When To See A Cardiologist For High Blood Pressure?

Blood pressure is the measurement of how much force is being exerted on the walls of your arteries as blood moves through your body. Two numbers make up a blood pressure reading: 

  • Systolic blood pressure – this is the pressure on the arteries when the heart is pumping blood and the top number when blood pressure is written down. 

  • Diastolic blood pressure – this is the pressure on the arteries when the heart is at rest and is the bottom number when the blood pressure is written down. 

Blood pressure is within a normal range if it's lower than 120 over 80 (often written as 120/80). It is measured in units of measurement called millimeters of mercury, abbreviated as mm Hg. Measurements above these numbers could mean you have high blood pressure, also known as hypertension. The readings for healthy and unhealthy blood pressure are as follows:

  • Normal: Less than 120 and less than 80mm Hg

  • Elevated: 120-129 and less than 80mm Hg

  • High blood pressure (hypertension stage 1): 130-139 or 80-89

  • High blood pressure (hypertension stage 2): 140+ or 90+

  • Hypertension urgency or crisis: 180+ and/or 120+

More than 100 million American adults¹ have high blood pressure. It's sometimes known as “the silent killer,” as many people are unaware of their condition because there are often no obvious symptoms. 

The only way to know for sure if you have high blood pressure is to have your blood pressure checked. This is a quick, non-invasive, and painless test that can be done at home with a blood pressure cuff that you can purchase at a pharmacy without a prescription or at a doctor’s office.

If you have high blood pressure, you can do things to help keep it in check, including medication and lifestyle changes. Some people may need to see a cardiologist or other medical professional regarding their blood pressure to prevent it from developing into other serious health concerns, including heart disease, heart attack, and stroke. 

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When should you see a cardiologist about high blood pressure?

If you have concerns about your blood pressure, talk to your primary care physician first. They'll be able to offer a diagnosis and medication or advice on lifestyle changes that may help. If there are additional concerns about your heart health, they can refer you to a cardiologist.

You may want to make an appointment with a cardiologist if: 

  • You have high blood pressure that isn't controlled by your current medication or lifestyle changes

  • You have a history of heart disease or heart attacks in your family 

  • You have high cholesterol levels or diabetes 

  • You are experiencing other symptoms such as swelling in the legs or feet, shortness of breath, irregular heartbeats, headaches, or lightheadedness, which can signal other heart-related problems

Cardiologists can treat as well as prevent heart conditions. If you have a history of heart disease in your family or are at an increased risk of developing heart disease, ask for a referral to a cardiologist from your primary care provider. A cardiologist can work with you to develop a plan to help lower your risk of developing heart disease or other life-threatening conditions.

What other types of doctor or specialist might you need to see for high blood pressure?

A cardiologist isn't the only doctor you can see if you have concerns about your heart health or high blood pressure. Other types of doctors who may help include your primary care provider. Primary care physicians are often the first to diagnose high blood pressure, as they will usually take a blood pressure measurement during routine appointments. They can also provide advice on lifestyle changes that may help keep your blood pressure in check and prescribe medication to help control your blood pressure if needed.

Your primary care physician can work with a cardiologist to monitor your condition over time and make adjustments to your care as needed.

In some cases, your high blood pressure may be caused by underlying kidney problems. Your primary care physician may advise you to have a kidney evaluation by a nephrologist (a kidney specialist), especially if your blood pressure is not under control despite taking a number of blood pressure-lowering medications or if you or someone in your family has known kidney disease.

Is high blood pressure considered a heart condition?

High blood pressure is not the same as heart disease or blockages in your blood vessels. It can, however, have a negative impact on the heart and the rest of your circulatory system, so in that sense, it is a heart condition.

High blood pressure increases the pressure on the walls of the arteries, causing them to lose their elasticity. This can lead to serious health problems such as heart attack, stroke, aneurysms, and heart failure. It's even linked to the development of certain types of dementia.  

Having high blood pressure also means your heart is working too hard to pump blood throughout your body, which can have a negative effect on your other organs as they depend on that blood supply for oxygen and nutrients. If your heart is working harder to supply blood to other areas of the body, it can put additional stress on organs such as your lungs, kidneys, and eyes.

Does high blood pressure guarantee a heart attack?

Having high blood pressure is not a guarantee that you will have a heart attack. It does, however, significantly increase your risk by putting more strain on your heart and arteries. High blood pressure can also cause your arteries to lose their elasticity and thicken - a condition called atherosclerosis.

Atherosclerosis is the main cause of heart attacks; this thickening of the arteries can restrict blood flow to the heart. If those arteries become clogged by plaque, they can stop blood flow to the heart altogether and trigger a heart attack.

This means that unmanaged high blood pressure can increase the risk of having a heart attack, though there is no guarantee that it will cause one. It's also possible to suffer a heart attack without having high blood pressure. 

When is high blood pressure an emergency?

Most people discover their blood pressure is high during a routine visit to their primary care physician. With early intervention and proper care, most people can successfully manage their blood pressure without further issues.

However, there are times when high blood pressure could become urgent and must be dealt with as an emergency.

Hypertensive urgency occurs when: 

  • Your blood pressure rises quickly

  • And it measures 180/120mm Hg or higher

If you get a blood pressure reading of 180 over 120 or higher but aren't experiencing any other symptoms, wait a few minutes and then retest your blood pressure. If it remains high, get in touch with your doctor to discuss your options. They may need to prescribe medication to help you lower your blood pressure levels. 

If, however, your blood pressure reading is 180 over 120 and you are experiencing any of the following symptoms, it may be a sign of a hypertension crisis: 

  • Memory loss

  • Chest pains

  • Shortness of breath

  • Headaches

  • Nosebleeds

  • Difficulty speaking

  • Back pain

  • Change in your vision

  • Numbness

If you think you are experiencing a hypertensive crisis, call 911 or visit your nearest emergency room. It may be an indication of a serious medical problem, including heart attack, eclampsia (if you are pregnant), or stroke. 

The lowdown

Blood pressure measures the amount of force placed on your artery walls as blood passes through them. Blood pressure is within normal range when the measurement is 120/80mm Hg or below. High blood pressure, or hypertension, means your heart works harder than normal to pump blood around the body to deliver oxygen and other vital nutrients. If blood pressure remains high, it can lead to a hardening and thickening of the arteries, and this can increase your risk of serious medical emergencies such as heart attack or stroke. 

The only way to know if you have high blood pressure is to test it. This is a quick, painless procedure routinely done during visits to your primary care provider. If they find you have high blood pressure, they may prescribe medication or recommend lifestyle changes that can help bring it back into the normal range. They may also recommend that you see a cardiologist if the medication isn't working if you have a family history of heart disease, or if you are at an increased risk of having a heart attack due to your other medical conditions.

Having high blood pressure does not guarantee that you'll have a heart attack. However, it does increase the risk of having one and puts you at risk for other serious medical conditions. High blood pressure can become an emergency if it measures over 180/120mm Hg and you are experiencing symptoms such as lightheadedness, nose bleeds, headaches, or chest pains. This is called a hypertensive crisis, and you should contact 911 or attend your nearest emergency room right away. It may be an indication of a heart attack or stroke that needs immediate evaluation.

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