HYPERTENSION (HIGH BLOOD PRESSURE)

High blood pressure, also known as hypertension, is a condition in which the blood flow against the inner walls of the arteries is persistently high. Hypertension increases the risk of more serious problems such as heart disease, stroke and kidney failure. It is also known as a "silent killer" because most cases do not present any symptoms and may silently damage the heart, kidneys, or blood vessels. 

Types of High Blood Pressure

There are 2 types of hypertension:

• Primary (essential) hypertension: This type is the most common and develops slowly over many years. Several factors, such as genetic predispositions, age, and lifestyle options, contribute to the development of essential hypertension.

• Secondary hypertension: This results from an underlying condition, which is latent, like kidney disease, hormonal disorder or taking some medicines. 

Hypertension Symptoms

Hypertension is typically asymptomatic, meaning that most individuals do not know that they have the condition, at least until later in the disease. Instead, it is through regular medical check-ups that most cases are diagnosed. If blood pressure becomes very high (hypertensive crisis), symptoms and signs can occur, such as:

• Severe headache

• Dizziness or dazed feeling

• Chest ache

• Shortness of breath

• Nosebleeds

• Poor vision

Causes of Hypertension

The causes of primary and secondary hypertension vary. While primary hypertension accounts for 90-95%, its cause might never be known, though it could be attributed to several factors, including:

• Family history

• Older age

• Lifestyle causes such as lack of physical exercise, inadequate diet, smoking, and too much alcohol consumption might all contribute to the occurrence of hypertension.

• Obesity

Secondary hypertension is attributed to identifiable causes such as:

• Impaired kidneys 

• Endocrine disorders such as Cushing's syndrome or hyperthyroidism.

• Medications such as birth control pills, NSAIDs, and decongestants.

Diagnosis

Hypertension is established by measuring blood pressure using a sphygmomanometer. Blood pressure has two numbers:

Systolic pressure: The pressure in the arteries during a heartbeat.

Diastolic pressure: The pressure in the arteries when the heart rests between beats.

Blood pressure readings fall into the following categories:

Normal: Less than 120/80 mmHg

Elevated: Systolic between 120-129 and diastolic less than 80

Stage 1 hypertension: Systolic 130-139 or diastolic 80-89

Stage 2 hypertension: Systolic 140 or higher or diastolic 90 or higher

In some patients, ambulatory blood pressure monitoring or even home blood pressure testing may be recommended to confirm the diagnosis and exclude "white coat hypertension," in which blood pressure is elevated transiently because of apprehension about office visits.

Treatment & Management

The treatment of hypertension is a combination of lifestyle measures and, sometimes, medications. Its aim is the reduction of blood pressure to near-normal levels, thus limiting complications. Important treatment strategies are as follows:

• Lifestyle modifications: Changing one's lifestyle can drastically minimize blood pressure. These changes may include the following:

  • Dietary changes: A diet low in sodium and high in fruits, vegetables, whole grains, and lean proteins, like the DASH diet, may help with lowering blood pressure.

  • Exercise: Regular physical activity such as walking, jogging, or swimming, blood pressure may also help manage blood pressure levels.

  • Weight loss: Weight loss lowers the heart's workload, further lowering blood pressure.

  • Reducing alcohol use and quitting smoking: Refraining from alcohol and smoking would prevent more damage to the inner walls of the blood vessels and subsequently reduce blood pressure.

• Medications: In extreme hypertension, medications are also given to the patient to control blood pressure. These include:

  • Diuretics

  • ACE Inhibitors

  • Calcium channel blockers

  • Beta-blockers