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.
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
· sleep apnoea
· Treating the underlying condition should see an improvement in blood pressure.
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
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:
Normal blood pressure
Less than 120
Less than 80
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
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
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.
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.
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.
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.
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:
· blurred or double vision
· palpitations, or irregular or forceful beating of the heart
Anybody who experiences these symptoms should see their doctor immediately.
Children with high blood pressure may have the following signs and symptoms:
· blurred vision
· 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
· 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.
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
· hypertensive retinopathies in the eye, which can lead to blindness
Regular blood pressure testing can help people avoid the more severe complications.
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.
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.
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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