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Understanding Hypertension

High blood pressure is one of the most significant risk factors for heart disease and stroke. Learn about hypertension, why it matters, and what options exist when medications aren't enough.

What is Hypertension?

Hypertension, or high blood pressure, occurs when the force of blood pushing against your artery walls is consistently too high. This increased pressure makes your heart work harder to pump blood and contributes to hardening of the arteries (atherosclerosis).

Blood pressure is measured in millimeters of mercury (mmHg) and expressed as two numbers: systolic (when the heart beats) over diastolic (when the heart rests between beats). Normal blood pressure is below 120/80 mmHg.

Normal

< 120/80 mmHg

Elevated

120-129/<80 mmHg

Stage 1 Hypertension

130-139/80-89 mmHg

Stage 2 Hypertension

≥140/90 mmHg

Why Blood Pressure Control Matters

Uncontrolled high blood pressure damages blood vessels throughout the body and significantly increases the risk of:

Heart Attack

Damaged arteries can become blocked

Stroke

Blood vessels in the brain can rupture or clog

Heart Failure

The heart becomes enlarged and weakened

Kidney Disease

Damaged kidney blood vessels impair function

Vision Loss

Blood vessels in the eyes can be damaged

Cognitive Decline

Reduced blood flow affects brain function

Treatment Options for Hypertension

Lifestyle Modifications

Lifestyle changes are the foundation of blood pressure management and can be effective for many people:

Reduce sodium intake
Maintain healthy weight
Exercise regularly
Limit alcohol consumption
Quit smoking
Manage stress
Follow a heart-healthy diet (DASH diet)
Get adequate sleep

Blood Pressure Medications

When lifestyle changes aren't enough, medications help control blood pressure. Common classes include:

  • Diuretics — Help kidneys remove excess sodium and water
  • ACE Inhibitors / ARBs — Relax blood vessels by blocking certain hormones
  • Calcium Channel Blockers — Relax blood vessel walls
  • Beta Blockers — Slow heart rate and reduce force of contractions

When Medications Aren't Enough: Resistant Hypertension

Some patients have resistant hypertension — blood pressure that remains above goal despite taking three or more medications at optimal doses (including a diuretic). This affects approximately 10-15% of patients with hypertension.

Why Does This Happen?

  • Overactive sympathetic nervous system — The "fight or flight" system keeps blood pressure elevated
  • Secondary causes — Conditions like sleep apnea, kidney disease, or hormonal disorders
  • Medication interactions or lifestyle factors— Certain medications, high sodium intake, or alcohol

Renal Denervation: A New Treatment Option

For patients with truly resistant hypertension, renal denervation offers a minimally invasive option. This catheter-based procedure reduces the activity of nerves around the kidney arteries that contribute to high blood pressure.

Learn More About Renal Denervation

Monitoring Your Blood Pressure

Regular blood pressure monitoring is essential for effective management. Home blood pressure monitoring helps:

  • Track your response to treatment
  • Identify "white coat hypertension" (elevated readings only at the doctor's office)
  • Detect "masked hypertension" (normal office readings but elevated at home)
  • Empower you to take an active role in your health

Your doctor may also recommend ambulatory blood pressure monitoring, which measures blood pressure automatically over 24 hours to get a complete picture of your daily blood pressure patterns.

Key Numbers

Target Blood Pressure
< 130/80 mmHg
Americans with HTN
~50% of adults
With Resistant HTN
10-15% of HTN patients

Hypertensive Crisis

Seek emergency care if blood pressure exceeds 180/120 mmHg, especially with:

  • • Severe headache
  • • Chest pain
  • • Vision changes
  • • Difficulty breathing
  • • Numbness or weakness

Concerned About Your Blood Pressure?

If your blood pressure is difficult to control, Dr. Bleszynski can help evaluate your options, including whether renal denervation might be right for you.

Schedule Consultation(702) 805-5678