A Simple Guide to Hypertension

A Simple Guide to Hypertension

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What is Hypertension?

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Hypertension, or high blood pressure, refers to a condition in which the blood is pumped around the body above normal pressure.

It is a silent disorder and the only way to detect it is to have your blood pressure checked.

When is it High Blood Pressure?

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Blood pressure is not fixed. It varies with time of day or night, physical activity and emotional factors. Therefore, blood pressure has to be taken under resting condition and on more than one occasion.

A blood pressure reading of 120/80 is read as 120 over 80 millimetres of mercury.

The top number is your systolic pressure. This is the pressure in your arteries when your heart pumps.

The bottom number is your diastolic blood pressure. This is the pressure measured in your arteries when your heart relaxes between pumps.

Blood pressure may vary from 90/60 in a young healthy person to 130/80.

Normal blood pressure is below 130/80.

Blood pressure between 130/80 and 139/89 is called "pre-hypertension".

Blood pressure of 140/90 or above is considered high.
Hypertension is present when your blood pressure is persistently at or above 140/90( at least 3 consecutive readings).

What are the Causes of Hypertension?

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In 95% of cases, there is no definite known cause and it is known as essential hypertension. Older people and men are more likely to develop high blood pressure.

It also tends to run in families. Although, you may inherit the tendency to get high blood pressure, other lifestyle choices (eating an unhealthy diet, smoking, not exercising) will often determine if you eventually get the disease.

The other 5% of high blood pressure cases are due to kidney disease, glandular (hormone/endocrine) problems or a side effect of some medications and are called secondary hypertension.

Listed below are some causes of secondary hypertension:

Adrenal gland tumours

Cushing's syndrome

Kidney disorders

Kidney failure

Use of medications, drugs, or other chemicals

Pregnancy or the use of oral contraceptives

Diabetes mellitus

Obesity

What are the Symptoms of Hypertension?

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Hypertension often causes no noticeable symptom but can cause damage of various organs in the body if the blood pressure remains persistently high. It is thus often called the silent killer. Over years it can lead to damage to the heart and blood vessels, making it more likely that the individual will develop a stroke or heart attack.

Occasionally, especially when the blood pressure is extremely high, the individual may experience:

Headaches,

Dizziness,

Alterations in vision.

Confusion

Nausea

Vomiting

Anxiety

Excessive perspiration

Redness of the face or other areas

Muscle tremors

Angina-like pain: crushing central chest pain

How is Hypertension Assessed?

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Assessment of hypertension is important in determining the known causes of Hypertension (5%) and in the treatment of the condition:

1. Medical history

2. Physical examination

3. Evidence of complications

4. Blood and urine tests

5. Chest x-ray

6. ECG (electrocardiogram)

What are the Complications of Hypertension?

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Hypertension is an important risk factor for coronary heart disease and cerebrovascular disease e.g. strokes.

Poorly controlled hypertension ultimately can cause damage to blood vessels in the eye, thickening of the heart muscle and heart attacks, hardening of the arteries (arteriosclerosis), kidney failure, and strokes.

An elevation of the systolic and/or diastolic blood pressure increases the risk of developing

1. Heart (cardiac) disease,

2. Kidney (renal) disease,

3. Hardening of the arteries (atherosclerosis),

4. Eye damage, and

5. stroke (brain damage).

These complications of hypertension are often referred to as end-organ damage because damage to these organs is the end result of chronic (long duration) high blood pressure.

For that reason, the diagnosis of high blood pressure is important so efforts can be made to normalize blood pressure and prevent complications.

It was previously thought that rises in diastolic blood pressure were a more important risk factor than systolic elevations, but it is now known that in people 50 years or older systolic hypertension represents a greater risk.

Prevention, early detection and adequate treatment of hypertension are necessary to prevent complications of hypertension.

What is the Treatment of Hypertension?

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The aim of treatment is to reduce the risk of complications.

This is done in 2 ways:

Control of high blood pressure

Management of the risk factors eg obesity, diabetes, raised blood cholesterol

Every hypertensive patient or person at risk of developing high blood pressure should adopt a healthy lifestyle.

This means eating wisely:

A diet with reduced salt,

Low fat and high fibre.

Keep your weight in the healthy range,

Exercise regularly,

Not smoke or drink and

Manage your stress better.

Occasionally, marginally raised blood pressure goes back to within the normal range when the patient loses weight, exercises more and cuts down salt intake.

If these measures are not successful, then drug treatment is necessary.

Once medication is started, it important to continue treatment as well as continue with healthy lifestyle practices.
The goal of treatment is to reduce blood pressure to a level where there is decreased risk of complications. Your doctor will try to prescribe a single drug with minimal side effects to control your hypertension. But if a single drug does not work, he will prescribe two or more drugs.

Some of the common drugs used are:
1. Diuretics, which increase urination, to reduce salt and water retention and lower blood volume. They may be used alone or in combination with other drugs.

2. Beta-blockers, which slow the heart rate and cause the heart to beat less forcefully. 3.Calcium channel blockers which relax the blood vessels by slowing the entry of calcium into cells.

4. Angiotensin-converting enzyme (ACE) inhibitors which block the production of angiotensin II (which causes arteries to constrict and stimulate the release of a hormone which causes salt retention).

5. Angiotensin II receptor blockers (ARB) which relax blood vessels by blocking the action of angiotensin II.

Which drug is suitable for you depends on the effectiveness of the drug on your blood pressure and also on the side effects. If the the side effects are severe, it is advisable to change the medications until you have a suitable drug.

Treatment for most people is life-long.

Do not stop or reduce the dosage of your medications without consulting your doctor.

For effective blood pressure control, you should visit your doctor regularly to monitor your blood pressure. You can also monitor your own blood pressure at home with an electronic blood pressure monitor.

How do you prevent the risk of Hypertension?

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You can adopt these lifestyle measures to reduce your risk of high blood pressure.

Lifestyle changes are also important for those who already have high blood pressure.

1.Lose weight, if overweight. Excess weight adds to strain on the heart. In some cases, weight loss may be the only treatment needed.

2.Adopt a healthy diet. Dietary adjustments may be beneficial, especially a decrease of sodium in your diet. Sodium intake may have little effect in persons without hypertension but may have a profound effect in those with hypertension. Salt, MSG, and baking soda all contain sodium. Make sure you eat a diet rich in vegetables and fruit and low in fat.

3.Stay active. Do at least 30 minutes of moderate intensity exercises five or more days a week. You can break up the 30 minutes of exercise a day into 10 minute bouts. As your fitness level improves, do vigorous intensity exercise for 20 minutes a day at least 3 times a week for example, jogging or swimming continuous laps. Remember to consult your doctor before you embark on any exercise plan.

4.Stop smoking. If you are a smoker, stop smoking. Smoking greatly adds to the risk of suffering a heart attack or stroke.

5.Limit alcohol intake. Keep your alcohol intake to less than 1 or 2 standard drinks a day.

6.Learn to relax and avoid stress. Meditation, yoga, tai-chi are some ways in which you can learn to relax and lead a less stressful life.

REMEMBER that long term effective control of high blood pressure is crucial in reducing the risks of serious complications of HYPERTENSION !