A clear fog around the subject

As is the trend with epic quests, the path can be unclear and muddied with possible clues and red herrings. Unfortunately, medicine can be the same way.

The advice and information I found about hypertension had as much fog and mystery as the English countryside. As the day went on, though, some of the fog lifted and I better understood the issues of hypertension.

Hypertension -- or high blood pressure; they are used interchangeably -- does indeed have different stages, which simply serve as a classification system showing how high a person's blood pressure is.

The different stages increase at 15- to 20-point intervals. Each level increase means a person's blood pressure is getting worse. Stage 1 registers 140/90 and is the lowest stage. Stage 4 is higher than 210/120 and qualifies as the worst stage.

As the numbers increase, so does your blood pressure and so does the strain on your organs. High blood pressure equals more wear and tear on the body, simply put.

How to deal with it? Doctors usually recommend diet and exercise first, according to Dr. Richard Mitchell, who practices at Riverside Family Practice.

Get active, don't smoke and avoid those Bloody Marys, as both sodium and alcohol are risk factors.

If after three months weight loss and a low-sodium diet haven't brought the numbers down, medicine can be prescribed to help the problem and relieve some pressure, so to speak.

The road begins to wind and new paths break off leading to the different causes and victim profiles of hypertension.

Most hypertension is "essential hypertension" with no exact cause. The hypothesis can vary from a high-sodium diet to stress to smoking. Age seems relative, as most people have high blood pressure for a while before they get tested and diagnosed with it.

High blood pressure develops earlier in life for blacks and is usually more severe than in whites, according to the American Heart Association.

Doctors said it seems hereditary, but no one is sure of the genetics of high blood pressure.

One thing is known, though: Diabetics are more prone to hypertension and high cholesterol.

About 10 percent of hypertension cases have a secondary cause, which can have to do with the arteries leading to or the kidneys themselves.

A cloud rolls in during diagnosis. There are no symptoms and you usually don't know you have high blood pressure unless you get tested. Because high blood pressure is a "wear and tear" disease, it slowly affects the organs, making the heart work harder and affecting kidney functions. It can lead to stroke, heart disease or problems with the eyes. None of this is seen, though, until later in life.

Many doctors have started checking earlier for hypertension, Mitchell said. Apparently, younger people can have high blood pressure, it's just usually not heard of because they aren't tested.

As obesity in younger Americans increases, it's possible that hypertension will become more common in younger ages.

Now you know.

Have a quest? Features Editor Chris Harris is ready to hunt down the answer. Send questions to charris@semissourian.com; post on semissourian.com/blogs under "Quest for the Healthy Grail" or c/o Quest, 301 Broadway, Cape Girardeau, Mo., 63703.