High blood pressure (or hypertension) is a chronic medical condition where there is an increase in the amount of pressure blood has on the blood vessels. Blood pressure is measured in terms of two numbers. The top number (systolic) is the amount of pressure during a heartbeat. The bottom number (diastolic) is the amount of pressure between heartbeats. Therefore, blood pressure is read as systolic “over” diastolic. A healthy blood pressure is a systolic less than 120, and diastolic less than 80. Patients are considered to have prehypertension when their blood pressure is above 120 but less than 140 (systolic) or above 80 but less than 90 (diastolic). Prehypertension significantly increases the patient’s chances of developing high blood pressure. Hypertension is formally diagnosed if the patient’s blood pressure is 140 or greater (systolic) or 90 or greater (diastolic). Almost one-third of the population has prehypertension, and another third meets the diagnosis for hypertension. Unfortunately, many people go undiagnosed, and for those with a diagnosis, half do not have their blood pressure under control. High blood pressure is often known as the “silent killer” because it typically does not produce symptoms until it is extremely high. When hypertension has symptoms, it is usually the swelling of hands and feet, blurred vision, dizziness, headaches, and sometimes nausea. Even without symptoms, hypertension can damage blood vessels, leading to kidney damage, stroke, heart attack, and permanent damage to vision. Seniors, certain ethnic groups (African-American and Native-American decent), and a family history of heart disease are considered to be risk factors for developing hypertension. Although these are risk factors that cannot be avoided, there are other risk factors that can be modified to decrease your chance of developing hypertension, or keep your blood pressure under control. Regular exercise, stress reduction techniques, maintaining a healthy weight, not smoking, moderating alcohol consumption, and eating a diet that is low in salt, are all ways to help keep your blood pressure at a healthy level and increase your overall health. Some patients may need prescription medications to help lower their blood pressure. If so, take your medication as prescribed, and keep all appointments for blood pressure checks. These blood pressure checks are important to determine how effective the medication is, and the dose may be increased or decreased, accordingly. If the medication has side effects, discuss them with your health professional. There may be other medications that are equally as effective without the side effects. Most importantly, medical treatment for hypertension is not a license to perform poorly in other aspects of life. Taking blood pressure medicine does not erase the damage of a high fat, high cholesterol, and high salt diet. Many patients have found that lifestyle changes may eliminate the need for medication, or significantly reduce the amount and doses of medicines they take. Also, living a healthy lifestyle and not being a member of a high risk group is not a substitute for routine medical screening. Everyone should have regular blood pressure screenings and be screened more often if their blood pressure is elevated. Seniors, in particular, may need to monitor their blood pressure more often, because blood pressure tends to increase with age.