High blood pressure
High blood pressure is a common condition that affects the body’s blood vessel. It’s also called hypertension. If you have high blood pressure, the force of the blood pushing against the artery walls is consistently too high. The heart has to work harder to pump blood.
In general, hypertension is a blood pressure reading of 130/80 mm Hg or higher.
Blood pressure higher than 180/120 mm Hg is considered a hypertensive emergency or crisis.
Symptoms
Most people with high blood pressure have no symptoms, even if blood pressure readings reach dangerously high levels.
You can have high blood pressure for years without any symptoms.
A few people with high blood pressure may have:
- Headaches
- Shortness of breath
- Nosebleeds
These symptoms aren’t specific. They usually don’t occur until high blood pressure has reached a severe or life-threatening stage.
Causes
Blood pressure is determined by two things: the amount of blood the heart pumps and how hard it is for the blood to move through the arteries. The more blood the heart pumps and the narrower the arteries, the higher the blood pressure.
Causes of Hypertension can be divided into two : Primary and Secondary
Primary hypertension:
- It is also called essential hypertension.
- For most adults, there’s no identifiable cause of high blood pressure. This type of high blood pressure is called primary hypertension or essential hypertension.
- It tends to develop gradually over many years.
- Plaque(fats) build-up in the arteries called atherosclerosis, increases the risk of high blood pressure.
Secondary hypertension:
This type of high blood pressure is caused by an underlying condition. It tends to appear suddenly and cause higher blood pressure than does primary hypertension.
Conditions and medicines that can lead to secondary hypertension include:
- Kidney disease
- Obstructive sleep apnoea
- Thyroid problems
- Smoking
- Adrenal gland tumours
- Blood vessel problems present at birth, also called congenital heart defects.
- Cough and cold medicines, some pain relievers, birth control pills, and other prescription drugs
- Illegal drugs, such as cocaine and amphetamines
- White coat hypertension
(White coat hypertension means that sometimes getting a health check-up causes blood pressure to increase.)
RISK FACTORS
There are modifiable and non-modifiable ( age,geneticetc) risk factors are there
- Have relatives who suffer from diabetes, heart disease, or high blood pressure.
- Have African ancestry.
- Are over 55 years old.
- Overweight / Obese.
- No physical activity.
- Consume sodium-rich foods (salt).
- Using tobacco or smoking.
- Are heavy drinkers—For men, heavy drinking is typically defined as consuming 15 drinks or more per week. For women, heavy drinking is typically defined as consuming 8 drinks or more per week.
COMPLICATIONS
In many cases, hypertension is a silent illness that can harm your body for years before any symptoms emerge.
You could experience serious, potentially fatal complications from untreated hypertension.
Complications of hypertension include the following.
Damaged arteries
Strong and flexible arteries indicate good health. Through healthy arteries and vessels, blood flows freely without any obstruction.
Atherosclerosis makes arteries less elastic, harder, and tighter. Dietary fats can more easily accumulate in your arteries and limit blood flow as a result of this damage. Increased blood pressure, blockages, and eventually a heart attack or stroke can result from this damage.
2. Damaged heart
Hypertension makes your heart work too hard. The increased pressure in your blood vessels forces your heart muscles to pump more frequently and with more force than a healthy heart should have to.
This may cause an enlarged heart. An enlarged heart increases your risk for the following:
- Heart failure
- Arrhythmias
- Sudden cardiac death
- Heart attack
- Damaged brain
Your brain relies on a healthy supply of oxygen-rich blood to work properly. Untreated high blood pressure can reduce your brain’s supply of blood:
- Temporary blockages of blood flow to the brain are called transient ischemic attacks (TIAs).
- Significant blockages of blood flow cause brain cells to die. This is known as a strok.
DIAGNOSIS
Your healthcare provider will need to check your blood pressure with a blood pressure cuff. They usually check your blood pressure at every annual check-up or appointment.
If you have high blood pressure readings at two appointments or more, your provider may tell you that you have high blood pressure.
If you are diagnosed with hypertension, they may recommend tests to check for a cause. Tests include:
- Lab tests.Blood and urine tests are done to check for conditions that can cause or worsen high blood pressure. For example, tests are done to check your cholesterol and blood sugar levels. You may also have lab tests to check your kidney, liver, and thyroid function.
- Electrocardiogram (ECG or EKG).This quick and painless test measures the heart’s electrical activity. It can tell how fast or how slow the heart is beating.
- This non-invasive exam uses sound waves to create detailed images of the beating heart. It shows how blood moves through the heart and heart valves.
- Ambulatory monitoring.A longer blood pressure monitoring test may be done to check blood pressure at regular times over six or 24 hours. This is called ambulatory blood pressure monitoring.
MANAGEMENT AND TREATMENT
Your healthcare provider will discuss your recommended blood pressure target or goal with you if they have diagnosed you with high blood pressure, which includes, lifestyle changes, medication etc.
Lifestyle changes including:
- Eating a heart-healthy diet with less salt (A heart-healthy diet emphasizes:fruits, vegetables, whole grains, lean proteins like fish)
- Getting regular physical activity
- Using a home blood pressure monitor, check your blood pressure frequently.
- Consume wholesome foods that are low in fat and salt.
- Find and keep your ideal body weight.
- Limiting alcohol: Men should not consume more than two drinks per day, and women should not consume more than one drink per day. 1 ounce of alcohol, 5 ounces of wine, or 12 ounces of beer are one drink.
- Getting 7 to 9 hours of sleep daily
- Stop smoking.
Sometimes lifestyle changes are insufficient to control high blood pressure. If these are ineffective, your doctor might suggest taking blood pressure medication.
Medications
The type of medicine used to treat hypertension depends on your overall health, age and how high your blood pressure is.
Most hypertensive patients require combination therapy to achieve target blood pressure. It can take some time to find the medicine or combination of medicines that works best for you.
GOAL
When taking blood pressure medicine, it’s important to know your goal blood pressure level. You should aim for a blood pressure treatment goal of less than 130/80 mm Hg if:
- You’re a healthy age 65 or older.
- You’re a healthy adult younger than age 65 with a 10% or higher risk of developing cardiovascular disease in the next 10 years.
- You have chronic kidney disease, diabetes, or coronary artery disease.
The ideal blood pressure goal can vary with age and health conditions, particularly if you’re older than age 65.
Medicines used to treat high blood pressure include:
Diuretics. Angiotensin-converting enzyme (ACE) inhibitors. Angiotensin II receptor blockers (ARBs),Calcium channel blockers.
If you’re having trouble reaching your blood pressure goal with combinations of the above medicines, your provider may prescribe:
- Alpha blockers, Beta blockers, Aldosterone antagonists, Renin inhibitors, Vasodilators, Central-acting agents.
Always take blood pressure medicines as prescribed. Never skip a dose or abruptly stop taking blood pressure medicines. Suddenly stopping certain ones, such as beta blockers, can cause a sharp increase in blood pressure called rebound hypertension.
OUTLOOK
- Treating hypertension often doesn’t erase or reverse the effects of uncontrolled hypertension. But it does lower the risks for future problems.
- Don’t change your treatment without your provider’s guidance.
- Maintaining a healthy lifestyle that includes eating well, keeping an eye on your weight, and exercising frequently is also a good strategy to regulate your blood pressure.