- Diseases, Disorders & Conditions
High Blood Pressure-explained simply
What Actually It Is ?
Hypertension,commonly known as high blood pressure ,is a condition in which blood flows with an increased force or pressure against artery walls,which ultimately in long term causes health problems.
This pressure depends on the amount of blood pumped by our heart and the amount of resistance the flow met in our arteries.Thus more the amount of blood and narrower the arteries,higher will be the blood pressure.
High blood pressure may or may not be present with any symptoms.Even without presenting any symptom it continue to damage organs of the body in long run,so it is a sort of silent killer.
Fortunately it can be easily detected by simple blood pressure measuring instrument by your family doctor during routine check ups.
Heart is like a pump.When it contract or beat it sends flow of blood through vessels increasing pressure.This is called systolic pressurs.When heart relaxes between the beats blood pressure decreases.This is called diastolic pressure.
Blood pressure is measured in millimeters of mercury(mm Hg).If your systolic pressure is 120 and diastolic pressure is 80,your blood pressure is recorded as 120 over 80 i.e.120/80 mm of Hg.
Stages of blood pressure:
NORMAL (systolic)120 or below and (diastolic)80 or below.
PREHYPERTENSION (systolic)120-139 and (diastolic)80-89
STAGE 1. (systolic)140-159 and (diastolic)90-99
STAGE 2. (systolic)160 or above and (diastolic)100 or above.
Types of High Blood Pressure
There are two types of blood pressure.(1)primary hypertension,where no cause or only environmental or genetic cause is found and it accounts for 80-90% cases of high blood pressure.(2)secondary hypertension,where cause is detected in renal,vascular,endocrinal disorders.Pregnancy is also secondary cause in certain cases.Secondary causes accounts for10-20% cases only.
Symptoms and Signs of High Blood Pressure
SYMPTOMS OF HIGH BLOOD PRESSURE::-
Symptoms are rare and when present are due to complications of high blood pressure.
Headache,dizziness,irritability,fatigue and insomnia are minor symptom and inappropriately attributed to high blood pressure and found in patient who already knows that they have high blood pressure.
SIGNS OF BLOOD PRESSURE::-With the help of stethoscope,simple palpation and auscultation,ECG and fundus examination of eyes, your doctor can definitely detect the various signs of hypertension.
Investigations like urine examination(for protein and cast),x-ray,EKG,Echo cardiogram,renal function test,plasma electrolytes,cholesterol,blood sugar helps greatly not only to diagnose the blood pressure but also to get the underlying cause and complications of it.
Who Is More at Risk for High Blood Pressure::
Your chance of blood pressure inrease
-as you gets older(after 40).
-if you are overweight(whose weight is 20% more than normal).
-if you have relative with high blood pressure.
-if you smoke.
-if you are of African or Caribbean descent.
-if you eat too much salt,high calory,high fat diet.
-if you are not eating enough fruit and vegetables.
-if you do not do enough exercise.
-if you drink too much alcohol.
-if you are under constant mental stress.
-if you are under certain medication like contraceptive pills,diet pills,
-if you are diabetic.
Complications of High Blood Pressure::
As high blood pressure itself cause no symptom,it is ignored for long time and left untreated.It silently damage your body for years.This ultimately leads to serious complications.Thus higher your blood pressure and the longer it remains untreated,the greater the damage.
--continuous high blood pressure leads to overstretching of flexible,elastic walls of arteries,which damages inner lining of artery,which in turn make walls thick and stiff.This is called arteriosclerosis.
--overstretching of vessels due to persistent high blood pressure leads to tiny tears in them.These tears and the scar tissue they leave behind can catch debris in the blood such as cholesterol.This results in a buildup of fatty deposits that narrows and clog the arteries,a condition known as atherosclerosis.
Thus arteriosclerosis and atherosclerosis are the conditions which are responsible for other serious complications of high blood pressure.
--when supply of blood to the heart is suddenly blocked due to atherosclerosis heart attack results.
--increased blood pressure can cause blood vessels to weaken and bulge forming an aneurysm.If aneurysm burst,it can threaten the life.
--heart failure is another complication of high blood pressure.As your heart has to pump blood against higher pressure in your vessels,heart muscles thickens, which in turn make more difficult for heart to pump the blood to meet your body's requirement.This leads to heart failure.
--high blood pressure weaken and narrow blood vessels in your kidneys and stop them working properly.
--thickened,narrowed and torned blood vessels in the eyes can results in vision loss.
--increased blood pressure affect your ability to think,remember and learn.
--hardening and thickening of artery walls of brain due to increased blood pressure can result in to brain stroke in which a part of brain is deprived of vital oxygen and other nutrients.
--erectile dysfunction is another complication of high blood pressure.
--high blood pressure during pregnancy makes it more complicated.
Management of High Blood Pressure:::
As discussed earlier high blood pressure is most important risk factor for coronary heart disease,stroke,heart failure,renal diseases and peripheral vascular diseases.So it is up to doctors to not only identify and treat the patient with high blood pressure but also promote healthy life style and preventive measures to control the prevalence of high blood pressure.Majority of patient with borderline or prehypertension stage can be easily managed by implementing certain lifestyle changes including dietary adjustments.Following lifestyle changes can help you to prevent and control high blood pressure.
√ stop smoking which is a key risk factor for high blood pressure,heart attack and stroke.
√ exercise regularly,make it a daily routine.This should include 30-60 minutes of moderate intensity dynamic activity,4-5 days a week.Taking stairs instead of the elevator.Doing household chores like mowing the lawn,raking leaves,scrubbing the floor also helps greatly.Park your car far in the lot.Jogging,cycling,swimming also favours the cause.Take part in activities you enjoy.
√ maintain a healthy body weight.For an extra kilo of a body weight heart has to pump blood in to extra 1.5 to 2 kilometers of blood vessels with increased force,thus possibility of high blood pressure increases considerably.BMI that is body mass index greater than 27 or a waist circumferance greater than 102cms(40 inches) in men and 88cms(35 inches) for women, is associated with increased risk for high blood pressure.
√ eat a well balanced diet.For an overall eating plan consider DASH,which stands for "Dietary Approach to Stop hypertension".The DASH diet is a life long approach to healthy eating that is designed to help treat and prevent high blood pressure.You can reduce your blood pressure by few points in just a couple of weeks by following DASH.It recommands following suggestions.
•••cut back foods that are high in saturated fats,trans fats and cholesterol,
take high fibre diet.
•••take good amount of vegetables,fruits,fish and low fat dairy products.
•••eat more whole grain food,fish,poultry and nuts.
•••use only half the butter or margarine you do now.
•••reduce sweets,sugary drinks and red meat.
•••instead of chips or sweets eat unsalted pretzels and nuts,raisins,low fat
and fat free yogurt,frozen yogurt,unsalted plain popcorn without butter.
•••reduce salt intake to 1500 milligrams a day(2 to 3 teaspoon).
Thus eating well does not mean giving up food you love,but it simply means choose wisely from a variety of foods.
√ limit alcohol consumption.
√ stay relaxed by listening music,reading a book,meditation,praying.
Blood Pressure Recorded(mm of Hg)
What This Means
what You Need To Do
less than 120/80
blood pressure is normal
follow a healthy lifestyle to keep B.P. at this level
between 121/81 and 139/89
blood pressure is little higher then it should be
make healthy changes to your lifestyle to lower it
140/90 and higher
it is high blood pressure
change your lifestyle,see your doctor,take medicines as advised
What Are the Medicines and How They Act ?
By changing to above mentioned life style approach and adopting DASH high blood pressure can be lowered to greater extent.But some time you need medicines to lower it further.There is a wide range of medicines available for high blood pressure which can be used single or in combinations.
There are five main classes of medicines that are used to lower blood pressure and there are various types and brands in each class.
(1)diuretics or waterpills /thiazides:They work by increasing the amount of salt and fluid that you pass out in urine.This reduces fluid in circulation which in turn reduces blood pressure.
(2)ACE(Angiotensin Converting Enzyme) inhibitors:They work by reducing the amount of a chemical angiotensin which tends to constrict your blood vessels,so less the amount of angiotensin in blood,blood vessels remain relaxed and widen and so pressure also lowers.Captopril,enalopril,lisinopril,ramipril etc. are some of the ACE inhibitors.
(3)AIIRB(Angiotensin II Receptor Blockers):They work by blocking the effect of angiotensin II on the blood vessel walls.So they have a similar effect to ACE inhibitors.Losartan,valsartan,candesartan etc. are some of the AIIRB.
(4)Beta blockers:They work by blocking certain nerve and hormonal signals to the heart and blood vessels and thus slowing heart rate and reducing force of heart.Atenolol,metoprolol are beta blockers.
(5)Calcium channel blockers:They prevent calcium from going in to heart and blood vessels' muscle cells thus causing cells to relax,which lowers blood pressure.Amlodipine,diltiazem,felodipine,nifedipine etc.are some of the calcium channel blockers.
Renin inhibitors are also used for management of high blood pressure.They work by inhibiting the effect of renin,which is an enzyme(produced by kidneys),that start a chain of chemical steps that increases blood pressure.