What is high blood pressure (hypertension)?
Hypertension is one of the leading medicinal problems faced by the world today. In simple terms, hypertension refers to the increased pressure of blood in the arteries. Arteries are the major blood vessels that carry blood from the heart to the various parts of the body. When the pressure of blood flowing in these arteries increases, it results in a condition known as hypertension.
Blood pressure of a medically fit person should be below 120/80. The number on top is the systolic blood pressure, which is the pressure on arteries when the heart contracts and pumps the blood. The bottom number represents the diastolic pressure, which is the arterial pressure when the heart relaxes after contraction. Blood pressure till 139/89 is known as pre-hypertension and exceeding 140/90 is considered to be high.
Hypertension is generally classified as:
• Essential or primary
In case of essential hypertension, no medicinal cause can explain a patient’s condition. A common form of hypertension, it affects almost 95 percent of the people. Secondary form of hypertension is caused due to some abnormality in the body such as adrenal gland, kidney or the aorta.
Factors that cause hypertension are:
• Salt sensitivity-when a person takes in too much of salt, the body draws more amount of water from the blood, increasing its pressure.
• Insulin resistance-secreted by pancreas, insulin has vasodilatory function. Extreme conditions result in constriction of the arteries, increasing the blood pressure.
• Renin- secreted by the kidney, this enzyme is found to be more in hyper tensed people.
• Sleep apnea
• Age-with time, increased collagen fibers in the artery walls makes the arteries stiff. Flexibility is lost resulting in increased blood pressure.
• Genetics-if anyone in the family has a previous record of hypertension, chances of the next generation having increased blood pressure is more.
Factors responsible for secondary hypertension are
• Adrenal hypertension-occurs due to the various abnormalities in adrenal cortex. Aldosterone may induce more of sodium retention, resulting in hypertension. Increased secretion of the cortisol hormone (Cushing’s syndrome) may also be one of the factors.
• Renal hypertension-caused due to the diseases affecting the kidney like glomerulonephritis, polycystic kidney or even diseases affecting the renal artery.
• Genetic causes-single gene mutations inherited according to Mendel’s laws, also lead to hypertension.
• Misalignment of the spinal cord-wrong alignment of the vertebrae within the spinal column, especially the atlas vertebra also leads to hypertension. An adjustment leads to a significant drop in the blood pressure level.
• Drugs-certain medicines like steroids may also cause high blood pressure.
Generally hypertension is not that severe to produce any symptoms as such. They are normally detected when blood pressure is measured during a regular check-up. However some people do complain of tiredness, fatigue, headache, dizziness, blurry vision and flushed face.
Hypertension when left untreated for a long time, may lead to malignant hypertension, also known as accelerated hypertension. It generally leads to end organ failure. This is generally detected when the retina is examined.
Increased blood pressure is not that critical. But it affects other organs and may lead to development of many complications like
• Myocardial infarction( also termed as heart attack)
• Cerebrovascular accident( stroke)
• Hypertensive cardiomyopathy(failure of heart)
• Hypertensive nephropathy(kidney failure)
• Hypertensive retinopathy(retina damage)
• Complications during pregnancy
Blood pressure is generally measured using a sphygmomanometer. Before measurement, it is important that the environment should be standardized. One hour before measurement, avoid food intake, exercise, intake of caffeine and smoking. These may cause the blood pressure to vary, resulting in incorrect measurement.
Once hypertension has been diagnosed, it is important to immediately take suitable steps.
• Losing excess flab and weight is the first step. Mild aerobic exercise, like jogging for instance helps to increase the flow of blood and heart rate.
• Salt intake should be reduced from our diet. Salt substitutes should be preferred.
• DASH diet (also referred to as Dietary Approaches to Stop Hypertension), rich in vegetables, fruits and low fat is very effective in blood pressure reduction. Additional intake of calcium increases the potassium and hence negates the effect of sodium.
• Alcohol consumption and smoking should be discontinued.
Various classes of antihypertensive medicines are prescribed by doctors.
• Alpha blockers
• ACE inhibitor
• Beta blockers
• Calcium channel blockers
It has been seen that reduction of pressure by 5mmHg results in a decrease in chances of stroke by 40% and also reduces the risk of heart failure, vascular diseases and dementia.
Hypertension is often called as “silent killer”. Suitable measures should be taken to prevent its occurrence. Avoid eating too much of salt, high calorie food, hard drinks and coffee. Exercise regularly and lead a healthy life.
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