Hypertension!Dr. Nitin Gupte
Basic Information About Blood Pressure And Hypertension!
Today many people are aware that diabetes is a grave illness.
And they take the threat of the disease seriously.
But more people have hypertension than diabetes and few people are aware that hypertension is as grave a disease as diabetes.
And a person with hypertension may not have any symptoms.
So many people may not even know that they have the disease.
So it is vital that you get a blood pressure check regularly, more so if you have family history of hypertension, heart disease and strokes.
And it is equally vital that you don’t ignore it, if you have it.
So What Is Hypertension?
Arterial blood pressure is measured as mm of Hg or mercury.
It has a higher level or the systolic blood pressure and a lower level or the diastolic blood pressure.
Systole is the phase of the heart beat in which the ventricles, the lower two chambers of the heart contract, the left ventricle sending blood out to the whole body and right ventricle to the lungs.
Diastole is that phase of the heart beat in which the ventricles relax after the contraction, receiving blood from the atria which are the two chambers above the ventricles.
The blood flowing through the arteries exerts certain pressure on the walls of the arteries when it flows through them, both when the ventricles contract, that is the systole and when they relax, the diastole.
The pressure when the ventricles contract is the systolic blood pressure and the pressure when they relax, is the diastolic blood pressure.
Hypertension or high blood pressure is a condition in which the blood pressures in the arteries are persistently higher than normal.
As per the American College Of Cardiology and the American Heart Association, the normal ranges and the raised levels of the blood pressure are as follows:
Normal blood pressure is 120 by 80 mm of Hg, or below.
Elevated blood pressure: Blood pressure ranging between systolic pressure 121 to 129 and diastolic pressure 80 or less mm of Hg, is elevated blood pressure.
Stage I hypertension: Systolic blood pressure between 131 to 139 and the diastolic between 80 to 89 mm of Hg.
Stage II hypertension: Systolic blood pressure between 140 or higher and the diastolic 90 or more, mm of Hg.
Types Of Hypertension:
Primary Or Essential Hypertension:
A complex combination of genes and environmental factors, excess salt consumption, Western kind of high fat – high calorie, high animal food diet deficient in complex carbohydrates, green vegetables and fruits, lack of exercise, abdominal obesity, stress, aging are some of the factors which can contribute to the development of hypertension.
In this type of hypertension, the major contributor to hypertension is the increased peripheral resistance to blood flow through arteries.
Secondary hypertension is the hypertension which has an underlying disease as the cause of hypertension.
Kidney disease, renal artery stenosis (narrowing) are the most common causes underlying this kind of hypertension, endocrinal disorders like Cushing’s Syndrome, hyperthyroidism, hypothyroidism, certain pituitary disorders and a pituitary tumour called pheochromocytoma can also cause hypertension.
Signs And Symptoms Of Hypertension:
Hypertension usually causes few symptoms. That is why it is called a silent killer.
Some people may complain of headaches, especially at the back of the head, vertigo, tinnitus and fainting. But anxiety and stress can also cause these symptoms.
That is why hypertension is often detected in general medical check up or sometimes when people go for blood donation.
Effects Of Hypertension:
Prolonged hypertension causes inflammation in the endothelium, the inner lining, of the arterial walls damaging the arteries including those of various organs of the body.
This can lead to hardening and thickening of the arterial walls and narrowing of their lumen. This is called atherosclerosis.
Atherosclerosis causes loss of elasticity in the arterial walls causing an increase in the peripheral resistance to the blood flow and it also leads to heart attacks and strokes.
Raised blood pressure causes greater resistance to the flow of the blood through the arteries and forces the heart to pump harder to circulate blood through our body, causing hypertrophy (thickening) of the heart muscle. The thickened heart muscle struggles to pump blood efficiently and eventually fails to do so, causing heart failure.
It can also lead to weakening and bulging of the arteries. This is called aneurism and such aneurisms can rupture and cause heavy internal bleeding causing grave complications, including strokes.
Thickening and narrowing and aneurysms of the arteries in kidneys or eyes can damage these organs and can lead to renal failure and loss of vision.
Hypertension also contributes to development of the metabolic syndrome that leads to development of diabetes, heart attacks and strokes.
It can also cause circulatory problems and strokes in the brain.
It can a lead to impairment of memory and understanding and development of vascular dementia, a general name given to a condition that causes decline of cognitive abilities of thinking, remembering and reasoning in a person leading to inability to perform daily activities.
Hypertension is a major cause of premature death all over the world.
Prevention Of Hypertension:
Hypertension is best prevented than treated.
Maintain ideal body weight.
Keep your salt consumption low, eat less than 6 gm table salt.
Keep your animal food consumption low, eat more of complex carbohydrates, vegetables, fruits and low fat milk.
Have at least five helpings of vegetables and fruits every day.
Have regular cardiovascular exercise like brisk walking, jogging, running, cycling, swimming, aerobics.
Keep stress low.
Limit alcohol consumption.
Treatment Of Hypertension:
Your doctor may advise lifestyle modification, healthy diet, low salt consumption, regular cardiovascular activity, weight loss, quitting alcohol and smoking and reduction in stress.
Doctors treat hypertension with a variety of anti hypertensive drugs including diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors (ACE inhibitors), angiotensin receptor blockers (ARBs) and beta blockers.
Previously beta blockers were thought to be effective as the first line treatment for hypertension, but the Cochrane Review, an independent, high quality review system of research in health care, has found that beta blockers were less effective in preventing heart disease than were the other anti hypertensive drugs.
According to a study published in 2003, 5 mm Hg drop in blood pressure reduces the risk of stroke by 34%, ischaemic heart disease by 21% and lowers the threat of dementia, heart failure and mortality due to heart disease.
So focus on getting your blood pressure down to the normal level, as early as possible!