High blood pressure is a very common condition with serious consequences if left untreated. This article is aimed at providing basic knowledge about the causes, treatment, complications and prognosis of hypertension.
High Blood Pressure or Hypertension is a very common and serious condition which if untreated may lead to permanent and often fatal damage to various organs of the body including the heart, kidneys, brain and eyes. Hypertension means the pressure of the blood inside the blood vessels is higher than what it should be. A blood pressure (BP) of more than 139/89 mmHg is regarded to be higher than normal range.
A high BP reading checked randomly on at least two occasions while the person is at rest is needed to make a diagnosis of hypertension. In almost 90-95% of the cases the cause of high blood pressure is not known, this is called essential/idiopathic hypertension. Remaining 5-10% of the cases are of secondary hypertension in which an underlying cause is identifiable.
Hypertension is called a silent killer as there are no distinct signs or symptoms of this disease. It is a leading cause of death and disability worldwide. End organ damage may manifest as heart attack, stroke, CKD (Chronic Kidney Disease), or hypertensive retinopathy. A vast majority of people are diagnosed incidentally on routine physical checkup.
The symptoms manifest only later in life when there has been irreversible organ damage. It is important to start controlling blood pressure as soon as the diagnosis is made so as to prevent or at least slow the progression of organ damage. Co-morbid conditions such as diabetes mellitus accelerate the organ damage.
High pressure inside the blood vessels causes damage to the inner lining of vessels leading to erosion, deposition of calcium, cholesterol and inflammatory cells collectively. This process is called atherosclerosis. This narrows the lumen of blood vessels especially the coronary arteries predisposing the individual to angina and heart attack. Similar process in carotid arteries and cerebral arteries may predispose an individual to stroke.
Myths and Facts About Hypertension
Read this article to know the myths and facts about hypertension.
Goal of therapy is to bring blood pressure within normal range. A stepwise approach is applied. First step is lifestyle modifications which include:
These measures should be followed in all individuals with hypertension regardless of whether the decision has been made to implement drug therapy. Second step is giving medications to control blood pressure. Your doctor may prescribe medications according to the response to therapy. These medications are also given in a stepwise manner. Patient is started on one type of medicine usually a calcium channel blocker or an ACE inhibitor. Other medications like diuretics and beta blockers may be added depending upon the response to treatment until optimum BP control is achieved. Usually these medications are taken throughout life to maintain blood pressure in normal limits.
For secondary hypertension when a cause is identified the treatment is aimed at addressing the cause. Some of the causes of secondary hypertension are renal artery stenosis, coarctation of aorta, pheochromocytoma, hyperthyroidism and tumor of the adrenal cortex.
If uncontrolled, high blood pressure has a poor prognosis with high risk of stroke and heart disease, the two leading causes of death worldwide. However, if blood pressure is well controlled and lifestyle modifications are implemented, the prognosis can be excellent with the risks decreased significantly.
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High blood pressure can sometimes be associated without any abnormal symptoms. Some signs of high blood pressure are anxiety, shortness of breath, moderate or severe headache, nosebleeds, and a feeling of pulsation in the neck. It is primarily a silent disease.
The five main symptoms of high blood pressure are fatigue, headache, heart palpitation, blurred vision, and fainting. Fatigue and headache are usually early warning signs of high blood pressure. However, when the symptoms become chronic, medical help should be considered.
The symptoms of high blood pressure in women include fatigue, headache, chest discomfort, and shortness of breath. High blood pressure makes the heart more difficult to work than normal. If left untreated in women, it can damage the arteries and lead to heart stroke, kidney failure, eye damage, and atherosclerosis (buildup of fat in arteries).
The blood pressure can be lowered immediately by taking a warm shower or bath for about 15 minutes, which helps reduce muscle tension. Deep breathing exercises can help in lowering blood pressure. Relaxing and avoiding stress can help in lowering blood pressure.
High blood pressure can make the person tired as it is associated with symptoms such as headache, nausea, and lethargy. Feeling tired can also be associated with lifestyle or anti-hypertensive medications. It is one of the common symptoms seen in a person suffering from high blood pressure.
The primary cause of high blood pressure is having too much potassium or sodium in the diet,, which may elevate the blood pressure. In addition, chewing tobacco, smoking cigarette, and secondhand smoking can increase the risk of high blood pressure. Age factor is another matter of concern that may lead to an increase in blood pressure.
Some studies suggest that men who lack deep sleep have an 80 % chance of having high blood pressure. People who sleep less than six hours usually have increased blood pressure.
People who sleep less often feel tired, resulting in increased blood pressure and require rest. Sleep helps control the hormonal levels in the body and stress. Resting with peace and a calm mind helps lower blood pressure.
Blood pressure with a reading such as 180/120 mm of Hg is considered stroke level blood pressure. It is high in range and is considered dangerous. It often requires immediate medication to reduce blood pressure.
The DASH diet is considered the best diet for high blood pressure. It is a healthy diet that helps prevent or treat high blood pressure. It includes food rich in calcium, magnesium, and potassium. These nutrients help to control blood pressure. In addition, the diet tends to limit foods high in added sugar, saturated fat, and sodium.
Sleeping on the left side is considered the best sleeping position for people with high blood pressure. This position relieves the pressure on the blood vessel that returns blood to the heart. The blood vessels positioned on the right side of the body can get compressed and slow down the circulation when sleeping on the right side.
The blood pressure can be lowered naturally at home by taking a hot shower or bath for at least 15 minutes. Breathing exercises are important to lower blood pressure. Consumption of less amount of salt can help avoid high blood pressure.
Walking for 15 minutes daily can help lower a person's blood pressure. However, the blood pressure is maintained only if the person continues the exercise. Therefore, diet is of utmost importance, along with walking, to ease blood pressure.
High blood pressure can be controlled by maintaining a healthy balanced diet and limiting salt consumption. In addition, physical exercise plays an important role in maintaining overall health. If high blood pressure cannot be controlled by diet or exercise, medications prescribed by doctors should be considered.
Among most cases of high blood pressure, the most affected organ is the kidney. Blood pressure can be triggered by abnormalities that cause the adrenal glands to secrete excessive hormones. These hormones are responsible for elevating blood pressure.
Last reviewed at:
14 Oct 2019 - 2 min read
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