The word “hypertension” means regular increase in arterial pressure. Blood pressure is increased when arteries and arterioles are narrowed. Arteries are like water channels feeding the earth and connecting the seas. But in a human body they are filled with the blood circulating between the heart and other bodies. Vasoconstriction may be observed because of regular spasms. The vessels remain narrowed due to thickenings of arterial walls.
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What is hypertension
1. WHAT IS HYPERTENSION?
The word “hypertension”meansregularincreaseinarterial pressure.Bloodpressure isincreasedwhen
arteriesandarteriolesare narrowed.Arteriesare like waterchannelsfeedingthe earthandconnecting
the seas.But ina human bodytheyare filledwiththe bloodcirculatingbetweenthe heartandother
bodies.Vasoconstrictionmaybe observedbecauseof regularspasms.The vesselsremainnarroweddue
to thickeningsof arterial walls.
The heart tryingto passthe blockedsitesand deliverthe bloodtoorgansincreasesanamountof the
bloodto pushitthroughthe vessels.These conditionsare consideredtobe the reasonof the
developmentof hypertension:bloodflowunderhighpressureaffectingthe vessel walls.
Sometimes,inone of tencases,highbloodpressuremaybe causedbydisorderof anyorgan. This
hypertensionisnamedsecondaryorsymptomatic.However,inmostcaseshypertensionhasprimary
character and calledessential hypertension.Thoughthe reasonsof primaryhypertensionhave notbeen
thoroughlystudied,itisevidentthatuntreatedhighpressure isbelievedtobe a seriousthreattohuman
healthandlife.The mostcommoncomplicationsof hypertensionare kidneysdisease,andbrainand
heartdisorders.
Nowadaysthe doctorsapplyreliable andeffective methodstotreathighpressure andavoidany
complications.The mainthingisyourexaminationandfollowingthe doctor’srecommendations.
Important
Everyfifthadulthashigharterial pressure (above 120/80).But only half of themknow aboutit.Half of
themtreat thisdisease properly.The mostof people believe thatif theydonotfeel anydisturbance due
to highpressure,theydonotneedthe treatment.However,treatmentrefusal isdangerous,younever
knowwhenit letyoudown!
Onlyhalf of the patientstakingprescribeddrugsfollow the doctor’srecommendations.The patients
discontinue drugtakingwhensee the firstsymptomsof improvement.Itmayleadtorelapse.Some
patientsadjustdrugdosage,thisisverydangerous.If youhave hypertension,youshouldstudysome
momentsandlive withit.
Hypertensionisanothername forhighbloodpressure.Itcanseverelyimpactqualityof life andit
increasesthe riskof heartdisease,stroke,anddeath.
Around85 million peopleinthe UnitedStates(U.S.) have highbloodpressure.
Hypertensionandheartdiseaseare global problems.The WorldHealthOrganization(WHO) suggests
that the growthof the processedfoodindustryhasimpactedthe amountof saltconsumed,andthat this
playsa role inhypertension.
Some typesof hypertensioncanbe managedthroughlifestyleanddietarychoices,suchasengagingin
physical activity,reducingalcohol andtobaccouse,andavoidingahigh-sodiumdiet.
2. What is hypertension?
Bloodpressure isthe force exertedbythe bloodagainstthe wallsof the bloodvessels.How greatthe
pressure isdependsonthe workbeingdone bythe heartandthe resistance of the bloodvessels.
Medical guidelinesdefine hypertensionasa bloodpressure higherthan140 over90 millimetersof
mercury(mmHg).The systolicreadingof 140 mmHgrefersto the pressure asthe heart pumpsblood
aroundthe body.The diastolicreadingof 90 mmHg referstothe pressure asthe heartrelaxesandrefills
withblood.
What is highblood pressure?
Highbloodpressure,orhypertension,occurswhenyourbloodpressure increasestounhealthylevels.
Your bloodpressure measurementtakesintoaccounthow quicklybloodispassingthroughyourveins
and the amountof resistance the blood meetswhile it’spumping.
Narrowarteriesincrease resistance.The narroweryourarteriesare,the higheryourbloodpressurewill
be.Overthe longterm,increasedpressure cancause healthissues,includingheartdisease.
Hypertensionisquitecommon.Infact,75 millionAmericansare livingwiththe condition.Hypertension
may developoverthe course of several years.Duringthose years,youmaynotnotice anysymptoms.
Evenwithoutsymptoms,highbloodpressure cancause damage toyour arteriesandbloodvessels.
Early detectionisimportant.Regularbloodpressure readingscanhelpyouandyour doctornotice any
changes.If your bloodpressure iselevated,yourdoctormaycheck yourbloodpressure overafew
weekstosee if the numberstayselevatedor fallsbacktonormal levels.
Treatmentforhypertensionincludesbothprescriptionmedicationandhealthylifestylechanges.If the
conditionisn’ttreated,itcouldleadtohealthissues,includingheartattackand stroke.
The AmericanHeart Association (AHA) definesthe followingrangesofblood pressure (inmmHg):
If the readingisthe same or higher,thisisa medical emergency.
The personshouldseekimmediateattentionatthe nearesthospital.
Causes
Bloodpressure variesthroughoutthe day.Itislowerduringsleepandhigheronawakening.
Occasionallyhavinghighbloodpressure forashorttime isa normal physiological response tomany
situations.Acute stressandintenseexercise,forexample,canbrieflyelevate bloodpressure inahealthy
person.
For thisreason,a diagnosisof hypertensionnormallyrequiresseveral readingsthatshow highblood
pressure overtime.
3. However,areadingof 180 over110 mmHg or highercouldbe a signof a hypertensivecrisisthat
warrantsimmediate medical attention.
Risk factors
A numberof riskfactors increase the chancesof havinghypertension.
Age:Hypertensionismore commoninpeopleagedover60 years.Withage,bloodpressure can
increase steadilyasthe arteriesbecome stifferandnarrowerdue toplaque build-up.
Ethnicity:Some ethnicgroupsare more prone to hypertension.
Size andweight:Beingoverweightorobese isa keyriskfactor.
Sex:The lifetimeriskisthe same formalesandfemales,butmenare more prone to
hypertensionata youngerage,while ratestendtobe higherrate inwomenat olderages.
Existinghealthconditions:Cardiovasculardisease,chronickidneydisease,andhighcholesterol levelsare
predictorsforhypertension,especiallyaspeople getolder.
Other contributingfactors include:
physical inactivity
a salt-richdietassociatedwithprocessedandfattyfoods
lowpotassiuminthe diet
alcohol andtobacco use
certaindiseasesandmedications
A familyhistoryof highbloodpressureandpoorlymanagedstressalsocontribute.
Primaryand secondaryhypertension
Highbloodpressure thatisnot causedby anotherconditionordisease iscalledprimary,oressential,
hypertension.If itoccursas a resultof anothercondition,itiscalledsecondaryhypertension.
Primaryhyperension
can resultfrommultiple factors,includingbloodplasmavolume andactivityof the hormonesthat
regulate of bloodvolume andpressure.Itisalsoinfluencedbyenvironmental factors,suchasstressand
lack of exercise.
Secondaryhypertension
has specificcausesandisa complicationof anotherproblem.
It can resultfrom:
diabetes,due tobothkidneyproblemsandnerve damage
kidneydisease
pheochromocytoma,arare cancer of an adrenal gland
4. Cushingsyndrome,whichcanbe causedbycorticosteroiddrugs
congenital adrenal hyperplasia,disorderof the cortisol-secretingadrenal glands
hyperthyroidism,oroveractive thyroidgland
hyperparathyroidism,whichaffectscalciumandphosphorouslevels
pregnancy
sleepapnea
obesity
chronickidneydisease (CKD)
CKD isa commoncause of highbloodpressure,becausethe kidneysdonotfilteroutfluid.Thisfluid
overloadleadstohypertension.
Commonreversible causesof secondaryhypertensionare excessivealcohol intakeandhormone
therapyformenopause.
Symptoms
A personwithhypertensionmaynotnotice anysymptoms,anditis oftencalledthe “silentkiller.”While
undetected,itcancause damage to the cardiovascularsystemandinternal organs,suchasthe kidneys.
Long-termhypertensioncancause complicationsthroughatherosclerosis,where the formationof
plaque resultsinthe narrowingof bloodvessels.Thismakeshypertensionworse,asthe heartmust
pumpharderto deliverbloodtothe body.
What are the symptomsof hypertension?
Hypertensionisgenerallyasilentcondition.Manypeoplewillnotexperience anysymptoms.Itmaytake
yearsor evendecadesforthe conditiontoreachlevelssevere enoughthatsymptomsbecome obvious.
Eventhen,these symptomsmaybe attributedtootherissues.
Symptoms of hypertensioninclude:
headaches
shortnessof breath
nosebleeds
flushing
dizziness
chestpain
visual changes
bloodinthe urine
These symptomsdon’toccurineveryone withhypertension,butwaitingforasymptomof thiscondition
to appearcouldbe fatal.
5. The bestway to knowif youhave hypertensionistogetregularbloodpressure readings.Mostdoctors’
officeswill take abloodpressure readingateveryappointment.
If you onlyhave a yearlyphysical,talktoyourdoctor aboutyour risksforhypertensionandother
readingsyoumayneedto helpwatchyourbloodpressure.
For example,if youhave afamilyhistoryof heartdiseaseorhave riskfactorsfor developingthe
condition,yourmanyneedtohave yourbloodpressure checkedtwice ayear.Thiswill helpyou and
your doctorstay on topof any possible issuesbeforetheybecome problematic.
Highbloodpressure raisesthe riskof a numberof healthproblems,includingaheartattack.
Hypertension-relatedatherosclerosiscanleadto:
heartfailure andheartattacks
an aneurysm,oran abnormal bulge inthe wall of an artery thatcan burst,causingsevere
bleedingand,insome cases,death
kidneyfailure
stroke
amputation
hypertensive retinopathiesinthe eye,whichcanleadto blindness
Regularbloodpressure testingcanhelppeople avoidthe more severe complications.
Diagnosis
Diagnosisof hypertensionismade bymeasuringbloodpressureoveratleast3 clinicvisitsusingthe
upper-armcuff device calledasphygmomanometer.
The doctor will take a historyandperforma physical examinationbeforediagnosinghypertension.
Some additional testscanhelpidentifythe cause of highbloodpressure anddetermine any
complications.
Tests may include:
urine tests
kidneyultrasoundimaging
bloodtests
electrocardiogram(ECG) andanechocardiograph
Treatment
Lifestyle choicescancontribute tothe treatmentandpreventionof highbloodpressure,andtheycan
have widerbenefitsforthe heartandoverall health.
Salt restriction
Average saltintake isbetween9grams (g) and 12 g a day in mostcountriesaroundthe world.
6. The WHO recommendreducingintaketounder5 g a day, to helpdecrease the riskof hypertensionand
relatedhealthproblems.Thiscanbenefitpeople bothwithandwithouthypertension,butthose with
hypertensionwill benefitthe most.
Moderatingalcohol consumption
Moderate to excessivealcohol consumptionislinkedtoraisedbloodpressureandanincreasedriskof
stroke.The AmericanHeartAssociation(AHA) recommendamaximumof twodrinksaday formen,and
one for women.
A drink, in thiscase, refersto:
12 ounce (oz.) bottle of beer
4 oz.of wine
1.5 oz.of 80-proof spirits
1 oz.of 100-proof spirits
A healthcare providercanhelppeople whofinditdifficulttocutback.
More fruitand vegetables,less fat
People whohave orwhoare at riskof highbloodpressure are advisedtominimize intake of saturated
fat and total fat.
Recommendedinsteadare:
whole-grain,high-fibre foods
a varietyof fruitand vegetables
beans,pulses,andnuts
omega-3-richfish twice aweek
non-tropical vegetableoils,forexample,olive oil
skinlesspoultryandfish
low-fatdairyproducts
It isimportantto avoidtrans-fats,orhydrogenatedvegetable oils,andanimal fats,where possible,and
watch yourportionsize.
Reducingand maintainingweight
Hypertensioniscloselyrelatedtoexcessbodyweight,andweightreductionisnormallyfollowedbya
fall inbloodpressure.A healthy,balanceddietwithacalorie intake thatmatchesthe individual’ssize,
sex,andactivitylevel will help.
Regular physical exercise
7. Doctors recommendthatpatientswithhypertensionengage in30 minutesof moderate-intensity
dynamicaerobicexercise,suchaswalking,jogging,cyclingorswimming,on5 to 7 daysof the week.
Stress reduction
Avoidingstress,ordevelopingstrategiesformanagingunavoidable stress,canhelpwithbloodpressure
control.
Usingalcohol,drugs,smoking,andunhealthyeatingtocope withstresswill addtohypertensive
problems.These shouldbe avoided.
Smokingcanraise bloodpressure.Givingupsmokingreducesthe riskof hypertension,heartconditions,
and otherhealthissues.
The DASH diet
The U.S. National HeartLung and BloodInstitute (NHLBI) recommendsthe DASHdietforpeople with
highbloodpressure.DASH,or“DietaryApproachestoStopHypertension,”hasbeenspecially
formulatedtohelppeoplelowerbloodpressure.
It isa flexibleandbalancedeatingplanbasedonresearchstudiessponsoredbythe Institute,whichsays
that the diet:
lowershighbloodpressure
improveslevelsof fatsinthe bloodstream
reducesthe riskof developingcardiovasculardisease
There isa National InstitutecookbookcalledKeepthe BeatRecipeswithcookingideastohelpachieve
these results.
There issome evidence thatusingprobioticsupplementsfor8weeksormore maybenefitpeople with
hypertension.
Drug treatments
Lifestyle measuresare standardfirst-line treatmentforhypertension,butpeople withbloodpressure
over140 over90 may use medication.
Drugs are usuallystartedone ata time,at a low dose.Side effectsassociatedwithantihypertensive
drugsare usuallyminor.
Eventually,acombinationof atleasttwoantihypertensivedrugsisusuallyrequired.
A range of drug types are available to helplower bloodpressure,including:
diuretics,includingthiazides,chlorthalidone,andindapamide
beta-blockersandalpha-blockers
8. calcium-channelblockers
central agonists
peripheral adrenergicinhibitor
vasodilators
angiotensin-convertingenzyme (ACE) inhibitors
angiotensinreceptorblockers
The choice of drug dependsonthe individualandanyotherconditionstheymayhave.
Anyone takingantihypertensive medicationsshouldbe sure tocarefullyreadlabels,especiallybefore
takingany over-the-counter(OTC) medications,suchasdecongestants.
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