HYPERTENSION : A Silent Killer

What is BLOOD PRESSURE (BP)?

          Blood pressure is the force of our blood pushing against the walls of our arteries. Each time our heart beats, it pumps blood into the arteries. Our blood pressure is highest when our heart beats, pumping the blood. This is called systolic pressure. When our heart is at rest, between beats, our blood pressure falls. This is called diastolic pressure. Our blood pressure reading uses these two numbers. Usually the systolic number comes before or above the diastolic number. For example, 120/80 means a systolic of 120 and a diastolic of 80.

What is HYPERTENSION (Hypertension Definition)?

          Hypertension is another name for high blood pressure. It is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. Blood pressure is determined both by the amount of blood our heart pumps and the amount of resistance to blood flow in our arteries. The more blood our heart pumps and the narrower our arteries, the higher is our blood pressure.

     Normal blood pressure is when our blood pressure is lower than 120/80 mm Hg most of the time. High blood pressure (hypertension) is when one or both of our blood pressure readings are higher than 130/80 mm Hg most of the time.

What are SIGNS & SYMPTOMS of Hypertension (Hypertension Symptoms)?

          Hypertension is called a "silent killer". Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. Its identification is usually through screening, or when seeking healthcare for an unrelated problem.

     Some people with high blood pressure report headaches (particularly at the back of the head and in the morning), as well as lightheadedness, vertigo, tinnitus (buzzing or hissing in the ears), altered vision or fainting episodes.

What are The CAUSES of Hypertension?

Many factors can affect blood pressure, including:

-          The amount of water and salt we have in our body

-          The condition of our kidneys, nervous system, or blood vessels

-          Our hormone levels

     We are more likely to be told our blood pressure is too high as we get older. This is because our blood vessels become stiffer as we age. When that happens, our blood pressure goes up. High blood pressure increases our chance of having a stroke, heart attack, heart failure, kidney disease, or early death.

     Most of the time, no cause of high blood pressure is found. This is called essential hypertension.

Some people have high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including:

-          Obstructive sleep apnea

-          Chronic kidney disease

-          Adrenal gland tumors

-          Thyroid problems

-          Certain defects we're born with (congenital) in blood vessels

-          Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs

-          Illegal drugs, such as cocaine and amphetamines

-          Hyperparathyroidism

-          Pregnancy or preeclampsia

How is High Blood Pressure DIAGNOSED?

          Hypertension is diagnosed on the basis of a persistently high resting blood pressure. The American Heart Association recommends at least 3 resting measurements on at least 2 separate health care visits. The UK National Institute for Health and Care Excellence recommends ambulatory blood pressure monitoring to confirm the diagnosis of hypertension if a clinic blood pressure is 140/90 mmHg or higher.

What are The RISK FACTORS for Hypertension?

High blood pressure has many risk factors, including:

-          Age

-          Race

-          Family history

-          Being overweight or obese

-          Not being physically active

-          Using tobacco

-          Too much salt (sodium) in the diet

-          Too little potassium in the diet

-          Drinking too much alcohol

-          Stress

-          Certain chronic conditions

What are The COMPLICATIONS of Uncontrolled Hypertension?

          Among other complications, hypertension can cause serious damage to the heart. Excessive pressure can harden arteries, decreasing the flow of blood and oxygen to the heart. The excessive pressure on our artery walls caused by high blood pressure can damage our blood vessels, as well as other organs in our body. The higher our blood pressure and the longer it goes uncontrolled, the greater the damage.

Uncontrolled high blood pressure can lead to complications including:

-          Heart attack or stroke

-          Aneurysm

-          Heart failure

-          Weakened and narrowed blood vessels in the kidneys

-          Thickened, narrowed or torn blood vessels in the eyes

-          Metabolic syndrome

-          Trouble with memory or understanding

-          Dementia

What are The TREATMENTS for High Blood Pressure?

          The goal of treatment is to reduce our blood pressure so that we have a lower risk of health problems caused by high blood pressure. Lifestyle adjustments are the standard, first-line treatment for hypertension. Some recommendations are here:

-          Regular Physical Exercise:-

   Current guidelines recommend that all people, including those with hypertension, engage in at least 150 minutes of moderate intensity, aerobic exercise every week, or 75 minutes a week of high intensity exercise. People should exercise on at least 5 days of the week.

Examples of suitable activities are walking, jogging, cycling, or swimming.

-          Stress Reduction:-

   Avoiding or learning to manage stress can help a person control blood pressure. Meditation, warm baths, yoga, and simply going on long walks are relaxation techniques that can help relieve stress.

People should avoid consuming alcohol, recreational drugs, tobacco, and junk food to cope with stress, as these can contribute to elevated blood pressure and the complications of hypertension. Smoking can increase blood pressure. Avoiding or quitting smoking reduces the risk of hypertension, serious heart conditions, and other health issues.

-          Medication:-

   People can use specific medications to treat hypertension. Doctors will often recommend a low dose at first. Anti-hypertensive medications will usually only have minor side effects. Eventually, people with hypertension will need to combine two or more drugs to manage their blood pressure.

Medications for hypertension include:

-          diuretics, including thiazides, chlorthalidone, and indapamide

-          beta-blockers and alpha-blockers

-          calcium-channel blockers

-          central agonists

-          peripheral adrenergic inhibitor

-          vasodilators

-          angiotensin-converting enzyme (ACE) inhibitors

-          angiotensin receptor blockers

The choice of medication depends on the individual and any underlying medical conditions they may experience.

What is The DIET CONSUMED in High Blood Pressure?

People can prevent high blood pressure by following a heart-healthy diet.

-          Reducing Salt Intake:-

   People's average salt intake is between 9 grams (g) and 12 g per day in most countries around the world. The World Health Organization (WHO) recommend reducing intake to under 5 g a day to help decrease the risk of hypertension and related health problems. Lowering salt intake can benefit people both with and without hypertension.

-          Moderating Alcohol Consumption:-

   Moderate to excessive alcohol consumption can increase blood pressure. The American Heart Association (AHA) recommend a maximum of two alcoholic drinks a day for men, and one for women.

The following would count as one drink:

-          a 12-ounce (oz) bottle of beer

-          4 oz of wine

-          1.5 oz of 80-proof spirits

-          1 oz of 100-proof spirits

A healthcare provider can help people reduce consumption if they find it difficult to moderate their alcohol intake.

-          Eating More Fruit and Vegetables and Less Fat:-

   People who have high blood pressure or people at high risk of developing high blood pressure should eat as little saturated and total fat as possible.

Instead, experts recommend:

-          Whole grain, high fiber foods

-          A variety of fruit and vegetables

-          Beans, pulses, and nuts

-          Fish rich in omega-3 twice a week

-          Non-tropical vegetable oils, for example, olive oil

-          Skinless poultry and fish

-          Low fat dairy products

It is important to avoid transfats, hydrogenated vegetable oils, and animal fats, as well as large portion sizes. Some fats, such as those in oily fish and olive oil, have protective effects on the heart. However, these are still fats. While they are typically healthful, people with a risk of hypertension should still include them in their total fat intake.

-          Managing Body Weight:-

   Excess body weight can contribute to hypertension. A fall in blood pressure usually follows weight loss, as the heart does not have to work so hard to pump blood around the body. A balanced diet with a calorie intake that matches the individual's size, sex, and activity level will help.