financial Analyst

Shift workers aren't the only ones losing sleep. Some financial analysts specialize in foreign markets, such as Europe or Asia. Keeping an eye on those markets can require working odd hours because of the time difference. Successful professionals also tend to work long hours. According to the Center for Work-Life Policy, 62% of high earners work more than 50 hours a week, and 10% work more than 80 hours a week.

Police Officer

To protect and serve the public all night and day, many police departments use rotating shifts. This ensures 24-hour coverage without singling out some officers for holidays or the worst hours. But rotating shifts have challenges of their own -- it's impossible to adapt to any one schedule. Alternating between a day shift and a night shift is more problematic than switching between a day shift and an afternoon shift

Medical Intern

Medical students may get used to cramming for exams, but the all-nighters don't end at graduation. As intermediate-level hospital staff, some residents are allowed to work in-house duty for up to 24 hours in a row. (They must have at least 14 hours free of duty afterward.) Studies show medical interns are twice as likely to crash their cars after a long shift. They're also more likely to make mistakes in diagnosing patients.

Airplane Pilot

Flying commercial planes deals a triple punch to a good night's sleep. Pilots face irregular hours, long shifts, and jet lag as they travel through multiple time zones. To avoid pilot fatigue, the FAA observes strict guidelines on flight time and rest time. In the 24 hours before completing a flight, pilots must have at least eight hours of uninterrupted rest

New Parent

There is one job that is legendary in its ability to wreck your sleep: parent. When a newborn wakes up every couple of hours, it's difficult for parents to get a solid stretch of deep sleep. One study found new moms sleep about seven hours over the course of a night, but the sleep is fragmented and not refreshing. Luckily, the situation usually improves by the time baby is 16 weeks old

Truck Driver

Truck drivers have long taken to the road at night, both to avoid daytime traffic and to manage tight delivery schedules. But this is one job where the consequences of poor sleep are well-documented. Roadway crashes are the top cause of work-related deaths in the United States, and drowsy driving is often a factor.

Bartender

With many bars open until at least 2 a.m. and around the clock in some cities, a bartender may end up working almost through the night. Some people are drawn to this type of schedule because they are "night owls" -- they are naturally more alert at night. The key to fully adapting to this shift is to keep the same schedule on your days off. But if you're a "lark," you may never adapt.

Shift Work Sleep Disorder

When your work schedule collides with your body's natural circadian rhythm, you are forced to try to sleep when you feel alert and work when you feel drowsy. This puts you at risk for shift work sleep disorder. The symptoms include insomnia, fatigue, irritability, decreased alertness, and trouble concentrating. Shift workers are also more likely to develop stomach problems and heart disease.

Tips for Working at Night

The best way to adapt to shift work is to stick to the same schedule, even on weekends. If this isn't possible, you're more likely to feel fatigued when working the night shift. But there are strategies that can help you stay alert. Try to work with others rather than alone. Drink a beverage with caffeine at the start of your shift. Walk around or get some exercise on your break. If napping is an option, give it a try.

When to Seek Help

If you've had work-related sleep problems for at least one month -- and they have affected your family or work life -- a sleep specialist may help. An evaluation can find underlying causes including medical conditions, emotional problems, substance abuse, medications, or poor sleep habits. If a shift work sleep disorder exists, a doctor can determine whether prescription drugs are safe and appropriate, given your personal health history and the risks of side effects.

Tips for Daytime Sleep

Although most people find it tough to sleep during the day, there are some tricks that can help. On your way home from work, wear dark glasses and stay out of the sun. Make your bedroom as dark as possible or wear an eye mask. Use earplugs to block out daytime noise. And create a bedtime ritual, like reading or a taking a bath, to signal to your brain that it's time to sleep.

Sex-Drive Killers

Sex-Drive Killers

Sex-Drive Killer: Stress

Some people do many things well when they're stressed. Feeling sexy usually isn't one of them. Stress at work, home, or in your relationships can happen to anyone. Learning how to handle it really helps. You can do a lot of it yourself, and a counselor or doctor can also help.

Sex-Drive Killer: Alcohol

A drink may make you feel more open to sex. But too much alcohol can numb your sex drive. Your being drunk can also be a turn-off for your partner. If you have trouble drinking less, seek help.

Sex-Drive Killer: Too Little Sleep

If your sexual get-up-and-go is gone, maybe you're not spending enough time in bed. Do you go to bed too late or rise too early? Do you have a sleep problem like trouble falling or staying asleep, or a condition such as sleep apnea? Anything that messes with a good night's rest can mess with sex. Fatigue saps sexy feelings. Work on your sleep habits, and if that doesn't help, talk to your doctor

Sex-Drive Killer: Medication

Some drugs turn down desire. They include some of these types of medications:

Antidepressants

Blood pressure medications

Birth control pills (some studies show a link; others don't)

Chemotherapy

Anti-HIV drugs

Finasteride

Switching drugs or dosages may help -- ask your doctor about that and never stop taking any medicine on your own. Tell your doctor, too, if  your sex drive stalls soon after you start taking a new drug.

Sex Drive Killer: Poor Body Image

Feeling sexy is easier if you like how you look. Work on accepting your body as it is today, even if you're working to get in shape. Feeling good about yourself can put you in the mood. If your partner has low esteem, assure them that they're sexy.

Sex-Drive Killer: Obesity

When you're overweight or obese, desire often dims. It could be that you don't enjoy sex, can't perform like you want to, or are held back by low self-esteem.  Working on how you feel about yourself, with a counselor if needed, may make a big difference

Sex-Drive Killer: Erection Problems

Men with ED (erectile dysfunction) often worry about how they will be able to perform sexually, and that worry can drain their desire. ED can be treated, and couples can also work to keep it from affecting their relationship

Sex-Drive Killer: Low T

The "T" hormone, testosterone, fuels sex drive. As men age, their T levels may drop a bit. Not all lose the desire for sex as this happens, but some do. Many other things -- from relationships to weight -- also affect a man's sex drive and testosterone levels, so there's not a one-size-fits-all answer for every man.

Sex-Drive Killer: Depression

Being depressed can shut off pleasure in many things, including sex. That's one of many reasons to get help. If your treatment involves medication, tell your doctor if your sex drive is low, since some (but not all) depression drugs lower sex drive. Talk about it with your therapist, too.

Sex-Drive Killer: Having Kids

You don't lose your sex drive once you're a mom or dad. You do lose some time to be close, though, with kids under foot. Hire a babysitter to nurture some time to be partners as well as parents. New baby? Try sex during nap time.