High Blood Pressure

Hypertension also known as high blood pressure is defined as a consistently elevated blood pressure exceeding 140/90 mm Hg. Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. Hypertension occurs when your heart pumps more blood resulting in narrowed arteries. It affects millions of people every year, even children and teens. It is called the silent killer because it usually does not show any symptoms for years even decades until it has damaged vital organs. Uncontrolled or poorly controlled hypertension can damage blood vessels in the eye, harden heart arteries leading to arteriosclerosis and can ultimately cause heart attacks and stroke. High blood pressure in pregnancy can lead preeclampsia or eclampsia (toxemia of pregnancy) which can harm the baby or mother. Pregnant women should be monitored closely by their obstetrician for complications of hypertension. For more information on preeclampsia go to http://yourhealth-check.com/2012/06/26/preeclampsia-in-pregnant-women/

CAUSES, INCIDENCE AND RISK FACTORS

The exact cause of hypertension is not known but several factors may contribute to its development. These include:

  • obesity
  • smoking
  • chronic disease like kidney failure
  • genetics
  • alcoholism
  • stress
  • too much salt intake
  • adrenal and thyroid disorder
  • old age
  • family history
  • Forms of hypertension

There are 2 main forms of high blood pressure – primary (essential) hypertension and secondary hypertension

Primary (essential) hypertension

This is this the most common for of the disease and it accounts for about 95% of all cases. This form is usually caused by a combined effect of several factors. Essential hypertension is greatly influenced by diet and life style and tends to develop gradually over many years. It is known to be very common in people with high salt intake. This link between salt and high blood pressure is alarming. People with hypertension are  sensitive to salt, meaning that anything more than the minimal bodily need for salt is too much for them and increases their blood pressure. Other risk factors includes sex (affect men more than women), race (prevalent in people with african american background), age, obesity, family history, genetics, diabetes and inactive lifestyle.

Secondary hypertension

Secondary hypertension accounts for 5% of hypertension and it’s caused by a specific abnormality in one of the organs or systems of the body. The abnormality could be kidney disease (this is ranked the highest), a tumor, adrenal gland malfunction and birth control (those containing estrogen). This type of hypertension occurs suddenly.People with this type tend to have higher blood pressure than those with primary.

SYMPTOMS OF HYPERTENSION

The dangerous thing about hypertension is you may have it but will not know for years or even decades. Almost one-third of people who have hypertension don’t know it. There are signs of extremely high blood pressure. These include headaches, dizzy spells, a few more nose bleeds than normal and blurred vision. At this time significant damage has been done to several vital organ. It is important to have regular physical examinations to make sure your blood pressure is within the normal range especially if your blood pressure has ever been high, if you have a family history of hypertension, or if you are obese or have medical conditions like diabetes.

SIGNS AND TESTS

Blood pressure is most often measured with a device known as a sphygmomanometer, which consists of a stethoscope, arm cuff, dial, pump, and valve. A blood pressure reading is given in millimeters of mercury (mm Hg). Blood pressure is measured in two ways: systolic and diastolic.   The upper number measures the pressure in your arteries when your heart beats (systolic pressure). The lower number measures the pressure in your arteries between beats (diastolic pressure).

The are 4 general categories of blood pressure reading and these are:

Normal: < 120/80

Prehypertension: 120 -139 over 80-89

Stage 1 HBP: 140-159 over 90-99

Stage 2 HBP: 160 and above over 100 and above

If you’re diagnosed with high blood pressure, your doctor may recommend other tests, such as:

Electrocardiogram (EKG or ECG) – This test measures the electrical activity, rate, and rhythm of your heartbeat through electrodes attached to your arms, legs, and chest. The results are recorded on graph paper.

Echocardiogram – This test uses ultrasound waves to provide pictures of the heart’s valves and chambers. These waves allow the healthcare professional to study the pumping action of the heart. In addition measurement of the chambers  and wall thickness of the heart can be made.

TREATMENT AND DRUGS FOR HYPERTENSION

Treating hypertension can take a multi-prolonged approach including diet changes, medication, and exercise. Blood pressure treatment goal depends on how healthy the individual is. For a healthy adult, blood pressure treatment goal is 140/90 mm Hg or lower . If you have a heart that does not pump properly or you have a heart malfunction like left ventricular dysfunction or heart failure or a chronic kidney disease your treatment goal will be 120/80 mm Hg or lower. Lastly for individuals with chronic kidney disease, diabetes or coronary artery disease or people who are at high risk of coronary artery disease, their treatment goal is 120/80 mm Hg or lower. If lifestyle changes are not enough to lower blood pressure, your doctor will prescribe medication to lower it. The category of medication depends on the severity of your condition and other medical problems.

MEDICATION

Thiazide diuretics – These are also called water pills and often the first choice of medication for hypertension. They act on your kidney to eliminate water and salt from your body are reduce blood volume.

Beta blockers – These work to reduce the workload on your heart and open your blood vessels. This makes your heart beat slower and with less force. These work better when combined with diuretics.

Angiotensin-converting enzyme (ACE) inhibitors – They work to relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels.

Angiotensin II receptor blockers (ARBs) – These medications block the action (not the formation) of a natural chemical that narrows blood vessels resulting in relaxation of the blood vessel.

Calcium channel blockers – They help relax the muscles of your blood vessels and may slow heart rate.

CAUTION – Grapefruit juice interacts with some calcium channel blockers, increasing blood levels of the medication and putting you at higher risk of side effects,

Renin inhibitors – Aliskiren (Tekturna) slows down the production of renin that starts a chain of chemical steps that increases blood pressure.

If your blood pressure goal is not reached with the above medication, your doctor may prescribe:

Alpha blockers – These work to reduce nerve impulses to blood vessels which in turn reduces the  effects of natural chemicals that narrow blood vessels.

Alpha-beta blockers – Alpha-beta blockers slow the heartbeat to reduce the amount of blood pumped through vessels and also reduce nerve impulses to blood vessels.

Central-acting agents – These prevent your brain from signaling the nervous system to increase  heart rate and narrow your blood vessels.

Vasodilators – They work directly on the muscles in the walls of your arteries to prevent them from tightening and narrowing your arteries.

Your doctor may ask you to take a daily aspirin once your blood pressure is under control.This helps to reduce your risk of cardiovascular disorders.

Even if you are taking medication it is recommended to have lifestyle changes to maintain a healthy blood pressure. A healthy diet and less salt intake is advised. It is also important to lose weight, exercise more and quit smoking.

COMPLICATIONS

If uncontrolled, hypertension can lead to;

  • heart failure
  • stroke
  • aneurysm
  • thickened, torn or narrowed blood vessels of the eyes
  • weakened and narrowed blood vessels of your kidney
  • memory problems

SUPPORT

High blood pressure(hypertension) isn’t a problem that you can treat and then ignore. It’s a life-time condition. Join support groups and interact with people who share your pain. Manage your stress, take your medication the right way, exercise and eat healthy.

 

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