High blood pressure/hypertension
Duke’s nationally ranked Heart Center takes a comprehensive approach to treating hypertension, also known as high blood pressure, which impacts approximately 30 percent of adults in North Carolina. With clinic locations in Durham, Raleigh and beyond the Triangle, our highly skilled specialists work together to actively screen for hypertension, evaluate the cause and determine the best course of treatment.
Comprehensive approach to treating hypertension
When the blood pressure in your arteries is elevated, your heart works harder to pump blood through your body. While the elevated pressure, known as high blood pressure, causes few if any symptoms, the damage it inflicts on your arteries can be severe. Left untreated, the constant effort to pump blood harder can damage blood vessels, and lead to heart attack, kidney disease and stroke.
Our experienced cardiologists diagnose hypertension early and work to identify the underlying cause of your high blood pressure. We involve our kidney specialists when the kidneys over produce a substance called renin that may cause blood pressure to rise. Our approaches to managing blood pressure are used by physicians nationwide, and our ongoing participation in clinical trials aim to uncover new ways to get blood pressure under control. Currently, we are evaluating a new, minimally invasive approach to treat blood pressure that is resistant to treatment -- also known as resistant hypertension. Our goal is always to identify the best approach to lower your blood pressure quickly and effectively while reducing your risk for the serious complications that can result.
Choose Duke Heart Center for your hypertension treatment because we offer:
- Top-ranked care. U.S. News and World Report ranks Duke Heart Center 5th in the nation, based on our patients’ survival rates, the number of procedures we perform, and the quality of our support services.
- Early intervention. We work to identify and reverse slightly elevated hypertension, often called pre-hypertension, by educating you about the potential risks and ways to lower your blood pressure through lifestyle changes.
- Support for lasting lifestyle changes. Experts in our cardiac prevention and rehabilitation program -- exercise physiologists, nutritionists, cardiologists, counselors and others -- work with you to help you quit smoking, exercise more, make healthy food choices. These lifestyle changes play an important role in lowering your high blood pressure.
- A comprehensive team. Our cardiologists and kidney specialists help you understand your prescribed treatment plan and set manageable goals. We also work to reduce any barriers, including financial concerns and complicated treatment plans, that may keep you from following our recommendations.
- Care innovators. Our team has pioneered new approaches to managing hypertension, including research regarding benefits of the DASH Diet (Dietary Approaches to Stop Hypertension). The diet is now recommended by the American Heart Association.
- Novel option for resistant hypertension. Our cardiologists and kidney specialists, also called nephrologists, work closely with patients who struggle to manage their high blood pressure with medication and diet restrictions. We are currently one of four sites in North Carolina involved in a clinical trial looking at the first minimally invasive approach to lower blood pressure in people with resistant hypertension.
HIGH BLOOD PRESSURE (HYPERTENSION)
The most effective way to manage high blood pressure. Our cardiac prevention and rehabilitation program provides the tools and support you need -- medically supervised exercise programs, stress management, nutrition and weight loss counseling, smoking cessation programs, and more -- to make lasting change that will positively impact your health.
Your doctor may prescribe medication in addition to lifestyle changes to help manage your blood pressure. They may include:
- Diuretics. Also called "water pills" because they cause the kidneys to flush excess water and sodium from the body. Typically, these will be prescribed along with another medication.
- Beta-blockers. Help the heart beat slower and with less force. Typically prescribed to those with angina (chest pain) or those who have had a previous heart attack.
- Angiotensin converting enzyme (ACE) inhibitors. Cause the vessels to widen, allowing blood to flow unhindered.
- Calcium channel blockers (CCBs). Limit the amount of calcium that enters the cells of the heart and vessels, causing blood vessels to relax.
We are currently testing this minimally invasive procedure to determine its effectiveness in lowering blood pressure in people who take multiple medications and have been diagnosed with resistant hypertension. If you are eligible to participate, a catheter is used to access the renal arteries, where a pulse of radiofrequency energy is delivered to deaden nerves that can be a main cause of hypertension when they become overactive. Once their activity is reduced, the body responds by lowering heart rate and other factors which appear to lower blood pressure.
HIGH BLOOD PRESSURE (HYPERTENSION)
Screening and tests
Measures the systolic pressure in your arteries when the heart is beating and the diastolic pressure between beats. Because blood pressure varies significantly over the course of the day, your doctor will take multiple readings at different times, and may also ask you to measure your pressure at home.
Additional tests may determine if you have signs of heart disease, diabetes or kidney disease. These may include a blood test to detect high cholesterol, a urinalysis to detect proteins signaling kidney disease, or advanced imaging scans such as an electrocardiogram that measures the heart’s electrical activity.