Hypertension, also known as high blood
pressure, can lead to severe complications such as heart disease, stroke or
even death.
The force exerted by the blood against
the walls of the blood vessels is called blood pressure. The pressure depends
on both the work being done by the heart and the resistance of the blood
vessels.
Medical guidelines define hypertension as
a blood pressure higher than 130 over 80 millimetres
of mercury (mmHg), according to guidelines issued
by the American Heart Association (AHA) in November 2017.
Types
High blood pressure can be split into 2
types. If it occurs due to another condition, it is called secondary
hypertension, if not, it is all primary or essential hypertension.
Primary hypertension can be a result of multiple factors, including blood plasma
volume and activity of the hormones that regulate of blood volume and pressure.
It is also influenced by environmental factors, such as stress and lack of
exercise.
Secondary hypertension has specific causes and is a complication of another problem.
It can result from:
·
diabetes, due to
both kidney problems and nerve damage
·
kidney disease
·
pheochromocytoma, a
rare cancer of an adrenal
gland
·
Cushing syndrome,
which can be caused by corticosteroid drugs
·
congenital adrenal
hyperplasia, a disorder of the cortisol-secreting adrenal glands
·
hyperthyroidism, or an overactive thyroid gland
·
hyperparathyroidism,
which affects calcium and phosphorous levels
·
pregnancy
·
sleep apnoea
·
obesity
·
CKD
·
Treating the
underlying condition should see an improvement in blood pressure.
Signs
Blood pressure can be measured by a blood
pressure monitor, also called a sphygmomanometer.
Having a high blood pressure over a short
period of time could be a normal response to many situations. Acute stress and
intense exercise, for example, may briefly elevate blood pressure in a healthy
person.
For this reason, a diagnosis of hypertension normally requires several readings
that consistently shows signs of high blood pressure.
The systolic reading refers to the
pressure as the heart pumps blood around the body. The diastolic reading refers
to the pressure as the heart relaxes and refills with blood.
The AHA 2017 guidelines define the
following ranges of blood pressure:
Systolic (mmHg) |
Diastolic (mmHg) |
|
Normal blood pressure |
Less than 120 |
Less than 80 |
Elevated |
Between 120 and 129 |
Less than 80 |
Stage 1 hypertension |
Between 130 and 139 |
Between 80 and 89 |
Stage 2 hypertension |
At least 140 |
At least 90 |
Hypertensive crisis |
Over 180 |
Over 120 |
If the reading shows a hypertensive
crisis when taking blood pressure, wait 2 or 3 minutes and then repeat the
test.
If the reading is the same or higher,
this is a medical emergency.
The person should seek immediate
attention at the nearest hospital.
Causes for hypertension
1) Age
The older you are the higher your risk of
having high blood pressure.
2) Family history
If there is a history of hypertension in
your family, the chances of you developing it as well is also significantly
higher.
3) Obesity and overweight
Both overweight and obese people are more
likely to develop high blood pressure, compared to people of normal weight.
4) Some aspects of gender
In general, high blood pressure is more
common among adult men than adult women. However, after the age of 60 years
both men and women are equally susceptible.
5) Physical inactivity
Lack of exercise, as well as having a
sedentary lifestyle, raises the risk of hypertension.
6) Smoking
Smoking causes the blood vessels to
narrow, resulting in higher blood pressure. Smoking also reduces the blood's
oxygen content so the heart has to pump faster in order to compensate, causing
a rise in blood pressure.
7) Alcohol intake
According to researches, people who drink
on a regular basis have a higher systolic blood pressure of about 7 millimetres
of mercury than does who do not.
8) High salt intake
Research has shown that the higher the
salt intake, the higher the chances of having a higher blood pressure.
9) High fat diet
Many health professionals say that a diet
high in fat leads to a raised high blood pressure risk. However, most
dietitians stress that the problem is not how much fat is consumed, but rather
what type of fats.
Fats sourced from plants such as
avocados, nuts, olive oil, and omega oils are good for you. Saturated fats,
which are common in animal-sourced foods, as well as trans fats, are bad for
you.
10) Mental stress
Various studies have offered compelling
evidence that mental stress, especially over the long term, can have a serious
impact on blood pressure. One study suggested that the way that
air traffic controllers handle stress can
affect whether they are at risk of developing high blood pressure later in
life.
11) Diabetes
People with diabetes are at a higher risk of developing hypertension. Among people
with type 1 diabetes, high blood sugar is a risk factor for incident hypertension -
effective and consistent blood sugar control, with insulin, reduces the
long-term risk of developing hypertension.
People with type 2 diabetes are at risk of hypertension due to high blood sugar, as well as
other factors, such as overweight and obesity, certain medications, and some cardiovascular diseases.
12) Pregnancy
Pregnant women have a higher risk of
developing hypertension than women of the same age who are not pregnant. It is
the most common medical problem encountered during pregnancy, complicating 2 to
3 percent of all pregnancies.
Symptoms
Hypertension is often called the “silent
killer” as the person may not have noticed any symptoms at all and while it is
undetected, it can still cause damage to
the cardiovascular system and internal organs, such as the kidneys.
Regularly checking your blood pressure is
vital, as there will usually be no symptoms to make you aware of the condition.
However, once blood pressure reaches
about 180/110 mmHg, it is considered a medical emergency known as a
hypertensive crisis. At this stage, symptoms will show, including:
·
headache
·
nausea
·
vomiting
·
dizziness
·
blurred or double vision
·
nosebleeds.
·
palpitations, or
irregular or forceful beating of the heart
·
breathlessness
Anybody who experiences these symptoms
should see their doctor immediately.
Children with high blood pressure may
have the following signs and symptoms:
·
headache
·
fatigue
·
blurred vision
·
nosebleeds
·
Bell's palsy, or an inability to control facial muscles on one side of the face.
Newborns and very young babies with high
blood pressure may experience the following signs and symptoms:
·
failure to thrive
·
seizure
·
irritability
·
lethargy
·
respiratory
distress
People who are diagnosed with high blood
pressure should have their blood pressure checked frequently. Even if yours is
normal, you should have it checked at least once every five years, and more
often if you have any contributory factors.
Complications
Long-term hypertension can cause
complications through atherosclerosis, where the formation of plaque results in the narrowing of blood
vessels. This makes hypertension worse, as the heart must pump harder to
deliver blood to the body.
Hypertension-related atherosclerosis can
lead to:
·
heart failure and heart attacks
·
an aneurysm, or an abnormal bulge in the wall of an artery that can burst,
causing severe bleeding and, in some cases, death
·
kidney failure
·
stroke
·
amputation
·
hypertensive
retinopathies in the eye, which can lead to blindness
Regular blood pressure testing can help
people avoid the more severe complications.
Treatment
Treatment for high blood pressure depends
on several factors, such its severity, associated risks of developing stroke or
cardiovascular, disease, etc.
Slightly elevated blood pressure
The doctor may suggest some lifestyle
changes if blood pressure is only slightly elevated and the risk of developing
cardiovascular disease considered to be small.
If blood pressure is moderately high and
the doctors believes the risk of developing cardiovascular disease during the
next ten years is above 20 percent, the doctor will probably prescribe
medication and advised on lifestyle changes.
Severe hypertension
If blood pressure levels are 180/110 mmHg
or higher, the doctor will refer the individual to a specialist.
Changes in lifestyle can help lower high blood pressure
The following are recommended lifestyle
changes that can help you lower your blood pressure. Note that you should always
check with a Doctor or healthcare professional to discuss lifestyle changes
before making any dramatic changes yourself.
Reducing the amount of salt
Average salt intake is between 9 grams
(g) and 12 g per day in most countries around the world.
The WHO recommends reducing intake
to under 5 g a
day, to help decrease the risk of hypertension and related health problems.
This can benefit people both with and
without hypertension, but those with high blood pressure will benefit the most.
Moderating alcohol consumption
Moderate to excessive alcohol consumption
is linked to raised blood pressure and an increased risk of stroke.
The American Heart Association
(AHA) recommend a
maximum of two drinks a day for men, and one for women.
The following would count as one drink:
12 ounce (oz.) bottle of beer
4 oz. of wine
1.5 oz. of 80-proof spirits
1 oz. of 100-proof spirits
A healthcare provider can help people who
find it difficult to cut back.
Eating more fruit and vegetables and less
fat
People who have or who are at risk of
high blood pressure are advised to eat as little saturated and total fat as
possible.
Recommended instead are:
whole-grain, high-fibre foods
a variety of fruit and vegetables
beans, pulses, and nuts
omega-3-rich fish twice a week
non-tropical vegetable oils, for example,
olive oil
skinless poultry and fish
low-fat dairy products
It is important to avoid trans-fats,
hydrogenated vegetable oils, and animal fats, and to eat portions of moderate
size.
Managing body weight
Hypertension is closely related to
excess body weight, and weight reduction is normally followed by a fall in blood
pressure. A healthy, balanced diet with a calorie intake that matches the
individual's size, sex, and activity level will help.
The DASH diet
The U.S. National Heart Lung and Blood
Institute (NHLBI) recommends the DASH diet for people with high blood pressure.
DASH, or "Dietary Approaches to Stop Hypertension," has been
specially designed to help people lower their blood pressure.
It is a flexible and balanced eating plan
based on research studies sponsored by the Institute, which says that the diet:
lowers high blood pressure
improves levels of fats in the
bloodstream
reduces the risk of developing
cardiovascular disease
There is a cookbook written
by the NHLBI called Keep the Beat Recipes with cooking ideas
to help achieve these results.
Sleep
Not getting
enough sleep can increase a person's risk of developing high blood pressure, scientists from the University of Chicago reported after monitoring
over 500 middle aged people for 5 years.
Some studies have suggested that adults sleep no less than 7 hours and no more than 8 hours per day. In 2008 the American Academy of Sleep Medicine published a study suggesting that people with sleep duration above or below the recommended 7-to-8 hours per night face an increased risk of hypertension.
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