What is Hypertension?
Hypertension is another name for high blood pressure. A repeatedly elevated blood pressure in adults exceeding 140/90 mmHg is defined as hypertension. This may eventually cause multiple health problems including heart attack and stroke. According to a study, there is an increased risk of morbidity due to abnormal blood pressures in people aged above 65.
- Primary (Essential) Hypertension: Hypertension due to nonspecific environmental and genetic factors.
- Secondary Hypertension: Hypertension due to an identifiable underlying primary cause like kidney disease, endocrine disease or some tumours.
- Gestational Hypertension: Hypertension that develops in pregnancy.
When blood flows in the blood vessels, it exerts a lateral thrust on the walls of the arteries. This pressure of the circulating blood is known as blood pressure. Blood pressure depends upon the amount of blood our heart pumps (systolic blood pressure) and the resistance to blood flow in our peripheral arterioles (diastolic blood pressure). A systolic BP of 110-140 mmHg and a diastolic BP of 70-90 mmHg is considered normal. A persistently high BP causes damage to the heart and blood vessels and thus has deleterious effects in the long run.
Have a look at the blood pressure or hypertension stages:
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How common is Hypertension?
According to a report 29.8% of Indians have hypertension, with 33% prevalence in urban and 25% in rural India. It is responsible for 29% strokes and 24% heart attacks in India. While older adults are always at a high risk, hardly 25% of the population knows about blood pressure problems.
What are the symptoms of Hypertension?
Most people with high blood pressure do not have any symptoms. Some minor symptoms include:
- Headache (particularly at the back of the head and in the morning)
- Fainting episodes
- Altered vision
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What are the causes of Hypertension?
Primary hypertension develops gradually over several years and does not have any underlying identifiable cause. Secondary hypertension can be caused due to:
- Kidney problems like renal artery stenosis, ADPKD (autosomal dominant polycystic kidney disease), nephrotic syndrome
- Adrenal gland tumours like pheochromocytoma
- Thyroid problems
- Congenital anomalies of blood vessels like coarctation of aorta
- Medications like oral contraceptive pills, medications for cold and flu
- Cocaine, amphetamines
Who is at a higher risk?
- Old people: Risk for developing high blood pressure increases with age.
- Male gender: Female sex hormone, estrogen is cardioprotective in females and hence women of childbearing age group do not have high blood pressure. Women tend to develop hypertension post menopause.
- Family history: High blood pressure commonly runs in families.
- Obesity: Being overweight or obese
- Tobacco: Tobacco damages the arterial walls and narrows the arteries thus increasing the BP.
- Alcohol: Too much alcohol causes direct damage to the heart.
- Salt diet: This causes the body to retain fluid which increases the blood volume and hence increases the BP.
- Stress: This is the most important risk factor for high BP nowadays.
- Faulty lifestyle: Lack of exercise, fatty diet increases the risk of hypertension.
- Kidney diseases: Renal artery stenosis, ADPKD or endocrine disorders can increase BP.
What are the complications with Hypertension?
- Heart attack: High blood pressure causes thickening of arterial walls and narrowing of arteries which can lead to atherosclerosis which can cause a heart attack.
- Stroke: Stroke occurs when arteries supplying blood to the brain are narrowed or occluded.
- Aneurysm: High blood pressure exerts stress on walls of arteries, which leads to bulging and outpouching of the arteries causing formation of aneurysms.
- Heart failure: In hypertensive patients, the heart has to exert greater force to pump blood against the higher pressure in the blood vessels and it eventually fails.
- Nephropathy: High pressure of blood damages the delicate vessels in the kidneys leading to kidney damage.
- Retinopathy: The retinal vessel cannot withstand the high pressure of blood and tend to burst leading to blindness.
- Encephalopathy: It manifests as decreased ability to think, remember and learn.
How is Hypertension treated?
- Healthy diet: Salt and fatty foods need to be cut down in the diet of hypertensives. Foods rich in potassium like coconut water need to be included.
- Physical activity: Daily physical exercise is a must to reduce weight and also to ensure optimum functioning of the heart.
- Limit alcohol and smoking: Drinking and smoking can elevate the problem, hence should be avoided.
- Manage stress: Meditation, yoga are effective ways to reduce stress.
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Some of the medications used to treat hypertension are as follows:
- Thiazide diuretics (Hydrochlorothiazide, Chlorthalidone): Diuretics are drugs that eliminate water from the body and reduce the blood volume and thus reduce pressure. They are the first choice medications in patients of high blood pressure. The only side effect is increased urination.
- ACE inhibitors and ARBs (Captopril, Lisinopril, Losartan, Candesartan): These medications prevent the constriction of blood vessels and thus reduce the pressure of blood in them.
- Beta-blockers (Atenolol, Metoprolol): They dilate the arterioles and also slow down the heart. Hence they reduce the workload on the heart. Beta blockers are given along with other medications and help to prevent complications of hypertension.
- Calcium channel blockers (Amlodipine): These drugs relax the muscles of blood vessels and reduce blood pressure.
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What lifestyle changes are required to manage Hypertension?
- Diet: Eat a low fat, low sodium and healthy diet. Include whole grains and fresh fruits and vegetables.
- Exercise: Physical activity is important in managing hypertension. Make sure you get at least 30 minutes of exercise every day to manage your blood pressure better.
How to take care of someone with Hypertension?
When taking care of someone with hypertension, ensure they take the diet as mentioned above, they exercise, visit doctors on time and take their medicines on time. A monitored and healthy lifestyle can help in keeping blood pressures in control.
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