High blood pressure is very common, with serious consequences if left untreated. Read the article to know in detail.
High Blood Pressure or hypertension is a very common and serious condition that, if left untreated, can 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 the normal range.
Primary Hypertension - It is also known as essential hypertension. It is the most common type of high blood pressure. This hypertension is caused by aging and unhealthy habits like not exercising regularly.
Secondary Hypertension - This type of high blood pressure is caused by medical conditions such as kidney problems or hormonal issues and sometimes due to medications that a person is taking.
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 condition in which the damage to the blood vessels of the retina limits the retina’s function, causing vision loss). A vast majority of people are diagnosed incidentally on routine physical checkups.
The symptoms manifest only later in life when irreversible organ damage occurs. 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 organ damage.
High pressure inside the blood vessels causes damage to the inner lining of vessels leading to erosion and 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 (chest pain due to reduced blood flow to the heart) and heart attack. A similar process in carotid arteries and cerebral arteries may predispose an individual to stroke.
Approximately 10 % of pregnancy complications happen due to high blood pressure. Many forms of high blood pressure can be experienced during pregnancy ranging from mild to severe. These include:
Chronic Hypertension - In this type, high blood pressure is present before pregnancy.
Gestational Hypertension - In this type, high blood pressure is experienced in the latter part of pregnancy.
Preeclampsia - This is a serious condition involving high blood pressure, generalized swelling, and protein in the urine and can even cause seizures. This is seen in the latter half of pregnancy.
Chronic Hypertension With Superimposed Preeclampsia - Pregnant women with chronic hypertension are at a greater risk of developing preeclampsia.
Age - Older people are at higher risk of developing high blood pressure. Until about age 64, men are more prone to high blood pressure. Women tend to have high blood pressure after 65.
Family History - A person is more likely to have high blood pressure if his parents or siblings suffer from it.
Race - Black people are more commonly affected by high blood pressure than white people.
Obesity - Overweight people are more prone to develop high blood pressure as excess weight causes changes in the blood vessels and other organs, causing increased blood pressure.
Too Much Salt - Excess salt in the body can cause the body to retain fluid, leading to increased blood pressure.
Tobacco Use or Vaping - Tobacco smoking immediately increases blood pressure for a short period of time. It damages the walls of the blood vessels and speeds up the process of hardening the arteries.
Low Potassium Levels - Low potassium levels due to lack of potassium in diet or certain medical conditions cause high blood pressure. Potassium is responsible for balancing the amount of salts in the body.
Stress - Increased levels of stress can cause temporary high blood pressure.
Drinking Too Much Alcohol - Alcohol consumption is related to high blood pressure.
A high blood pressure reading checked randomly on at least two occasions while the person is at rest is needed to make a diagnosis of hypertension. Blood pressure is measured as mmHg and has two numbers, namely systolic and diastolic pressures. Systolic pressure is the pressure in the arteries when the heart beats and diastolic is the pressure in the arteries between the heartbeats. In almost 90 to 95 % of the cases, the cause of high blood pressure is unknown; this is called essential/idiopathic hypertension. The remaining five to ten percent of the cases are of secondary hypertension with an identifiable underlying cause. Depending on how high the blood pressure is it is grouped in the following staging:
Stage 1 Hypertension - Systolic pressure is between 130 to 139 mmHg or diastolic pressure is between 80 to 89 mmHg.
Stage 2 Hypertension - Systolic pressure is 140 mmHg or higher or diastolic pressure is 90 mmHg or higher.
The goal of therapy is to bring blood pressure within normal range. A stepwise approach is applied.
The first step is lifestyle modifications which include:
Limiting dietary salt intake.
Aerobic exercise at least 30 minutes a day, five times a week.
Maintaining BMI (body mass index) between 20 to 25.
Reducing dietary fat content.
Increasing fruits and vegetables in the diet.
These measures should be followed in all individuals with hypertension regardless of whether the decision has been made to implement drug therapy.
The 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. The patient is started on one type of medicine, usually a calcium channel blocker or an angiotensin-converting enzyme (ACE) inhibitor. Other medications like diuretics (remove excess sodium from the body) and beta-blockers (reduce the work load on the heart) may be added depending upon the response to treatment until optimum blood pressure control is achieved. Usually, these medications are taken throughout life to maintain blood pressure within normal limits.
For secondary hypertension, when a cause is identified, the treatment is aimed at addressing the cause. Secondary hypertension occurs in renal artery stenosis (narrowing of arteries carrying blood to the kidneys), coarctation of the aorta (narrowing of the large blood vessel called the aorta carrying blood to the heart), pheochromocytoma (tumor of adrenal glands), hyperthyroidism (thyroid glands produces excess thyroxine hormone), and tumor of the adrenal cortex.
Prognosis - If uncontrolled, high blood pressure has a poor prognosis with a 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.
High blood pressure can cause a lot of complications in people, even in pregnant women if not taken care of. The ideal blood pressure to be maintained varies with age and health conditions. Proper medications and certain lifestyle changes can help in dealing with high blood pressure.
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:
07 Oct 2022 - 5 min read
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