Quick look at hypertension

Hypertension or high blood pressure is consistently elevated blood pressure of 140 mmHg systolic and 90mmHg diastolic.Blood pressure is the force of the blood pushing against the walls of those arteries.

When the heart is pumping the blood, it is called systolic pressure.

When the heart is resting or in between beats, your blood pressure falls;

this is the diastolic pressure.

High blood pressure develops,if

1. The walls of larger arteries lose their elasticity and become rigid.
2. The small blood vessels become narrower.

• Normal blood pressure: less than 120/80 mmHg
• Prehypertension: 120-139/80-89 mmHg
• Hypertension: greater than 140/90 mmHg
• Stage 1 Hypertension:140-159/90-99 mmHg
• Stage 2 Hypertension: 160 or greater/ 100 or greater mmHg

Two types of Hypertension:

1. Essential or primary hypertension:In about 90% of people having hypertension,the causes are unknown.Its reffered to as essential or primary hypertension.
2. Secondary Hypertension:In about 10% of people hypertension is caused by another disease(kidney disease,hyperthyroidism).When the root cause is treated BP returns to normal.

What cause Hypertension:As almost in 90 percent of all high blood pressure cases, the exact cause is unknown.Several condition and factors may paly a role in it development.They are

1. Being overweight
2. Smoking
3. Too much salt in the diet
4. Oral contraceptives
5. Genetics
6. Having high cholesterol.
7. Eating a diet low in potassium, magnesium, and calcium
8. Too much alcohol consumption(nomore than 1-2 drinks per day)
9. Heredity i.e family history of high BP.
10. Chronic kidney disease
11. Adrenal & thyroid disorders
12. Stress
13. Older age

There are no clear cut symptoms of hypertension,however their might be certain mild & vague symptoms at extremely high blood pressure that could lead to heart attack or stroke(diseases affecting the arteriesthat supply blood to the brain).Many patients(reportedly 1/3rd) are unaware of their hypertension problem.

1. Severe headache
2. Fatigue or confusion
3. Nose bleeds
4. Vision changes
5. Chest pain
6. Difficulty breathing
7. Irregular heartbeat
8. Blood in the urine

Hypertensive crisis and its two types:

When hypertension gets too high(diastolic pressure above120mmHg)its called hypertensive crisis thats divided into hypertensive urgency(severe elevation in BP without organs damage) and hypertensive emergency(severe elevations in BP with target organ damage to brain,heart,kidney or other organs).

Examples of organ damage in hypertensive emergency:

Hypertensive encephalopathy, intracranial hemorrhage, unstable angina pectoris, or acute myocardial infarction, acute left ventricular failure with pulmonary edema, dissecting aneurysm, or eclampsia. In hypertensive emergency blood pressure must be reduced immediately to prevent organ damage keeping patient in intensive care unit(ICU )while in hypertensive urgency BP may be reduced safely within few hours with the help of BP medication.

Diagnosis of Hypertension:

The only way to know about hypertension is by checking with an instrument called Sphygmomanometer.The sphygmomanometer consists of an air pump, a pressure gauge, and a rubber cuff.

How is Blood pressure measured:The cuff is placed around the upper arm usually upper left arm and inflated with an air pump to a pressure that blocks the flow of blood in the main artery (brachial artery) running through the arm.The arm is then extended at the side of the body at the level of the heart, and the pressure of the cuff on the arm and artery is gradually released. As the pressure in the cuff decreases, a health practitioner listens with a stethoscope over the artery at the front of the elbow. The pressure at which the practitioner first hears a pulsation from the artery is the systolic pressure (the top number). As the cuff pressure decreases further, the pressure at which the pulsation finally stops is the diastolic pressure (the bottom number).Blood pressure should have checked atleast once a year to make sure about hypertension.

How is hypertension treated?

Hypertension is typically treated by making changes in life stlye and medication(antihypertensive drugs).Life style changes include lose weight,quit smoking and alocohol abuse ,eating a healthy diet(suchas Dashdiet that includes lowering sodium (about 1 teaspoon of salt a day or less). but including foods,low fat dairy products ,vegetables and whole grain foods)& getting enough exercise especially aerobic exercise(such as brisk walking at least 30 minutes a day, several days a week).

Several types of drugs are available to treat hypertension including

ACE inhibitors

ARBs

Diuretics

Betablockers

"Ca" channel blockers

Efficacy of all the five categories of antihypertensive drugs is similar.Using criteria of effectiveness and cost Thiazides are clearly the choice of first drug.In almost 50% of patients BP can be controlled with aThiazide alone.Many patients require more than one drug(agent) to control their BP.To lower blood pressure with Angina pectoris,a Beta blocker is the drug of first choice.ACE inhibitors is the drug of first choice inpatients with hypertenCongestive hear failure(CHF).

If high blood pressure is left untreated, it can cause: Enlarged heart,stroke,uremia,atherosclerosis(hardening of arteries),heart attack,vision loss.high blood pressure appears to be both a disease and a risk factor for other diseases.

High blood pressure can be prevented by taking following measures.

Maintaining a healthy weight & keeping cholestrol at a low level

Exercising more.

A diet low in magnesium may make your blood pressure rise.

Eating foods low in salt.

Eating foods rich in potassium

Eating healthy foods like fruits and vegetables.

Drinking alcoholic beverages in moderation

Eating foods low in calories and fat and high in starch and fiber

Large amounts of fish oils may help reduce high blood pressure, but their role in prevention is unclear. Moreover,taking potassium or magnesium supplements is not required.