Hypertension (High Blood Pressure)

What is hypertension?

Hypertension is the clinical term for high blood pressure. The pumping of blood into arteries exerts a fluid pressure on the arterial walls which is defined as blood pressure. When the heart contracts maximum pressure is exerted and this is called systole. When blood is filled in the heart between two subsequent heart beats, the pressure is minimum and called diastole. Normal blood pressure, designated as systolic/ diastolic pressure, is 120/ 80 mm of Hg. However, not every person’s blood pressure will stay constant at this level throughout the day. In addition there is some degree of fluctuation among individuals, which is also influence by age.

What are the stages of hypertension?

Hypertension is classified as :

  • Stage 1 of hypertension is marked by blood pressures ranging from 140/ 90 to 159/99.
  • Stage 2 is when the pressure is higher than 160/100. When the diastolic pressure increases beyond 140, the condition is called malignant hypertension.

What are the symptoms of hypertension?

Hypertension is asymptomatic at the outset in most people. It is therefore often referred to as a silent killer. Symptoms associated with hypertension include :

  • headache
  • dizziness
  • blurred vision
  • vomiting
  • dyspnea (shortness of breath)
  • chest pain
  • arrhythmia (irregular heart beat)

However, many of these symptoms are non-specific meaning that it be due to various types of diseases. Hypertensives are at risk of various conditions which may also be present and therefore contribute to some of the signs and symptoms. This includes heart attacks, aortic aneurysms, stroke (ischemia) or kidney failure. Malignant hypertension can cause complications like brain hemorrhage and stroke.

What causes hypertension?

Primary  hypertension is high blood pressure that arises on its own without any underlying disease. The cause of primary hypertension, also known as essential hypertension, is unknown. However, there are several risk factors that have been identified in primary hypertension such as :

  • Arteriosclerosis
  • Obesity
  • Sodium sensitivity
  • Alcohol consumption
  • Lack of exercise
  • Oral contraceptives
  • Age
  • Family history

Secondary Hypertension

The other type, secondary hypertension, is high blood pressure as a result of certain identifiable diseases or disturbances in the body. Secondary hypertension can be caused by :

  • Chronic kidney disease.
  • Adrenal gland disorders such as Cushing’s syndrome.
  • Pregnancy.
  • Medications such as amphetamines and drugs containing pseudoephedrine.
  • Renal artery stenosis.
  • Hyperthyroidism and hyperparathyroidism.

How is hypertension treated?

Hypertension is diagnosed if the blood pressure is higher than normal on at least two separate occasions. If hypertension is diagnosed, a battery of tests is performed to identify the underlying cause. These include blood tests to check the salt levels and lipid profiles, urine tests measuring electrolyte and protein concentrations as well test of heart function such as an electrocardiogram (ECG), echocardiogram and Doppler’s ultrasound.

Medications used for treatment of hypertension include :

  • Angiotensin-converting enzyme (ACE) inhibitors, calcium channel blockers and vasodilators that widen the blood vessels
  • Angiotensin II receptor blockers which antagonize angiotensin, a substance that constricts the blood vessels.
  • Thiazide, loop or potassium-sparing diuretics which increase the elimination of excessive salts from the body and hence called “water pills”.
  • Beta-blockers which counteracts the effects of adrenaline on heart so that it does not pump very hard.

ACE inhibitors and angiotensin II receptor blockers must be avoided in hypertension during pregnancy. The administration of these drugs must be coupled with lifestyle changes such as regular exercise, a healthy diet, reducing salt intake, quitting smoking and minimizing alcohol consumption. Regular monitoring of blood pressure is necessary to safeguard oneself from the detrimental effects of this “silent killer” disease.

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