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  • Cardiac Wellness Program: Reduce Cardiac Risk

    Heart disease is the number one cause of death in the U.S. for both men and women. Although genetics plays a role in the development of heart disease, lifestyle choices have been proven to significantly influence the health of your heart. The more risk factors you have, the greater your chance of having a heart attack or stroke. This program is held at MGH West in Waltham, MA.

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    The Massachusetts General Hospital Weight Center is a fully integrated center within the Digestive Healthcare Center that supports the spectrum of needs for people of all ages seeking help with obesity and weight loss.

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    The Bariatric and Metabolic Surgery Program at Massachusetts General Hospital offers a full spectrum of safe and effective surgical procedures for obesity, weight disorders and metabolic disease.

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  • Heart Imaging

    The Heart Imaging Program at Massachusetts General Hospital provides comprehensive diagnostic cardiac imaging, using state-of-the-art CT and MRI technology. Every exam is interpreted by a specialist with advanced training in cardiovascular imaging.

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  • Resistant Hypertension Program

    The Resistant Hypertension Program at Massachusetts General Hospital specializes in the evaluation, diagnosis and management of patients with resistant or difficult to treat hypertension.

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  • Nephrology/ Hypertension at MGH West Vascular Center

    The Division of Nephrology and the Vascular Center offer consultation, diagnosis and treatment of kidney diseases and hypertension on an appointment basis at Mass General West in Waltham, MA.

  • Center for Renal Education

    The Center for Renal Education provides education about Chronic Kidney Disease and its management and individualized plans of care that include nutritional counseling, blood pressure management, medication review and supportive services.

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    Renal Associates provides services in general nephrology including diabetes, water and electrolyte disorders, kidney disease in pregnancy, urinary tract infections, and primary and secondary diseases of the kidney.

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  • Midlife Women's Health Center

    The Massachusetts General Hospital Midlife Women’s Health Center brings together experts from more than 15 specialties to improve, promote and advance health care for women at menopause and beyond through research, collaboration and education.

    Contact us: 617-726-6776

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  • Psychology Assessment Center

    The pediatric neuropsychology specialists at Massachusetts General Hospital’s Psychology Assessment Center provide neuropsychological assessments to aid in the diagnosis and treatment of neurological, medical, genetic and developmental disorders.

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About This Condition

High Blood Pressure/Hypertension

What is blood pressure?

Blood pressure is the force of the blood pushing against the artery walls. The force is generated with each heartbeat as blood is pumped from the heart into the blood vessels. The size and elasticity of the artery walls also affect blood pressure. Each time the heart beats (contracts and relaxes), pressure is created inside the arteries.

The pressure is greatest when blood is pumped out of the heart into the arteries. When the heart relaxes between beats (blood is not moving out of the heart), the pressure falls in the arteries.

Two numbers are recorded when measuring blood pressure.

  • The top number, or systolic pressure, refers to the pressure inside the artery when the heart contracts and pumps blood through the body.

  • The bottom number, or diastolic pressure, refers to the pressure inside the artery when the heart is at rest and is filling with blood.

Both the systolic and diastolic pressures are recorded as "mm Hg" (millimeters of mercury). This recording represents how high the mercury column in the blood pressure cuff is raised by the pressure of the blood.

Blood pressure is measured with a blood pressure cuff and stethoscope by a nurse or other healthcare provider. You can also take your own blood pressure with an electronic blood pressure monitor. These are available at most pharmacies.

High blood pressure, or hypertension, directly increases the risk of heart attack and stroke. With high blood pressure, the arteries may have an increased resistance against the flow of blood, causing the heart to pump harder to circulate the blood. Usually, high blood pressure has no signs or symptoms. However, you can know if your blood pressure is high by checking it yourself or by having it checked regularly by your healthcare provider.

The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health (NIH) has determined 2 levels of high blood pressure for adults:

  • Stage 1

    • 140 mm Hg to 159 mm Hg systolic pressure—higher number

      and

    • 90 mm Hg to 99 mm Hg diastolic pressure—lower number 

  • Stage 2

    • 160 mm Hg or higher systolic pressure

      and

    • 100 mm Hg or higher diastolic pressure

The NHLBI defines prehypertension as:

  • 120 mm Hg to 139 mm Hg systolic pressure

    and

  • 80 mm Hg to 89 mm Hg diastolic pressure

The NHLBI guidelines define normal blood pressure as follows:

  • Less than 120 mm Hg systolic pressure

    and

  • Less than 80 mm Hg diastolic pressure

Use these numbers as a guide only. A single elevated blood pressure measurement is not necessarily an indication of a problem. Your healthcare provider will want to see multiple blood pressure measurements over several days or weeks before making a diagnosis of high blood pressure and starting treatment. If you normally run a lower-than-usual blood pressure, you may be diagnosed with high blood pressure with blood pressure measurements lower than 140/90.

What are the risk factors for high blood pressure?

Nearly one-third of all Americans have high blood pressure, but it is particularly prevalent in:

  • People who have diabetes, gout, or kidney disease

  • African Americans (particularly those who live in the southeastern U.S.)

  • People in their early to middle adult years; men in this age group have higher blood pressure more often than women in this age group

  • People in their middle to later adult years; women in this age group have higher blood pressure more often than men in this age group (more women have high blood pressure after menopause than men of the same age)

  • Middle-aged and elderly people; more than half of all Americans age 60 and older have high blood pressure

  • People with a family history of high blood pressure

  • People consuming a high salt diet

  • Overweight people

  • Heavy drinkers of alcohol

  • Women who are taking oral contraceptives

  • People with depression

How does blood pressure increase?

The following conditions contribute to high blood pressure:

  • Being overweight

  • Excessive sodium intake

  • A lack of exercise and physical activity

How is high blood pressure controlled?

These steps can help you control your blood pressure:

  • Take prescribed medicine exactly as directed by your healthcare provider

  • Choose foods that are low in sodium (salt)

  • Choose foods low in calories and fat

  • Choose foods high in fiber

  • Maintain a healthy weight, or losing weight if overweight

  • Limit serving sizes

  • Increase physical activity

  • Reduce or omit alcoholic beverages

Sometimes daily medicine is needed to control high blood pressure. If you have high blood pressure, have your blood pressure checked routinely and see your healthcare provider to monitor the condition.

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