Hypertension

What is Blood Pressure?

Blood pressure is the force exerted by the blood against the walls of the arteries, as it flows through them. It is expressed as two numbers, for example 120/80 mm of Hg. The first number (120) is the systolic pressure, the pressure exerted when the heart contracts and pumps blood throughout the body. The second number (80) is the diastolic pressure, the pressure when the heart is resting in between the pumps.Though there is variation from person to person, the usual systolic pressure is between 110 to 130 mm of Hg. And the diastolic pressure is between 70 to 90 mm of Hg. That is, the reading may be 110/70 and go up to 130/90. Normal blood pressure is about 90/ 60 at birth, rising steadily to about 120/ 80 in a healthy adult.

When can we say that a person is having high blood pressure or Hypertension?

When the BP reading is 140/90 on at least two occasions, the person is said to have high blood pressure or hypertension. Elevated blood pressure indicates that the heart is working harder than normal, putting both the heart and arteries under greater strain.

Does blood pressure change in healthy people?

Blood pressure can vary at different times and under different conditions, even in healthy people. For example, at night, blood pressure is slightly lower, than during the day. Physical exercises, stress and pain may increase blood pressure for a few minutes. Temperature changes outside may cause changes in blood pressure. In a healthy person, these changes last only for a short time.

What are the causes of Hypertension?

In 90% of people having hypertension, the cause is not known. This is called ‘Primary Hypertension’ or ‘Essential Hypertension.’ The other 10% have ‘Secondary Hypertension’ which may be due to some disease in the body like problems of the Kidney (nephritis, renal tumors), problems of the thyroid, Cardiovascular diseases (coarctation, renal artery stenosis) and problems with the Central Nervous System. Many factors such as genetics, age, race, stress, obesity, smoking, a high-salt diet, excessive alcohol consumption and a sedentary lifestyle can be responsible for Hypertension.

Why is Hypertension called the ‘Silent Killer?’ What are the symptoms of Hypertension

Most people who have an elevated blood pressure do not know about it until some serious symptoms show up. That is why Hypertension is called a ‘Silent Killer.’ The symptoms, when they show up include:

- Nosebleeds, - Palpitations, - Rapid or irregular heartbeat, - Headaches especially in the mornings, - Dizziness or Vertigo, - Chest pain, - Tinnitus or noise in the ears, - Shortness of breath or becoming tired easily after physical exertion and - Sleep disorders

Is it true that men are affected by Hypertension more than women?

This is true in the younger age groups. It is thought that the hormones in a woman’s body before menopause give adequate protection against hypertension. But as people age, the incidence of hypertension is the same in men and women

What is the treatment for Hypertension?

Primary Hypertension cannot be cured, but only controlled. This can be done by Change in Lifestyle, Diet and by Medication. Hypertension can be controlled by:

- Limiting salt intake - Limiting fats (like butter) - Avoiding red meat (mutton) and instead having fish or chicken - Limiting the amount of ‘Bad’ Cholesterol (LDL) in the diet - Increasing the amount of ‘Good Cholesterol’ (HDL) in the diet - Eating more fresh fruits, vegetables, grains and foods high in fiber and less in fat - Reducing stress, on and off the job, including relaxation techniques, yoga and meditation - Controlling the consumption of alcohol - Exercising regularly (jogging, swimming or cycling for 30 minutes a day, three days in a week) - Keeping one’s weight within normal limits - Quitting the habit of smoking Medication: When hypertension is not controlled by the above-mentioned methods, a doctor may advise any of the different types of drugs available to reduce hypertension. These include Diurectics, which reduce the salt and water in the body, Beta-blockers which also decrease the contractility of the heart muscle and the heart rate, Calcium channel blockers, Angiotensin Converting Enzyme Inhibitors (ACE Inhibitors), Alpha Blockers and Nitrates. The drugs should not be stopped abruptly. A person who is on medication for hypertension should regularly check the blood pressure at home, or get it checked by a doctor. Usually the drugs have to be taken for life, to keep the blood pressure under control. Secondary Hypertension may be treated by removing the cause. For example an adrenal or renal tumor may be excised.

What happens when Hypertension is not controlled?

With hypertension, the heart needs to work harder. The increased pressure leads to thickening of the chambers of the heart, which in turn may lead to weakness of the heart. Premature arteriosclerosis in the coronary arteries increases the risk of Coronary Arteries Disease (CAD) . Heart failure and Coronary Artery Disease are the most common causes of death in hypertension. There may be changes in the retina of the eye. This is called hypertensive retinopathy. There may be changes in the Central Nervous System causing ischemia (lack of blood supply), stroke, or bleeding into the brain. Aneurysm of abdominal aorta is another complication. A condition called Malignant Hypertension may develop which is characterized by diastolic pressure over 120mmHg, and multiple organ changes (blurry vision, renal insufficiency). This condition may develop in some patients with hypertension. It is a life threatening condition.