A brief overview of symptoms, complications, risk factors and management of hypertension

The term ‘hypertension” means high blood pressure. Blood pressure refers to the force that the blood exerts on the walls of arteries during circulation. It is measured in systolic and diastolic values. Systolic pressure (top number) is that pressure which is measured when the heart squeezes out blood while the diastolic pressure is the one when heart relaxes and fills back up. The normal blood pressure reading according to many heart associations is considered to be 120/80mm Hg. According to World Health Organization American Heart Association, a person having readings at or above 140/90mmHg when taken repeatedly on different days is considered to have hypertension.

It is to be noted that many different conditions like increased physical activity or stress can raise the blood pressure however, this temporary increase does not mean a person is having hypertension. A diagnosis of hypertension can be made only if the person shows multiple high BP readings over a period of time.

A blood pressure of more than 180mm systolic and more than 120mmHg diastolic is considered to be malignant hypertension which needs immediate hospitalization.

Warning signs of hypertension

Signs and Symptoms generally show at higher blood pressure levels like severe headache, chest pain, difficulty in breathing, blurred vision, nosebleeds, dizziness, mental confusion, irregular heartbeats.

Complications of hypertension

High blood pressure, if not controlled, becomes a silent killer and a cause of many serious complications as mentioned below:

1. STROKE : High BP can damage the blood vessels in brain leading to STROKE. If the blood vessels rupture, it is called haemorrhagic Stroke or if blood vessels become blocked by clot, it’s called ischaemic Stroke.
2. DEMENTIA : Narrowed or blocked arteries can also decrease blood flow to the brain leading to dementia where there is a trouble in thinking and memory.
3. CHEST PAIN or HEART ATTACK: Damage to blood vessels of heart can make them less elastic and prone to fat build up which is also called Atherosclerosis. This will reduce the blood flow to heart causing chest pain or heart attack.
4. HEART FAILURE: To pump against high BP, the heart muscle has to extra work so gradually it thickens, stiffens and becomes weak, thus fail to pump blood effectively from heart. This condition is called HEART FAILURE.
5. KIDNEY FAILURE: Damage to blood vessels in kidney can lead to kidney failure where the kidneys stop filtering waste from blood effectively.
6. VISION LOSS : High BP can cause bursting of tiny blood vessels in the retina of the eye. This condition is called hypertensive retinopathy and can lead to blurred vision and sometimes total blindness.
7. NERVE DAMAGE: high BP can also damage tiny blood vessels supplying to nerves thereby devoiding them of Oxygen and nutrients that can lead to nervous dysfunction. Moreover, the high BP which remains for long time can increase the production of free radicals that can directly injure nerve cells.

Classification of hypertension

Hypertension is classified into two types:

• Primary hypertension: It is also called essential hypertension and here the exact cause is not known.
• Secondary hypertension: here the cause could be any underlying medical condition like diabetes, renal disease or taking medicines which can increase BP

Risk factors for hypertension

Risk factors can be divided into modifiable or Non-modifiable risk factors:

Modifiable risk factors (which can be easily altered) include:

• Lifestyle habits: like consumption of high salt, fats, trans fats and consuming low potassium, vegetables and fruits;
• Use of excess alcohol and tobacco
• High stress levels; physically inactivity.

Non-modifiable risk factors (which cannot be altered) includes:

• Increasing Age
• Gender: Men are at higher risk to develop hypertension at younger age while women are at more risk mainly at higher age especially after menopause.
• Family history or genetics
• Medical conditions like diabetes, high cholesterol level, chronic kidney disease, obesity
• Medications: Use of hormonal birth control pills (Oral Contraceptives), non-steroidal anti-inflammatory drugs like Aspirin, antidepressants etc.
• Race: Black people are at more risk than White people

Management of hypertension

It needs a combination of lifestyle modifications and often medicines to control blood pressure.

The key lifestyle modification strategies involve:

• Adopting DASH i.e Dietary Approaches to stop Hypertension: this emphasizes use of more fruits, vegetables, whole grains, and low fats.
• Reduce Sodium and increase Potassium in diet
• Use of supplements like garlic, omega 3 fatty acids, CoQ10
• Avoid smoking and limit alcohol intake
• Make a regular physical exercise routine
• Regular health check-ups
• Reduce body weight in case of obesity
• Practice deep slow breathing technique or meditation

Medicine management for hypertension

Medicines are mainly used if diet alone cannot control the high blood pressure levels. These aim to relax the blood levels, remove the excess sodium and water from the body and lower heart rate in order to put less strain on heart. Some of the first line medicines with different modes of actions include use of diuretics, Calcium channel blockers, angiotensin receptor blockers. So, timely Monitoring of blood pressure along with good lifestyle habits can protect our Heart and give us a longer and healthier life.