High blood pressure or hypertension poses a global health burden. Studies estimate that about 1.13 billion people throughout the globe suffer from hypertension. Less than 1 in 5 individuals suffering from hypertension have the problem under control. This is also a leading cause of premature or young deaths worldwide due to life threatening complications associated with it.
Blood Pressure Definition
Hypertension is a measure of the amount of resistance heart has to face while pumping blood. We all know that the function of the heart is to pump blood throughout the body via the blood vessels. This pumping requires heart to generates pressure like any other pump to push the blood. Now, if due to any reason the blood vessels gets stiff or their lumen becomes narrower due to deposition of cholesterol plaques inside, the pressure required to pump becomes high causing hypertension.
Causes Of Hypertension
To understand the causes, first you need to know that there are two basic types of hypertension.
Primary Hypertension: This is the most common type of hypertension encountered in clinical practise. It develops with age over time and the exact etiology of this is still not well understood. However following are the most important factors that can play a role in its development.
- Familial or Genetics
- Type A personality
- Sedentary Lifestyle
- Ageing
- Smoking Habit
Secondary Hypertension: This type develops as a result of some other ongoing medical condition. Common causes includes.
- Kidney Disease
- Thyroid Dysfunction
- OSA or Obstructive Sleep Apnoea
- Endocrine Tumors
- Certain Drug Abuse
- Adrenal Gland Dysfunction
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Symptoms Of Hypertension
Majority of the individuals suffering from hypertension never realises they have it, until late when some complication like stroke or heart disease develop. Some common warning features includes
- Generalised Headaches On and Off
- Blurred Vision
- Giddiness
- Dizziness
- Chest Discomfort
- Abrupt Nose Bleed
- Flushing
If you encounter any of these symptoms then you need to start monitoring your blood pressure on daily basis. It should be done twice a day for at-least a week after relaxing for minimum of 15 minutes while sitting upright on a chair with your feet resting on ground. There should be no consumption of Tea or Coffee at-least an hour prior to blood pressure recording.
Risk of developing hypertension is even higher if there is a family history of same.
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How Hypertension Is Diagnosed
How to know if you have hypertension or not? The proper diagnosis of high blood pressure or hypertension is based on a series of BP readings taken in a controlled manner. The diagnosis of hypertension is not made on the basis of a solely high BP reading.
Blood pressure can easily be affected by local environmental factors, stress/anxiety or being at a doctor’s clinic. So, if your BP reading come high in the clinic your doctor may advise you to monitor BP and do charting at home where you will be more relaxed.
Now if your BP reading come high in more than two consecutive readings then your doctor may suggest some further tests to evaluate the underlying causes and probably will recommend lifestyle modifications or start you on some antihypertensives or may suggest a combination of both taking into consideration other associated factors.
Right Technique To Measure Blood Pressure At Home
Here are some important points to keep into consideration:
- Don’t drink a caffeinated beverage or smoke during the 30 minutes before the test.
- Sit quietly for five minutes before the test begins.
- During the measurement, sit in a chair with your feet on the floor and your arm supported so your elbow is at about heart level.
- The inflatable part of the cuff should completely cover at least 80% of your upper arm, and the cuff should be placed on bare skin, not over a shirt.
- Don’t talk during the measurement.
- Have your blood pressure measured twice, with a brief break in between. If the readings are different by 5 points or more, have it done a third time.
Recommended Blood Pressure Values
According to American Heart Association blood pressure is divided into following categories
- Normal: Less than 120/80 mmHg
- Elevated: Systolic between 120-129 and diastolic less than 80 mmHg
- Stage 1: Systolic between 130-139 or diastolic between 80-89 mmHg
- Stage 2: Systolic at least 140 or diastolic at least 90 mmHg
- Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.
Treatment
Lifestyle modification can go a long way toward controlling high blood pressure. Your doctor may recommend you make lifestyle changes including:
- Eating a heart-healthy diet with less salt ( DASH diet )
- Regular physical activity
- Maintaining a healthy weight or losing weight if you’re overweight or obese
- Limiting the amount of alcohol you drink
But sometimes lifestyle changes aren’t enough. In addition to diet and exercise, your doctor may recommend medication to lower your blood pressure.
Your blood pressure treatment goal depends on how healthy you are.
Your blood pressure treatment goal should be less than 130/80 mm Hg if:
- You’re a healthy adult with age 65 or more.
- You’re a healthy adult younger than age 65 with a 10 percent or higher risk of developing cardiovascular disease in the next 10 years.
- You have chronic kidney disease, diabetes or coronary artery disease.
If you’re age 65 or older, and use of medications produces lower systolic blood pressure (such as less than 130 mm Hg), your medications won’t need to be changed unless they cause negative effects to your health or quality of life.
There are many categories of antihypertensive drugs but your physician will prescribe you according to your other medical problems.
Medications to treat high blood pressure
- Thiazide diuretics
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin II receptor blockers (ARBs)
- Calcium channel blockers.
- Alpha blockers
- Alpha-beta blockers
- Beta blockers
- Aldosterone antagonists
- Renin inhibitors
- Vasodilators
- Central-acting agents
Lifestyle Changes
Lifestyle changes can help you control and prevent high blood pressure, even if you’re taking blood pressure medication. Here’s what you can do:
- Eat healthy foods
- Decrease the salt in your diet
- Maintain a healthy weight
- Increase physical activity
- Limit alcohol
- Don’t smoke
- Manage stress
- Monitor your blood pressure at home.
- Practice relaxation or slow, deep breathing
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