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High blood pressure or hypertension is frequently asymptomatic and undetected. High blood pressure is a major risk factor for heart attack and stroke and can be evaluated by a cardiologist with blood pressure testing both in the doctor’s office and a program of at-home blood pressure recordings over several weeks.
What is Hypertension?
Hypertension can lead to a heart attack, stroke, or heart failure. Determining the correct diagnosis is essential to getting the correct care. Any heart specialist can treat your symptoms, but only an expert doctor can pinpoint the cause of your condition and take steps to treat it at its source.
Normal blood pressure: generally less than 140/90 mmHg (i.e. systolic blood pressure less than 140 and diastolic blood pressure less than 90 mmHg).
High blood pressure: 140/90 mmHg or higher.
Knowing Your Blood Pressure Numbers
The average reading that indicates normal blood pressure is 120/80 or lower. You’re considered to have high blood pressure if your systolic blood pressure is 130 or higher and your diastolic pressure is higher than 80 and stays that high over time. Infrequent spikes may be nothing to worry about, but persistent high readings can lead to serious consequences, including a heart attack or stroke.
Why Your Blood Pressure Should Be Less Than 130/80?
Some people experience high blood pressure readings only at the doctor’s office. This is known as white-coat hypertension. If you fall into this category, you get so nervous going to the doctor’s that your blood pressure spikes. Your specialist may recommend that you wear an ambulatory blood pressure monitor temporarily or check your blood pressure at home. The monitor records your blood pressure as you move around doing normal daily activities. It allows your New York cardiologist to get a more accurate reading of your blood pressure.
Learn more about: How to Measure Blood Pressure With Apple Watch
What Are The Symptoms of High Blood Pressure?
Even if your blood pressure levels are dangerously high, it still possible that you may have zero signs or symptoms. Some people with hypertension will notice they have nosebleeds, are short of breath, or may develop headaches. However, these symptoms aren’t specific enough to indicate high blood pressure and often do not occur until hypertension has reached dangerously high levels or is even life-threatening.
Why Does High Blood Pressure Matter for Cardiac Health?
- High blood pressure damages the walls of the arteries. When you have high arterial pressure, the force put on your arteries is far greater than what is considered “normal.” If it is really high, it can cause microscopic tears in the artery walls, which eventually turn into scar tissue.
- Damaged arteries accumulate circulating materials such as cholesterol, platelets, fats, and plaques.
- High blood pressure speeds up the hardening of the arteries. Your arteries will naturally harden and become less elastic as you age. This happens even in people who do not have high blood pressure.
Dr. Steven Reisman is very smart and has great bedside manners. He will send as much time as you need and will have a plan to help you get better. The office staff is very nice and can always get you an appointment in a reasonable amount of time and he takes insurance.~ ZocDoc
The following factors increase the risk of serious problems associated with high blood pressure:
- Smoking
- Age: the older you are, the higher your risk
- Your family history. High arterial pressure may be genetic.
- Having high blood cholesterol
- Being overweight
- Having diabetes
- Your race/ethnicity. Certain ethnic groups, such as African Americans, have a greater risk of developing high blood pressure at an early age.
Your lifestyle is important in helping you control high blood pressure and the risks that come with it. The NYC cardiologist will probably advise you to:
- Quit smoking
- Reduce your salt intake
- Achieve and maintain a healthy body weight
- Limit your alcohol intake
- Undertake regular physical activity
According to the latest study, Physical Activity and the Prevention of Hypertension: “Recent evidence from prospective studies continues to suggest a relationship between physical activity and hypertension. These data are supported by a large body of literature on the effects of physical activity/exercise interventions on BP among normotensives and prehypertensives. Together, the available evidence strongly supports the role of physical activity in the prevention of hypertension.
Diagnosing High Blood Pressure
Because blood pressure readings can vary from one appointment to the next, your cardiologist may want to take several readings over multiple appointments before making a firm diagnosis of hypertension. They may take blood pressure readings in both arms for comparison and may recommend you to check your blood pressure at home and note the results. It is critical not to rush a diagnosis in order to receive the appropriate treatment.
Other tests that your cardiologist may recommend to diagnose high blood pressure more accurately include:
- Echocardiogram: It’s an ultrasound test taken through the chest to detect heart problems such as enlargement, heart valve abnormalities, and blood clots in the blood vessels.
- Electrocardiogram (EKG): It’s a test that records the electrical heart rhythm as well as heart rate. It checks whether there is any enlargement of the heart due to high blood pressure.
- Stress testing: These are tests meant to record the change in heart rate with the level of activities. It mostly checks the presence of coronary heart disease.
In addition, your hypertension treatment specialists may order blood and urine tests to measure hormone levels and rule out underlying problems such as urinary tract infection, kidney damage, or diabetes.
How is High Blood Pressure Treated?
Often, high blood pressure can be treated by making lifestyle changes such as eating a healthy diet, losing excess weight, and exercising regularly. Otherwise, your cardiologist may prescribe medicines to reduce blood pressure levels. The medicine prescribed depends on your health history and your blood pressure readings. Sometimes it’s necessary to try a few different medicines to see which one works best for you.
Some of the medications that can help manage high blood pressure include:
- Thiazide diuretics: These are medicines designed to help the body lose more water and sodium. Their main goal is to reduce blood volume, which in turn reduces blood pressure. Chlorthalidone and hydrochlorothiazide are two examples of these medications.
- ACE inhibitors: These are medications used to relax the blood vessels. If blood vessels narrow while the volume remains constant, there is a strong likelihood of high blood pressure. These medications work by relaxing the blood vessels in order to lower blood pressure. Angiotensin II receptor blockers (ARB) are another group of medications that work by inhibiting the action of angiotensin, a chemical in the body that raises blood pressure.
- Alpha-blockers: These reduce high blood pressure by reducing nerve impulses to blood vessels.
- Beta-blockers: These minimize the workload on the heart, widen the blood arteries, and lower blood pressure.
Pulmonary Hypertension
Pulmonary hypertension occurs when the arteries in the lungs and the right side of the heart become narrowed, hardened, and blocked. This causes high blood pressure and forces the lower right chamber of the heart, the right ventricle, which pumps oxygen-rich blood through the lungs, to work harder.
Excess resistance in pumping blood through the lungs can cause the heart muscle to become significantly weakened, resulting in the following symptoms:
- Shortness of breath
- Dizziness and fatigue
- Chest pain
- Swelling in ankles and legs (edema)
- Heart palpitations
- Dry cough
- Bluish discoloration of the skin and lips
- Accumulation of fluid inside the abdomen (ascites)
Pulmonary Hypertension Treatment
Although pulmonary hypertension has no cure, there are ways to help stabilize your condition and relieve symptoms. Based on the results of your comprehensive evaluation, your doctor can establish a tailored treatment plan that may include medications (oral, intravenous, subcutaneous, and inhaled), as well as dietary and exercise recommendations. If all conservative hypertension treatment options have been exhausted and your symptoms persist or worsen, surgery may be necessary.
Hypertensive Emergency Treatment
A hypertensive emergency is a dangerously high blood pressure with new or progressive damage to target organs that requires admission to an intensive care unit.
Rapid-acting medications such as clevidipine, nitroprusside, nicardipine, labetalol, esmolol, and hydralazine will be used by your doctor to prevent or limit target organ damage and improve clinical outcomes. These are typically delivered by an intravenous (IV) line placed into a vein.
Hypertensive emergency treatment aims at reducing mean arterial blood pressure by no more than 25% within minutes to an hour and then stabilizing it at 160/100-110 mm Hg within the next 2 to 6 hours. A follow-up appointment with your healthcare provider within a week of the episode is necessary.
Finding a High Blood Pressure Doctors Near Me
When looking for effective ways to manage and treat low or high blood pressure, choose a board-certified cardiologist specialized in recognizing both hypertension and hypotension manifestations, as well as preventing and addressing their neurogenic causes with the latest evidence-based drug and non-drug treatments.
Locate a blood pressure doctor near you who offers a patient-oriented approach to care, using a combination of nonpharmacologic strategies and drugs clinically proven to be efficacious. The Cardiac Diagnostic Center combines the most recent developments in hypertension and hypotension diagnosis and management with the goal of effectively preventing the morbidity and mortality associated with the conditions.
If you have any questions about the best-in-class NYC cardiologist or would like to schedule a consultation or appointment, please feel free to contact Dr. Steven Reisman of the New York Cardiac Diagnostic Center and indicate which Manhattan office (Upper East Side, Cardiologist in Midtown Manhattan, or Wall Street / Financial District) you would like to see the cardiologist for a cardiac consultation.
Dr. Steven Reisman is an internationally recognized cardiologist and heart specialist. He is a member of the American College of Cardiology, American Heart Association, and a founding member of the American Society of Nuclear Cardiology.
Dr. Reisman has presented original research findings for the early detection of "high risk" heart disease and severe coronary artery disease at the annual meetings of both the American College of Cardiology and the American Heart Association. Dr. Reisman was part of a group of doctors with the Food and Drug Administration who evaluated the dipyridamole thallium testing technique before the FDA approved it.
Dr. Steven Reisman's academic appointments include Assistant Professor of Medicine at the University of California and Assistant Professor at SUNY. Hospital appointments include the Director of Nuclear Cardiology at the Long Island College Hospital.
