Hypertension

What is high blood pressure or Hypertension?

It means high pressure or tension in the arteries, which carry blood from the heart to all the tissues and organs of the body. High blood pressure does not mean excessive emotional tension, but emotional tension and stress can temporarily increase blood pressure.
Normal blood pressure is below 120/80.Blood pressure between 120/80 and 139/89 is called “pre-hypertension”, and a blood pressure of 140/90 or above is considered high.

Hypertension can be either

  • Essential Hypertension – as in the case of 95% of the people with hypertension, with no specific cause

Or

  • Secondary Hypertension- as in the case of 5% of the people with hypertension, caused by an abnormality somewhere in the body, such as the kidneys etc.

Essential hypertension may run in some families, so it would be wise that you be cautious about your blood pressure if your mother or father had a history of high blood pressure.

Hypertension can be classified as

Category Systolic (mmHg) Diastolic (mmHg) Follow up
Normal <120 <80 Re check in 2 years
Pre hypertensive 120-139 80-89 80-89
Grade 1 Hypertension (mild) 140-159 90-99 Confirm within 2 months
Grade 2 hypertension (moderate) 160-179 100-109 Evaluate within 1 month
Grade 3 hypertension (severe) >180 >110 Evaluate and treat immediately or within 1 week
Isolated systolic hypertension >140 <90  

High blood pressure may remain without any symptoms (silently) and so hypertension has been labeled “the silent killer.” Untreated, it can lead to heart disease , kidney disease, stroke and even blindness.

Sometimes, people with high blood pressure have the following symptoms:

  • Headache
  • Dizziness
  • Blurred vision
  • Nausea

People often do not seek medical care until they have symptoms arising from the organ damage caused by chronic (ongoing, long-term) high blood pressure. The following types of organ damage are commonly seen in chronic high blood pressure:

  • Heart attack
  • Stroke or “mini stroke” (transient ischemic attack, TIA)
  • Kidney failure
  • Eye damage with loss of vision
  • Peripheral arterial disease
  • Out pouching of the aorta, called aneurysms

See your doctor, if a routine blood pressure measurement (during health screening) reveals systolic blood pressure higher than 140 mm Hg, diastolic blood pressure higher than 90 mm Hg, or both. Call your Doctor if you have any of the following symptoms:

  • Unexplained severe headache
  • Sudden or gradual changes in vision
  • Light-headedness or dizziness
  • Nausea associated with severe headache
  • Chest pain or shortness of breath on exertion
  • Life style modifications-

1)Healthy diet -
Eat a lot of vegetables, fruits, whole grains. Reduce the salt & fat. This can be reduced by reducing the junk / fast food. Frequently eating small meals is a good way to boost your metabolism. Drink plenty of water. Avoid  excessive alcohol and coffee

2)Give up smoking

3)Losing weight-
set up realistic goals to achieve targets to lose weight by workouts.In addition to your workouts, try taking the stairs instead of the elevator. Park further away in the parking lot.

4)Avoid a sedentary life style-
Reduce the stressful lifestyle by getting yourself engaged in relaxation activities such as recreation,religious activities (eg:meditation)

  • Drug treatment-

For mild hypertension, lifestyle changes may be sufficient to bring blood pressure into the normal range. For more severe cases, medication is needed. Your doctor may try different drugs or combinations of drugs before finding the best one for you. Some medications your doctor may prescribe include:

  1. Diuretics (water pills). These help the body get rid of extra water. Less fluid in the blood vessels decreases pressure. Eg:Frusemide
  2. Beta-blockers. These will block the effect of adrenaline so the heart then slows down, resulting in lower blood pressure. Eg:Atenelol
  3. Calcium channel blockers. These widen blood vessels by slowing down the movement of calcium ions into cells. This relaxes the blood vessels and the heart muscle.Eg:Nifedipine
  4. ACE inhibitors. ACE inhibitors also widen blood vessels. They do this by blocking the chemicals that cause blood vessel constriction. Eg:Enalapril

Lifestyle adjustments in diet and exercise and compliance with medication regimes are important factors in determining the outcome for people with hypertension.

Again and again it should be stressed that screening for hypertension is extremely important because it helps your doctor detect it early enough so that it can be treated, so that much of the harm can be prevented.