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High Blood Pressure (Hypertension)

Monday, 17 January 2011

Hypertension is defined as the elevation of the systolic or diastolic pressure. In other words, the pressure of the blood in the arteries is above normal values.
Before we discuss more details about hypertension, we must outline the normal values of blood pressure:
  • If the systolic B.P is <120 and diastolic B.P is <80, this is known as optimal blood pressure.
  • If the systolic B.P is <130 and diastolic B.P is <85, this is a normal blood pressure.
  • If the systolic B.P is between 130 - 139 and diastolic B.P is between 85 - 89, this is a high normal blood pressure.
These were the variations in the values of normal blood pressure. (all blood pressure values written in this article are in mmHg).
Hypertension is said to be present if the systolic B.P is more than 140 and the diastolic B.P is more than 90. 

How is hypertension diagnosed ?
If an individual measures his/her blood pressure in 3 different occasions and finds out that the systolic B.P is greater than 140 and the diastolic B.P is greater then 90, then this person is hypertensive.

What are the types and causes of hypertension ?
1- Essential hypertension: there is no a specific underlying cause for hypertension. More than 85% of hypertensive patients have this type.
What can increase the risk of having essential hypertension ?
Factors include family history of hypertension, old age, smoking, obesity, sedentary lifestyle, high intake of sodium or saturated fats in the diet.

2- Secondary hypertension: a specific cause is present. It can occur due to:
  • Renal diseases: as renal vascular disease, renal parenchymal diseases (especially glomerulonephritis) and polycystic kidney disease.
  • Endocrine diseases: as pheochromocytoma, cushing's syndrome, conn's syndrome, hyperparathyroidism and thyroid diseases. 
  • Drugs: as oral contraceptives, corticosteroids and non-steroidal anti-inflammatory drugs.
Any of the above causes can cause hypertension. Therefore, treating the cause will abolish high blood pressure forever.

What are the grades of hypertension ?
There are three grades for hypertension:
  • Grade I (mild): systolic B.P is between 140 - 159 and the diastolic B.P is between 90 - 99.
  • Grade II (moderate): systolic B.P is between 160 - 179 and the diastolic B.P is between 100 - 109.
  • Grade III (severe): systolic blood pressure is equal to or more than 180 and the diastolic B.P is equal to or more than 110.
What are the symptoms of hypertension ?
In many cases, it causes no symptoms. That's why it is called the silent killer. Because it can cause a serious fatal complication without warning symptoms.
In some cases, symptoms of hypertension can present as any of the following:
- Occipital headache: headache felt at the back of the head.
- Epistaxis: nosebleeds.
- Blurry vision.
- Vaginal bleeding in a menopausal woman.

What are the dangers of uncontrolled high blood pressure ?
Complications of hypertension include: 
- Heart attack: high blood pressure can increase the rate of atherosclerosis. This leads to narrowing of the blood supply to the heart which can result in a heart attack or myocardial infarction.
- Stroke: by the same mechanism explained above.
- Aneurysm: high blood pressure can cause weakening of the arteries and lead to formation of an aneurysm. (Aneurysm is a localised dilatation of an artery). The following image shows the mechanism involved.

- Metabolic syndrome.
- Retinal damage that can lead to loss of vision.
- Kidney damage.
- Heart failure: imagine a heart which is pumping blood and is met with a high pressure in the arteries. On long term effects, the heart will start to fail.

Treatment of hypertension:
Management of hypertension is consisted of two major components: Lifestyle modifications (see below) and anti-hypertensive drugs. In cases of secondary hypertension, treatment of the cause will treat hypertension.
Anti-hypertensive drugs can be any of the following:
Diuretics, beta blockers (metoprolol, atenolol, bisoprolol), ACE inhibitors, angiotensin receptor blockers, calcium antagonists.
Treatment should be started once an individual is diagnosed as having grade I hypertension. Some doctors recommend starting treatment once the individual is diagnosed with high normal hypertension.

How to prevent hypertension ?
Preventing hypertension is possible and it involves making some lifestyle modifications in order to have a better health and a life free from hypertension.
- Exercise regularly at least 30 minutes daily.
- If you are overweight, do your best to lose weight and maintain a normal body weight.
- Limit your intake of foods that contain excess salt.
- If you are a smoker, quit smoking. Click here to learn how to quit smoking.
- Avoid alcohol consumption.
- Eat excess fruits and vegetables.
- Avoid foods containing saturated fats and cholesterol.
- Relax and try to live a stress-free or low-stress life. 

Take care:
- White coat hypertension is a common condition. What happens is that the individual's blood pressure rises when examined by a doctor. That's why it is important to take various measurements before diagnosing hypertension. 
It's solution is to let a family member measure the blood pressure of that individual at home. 
- Hypertension during pregnancy, also known as preeclampsia, occurs more commonly in first pregnancies. It needs a careful follow-up with a gynecologist otherwise can progress to eclampsia.

At the end of this article, i hope you had benefited from it. I tried to be comprehensive as much as possible.
If you have any questions, please post them as a comment below.

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