Hypertension or High Blood Pressure: A Silent Killer present in Every 3rd Person

Hypertension or High Blood pressure is a condition in which there is higher than normal pressure in the arteries of the body. It is a risk factor for several problems like coronary heart disease, congestive heart failure, stroke, kidney failure. According to new guidelines, every 1 out of 3 adults over the age of 20 has high Blood pressure.

What is Blood Pressure?

The heart pumps blood to the body via blood vessels called arteries. Blood Pressure is the force that blood exerts on the walls of the arteries of the body.  There are two values in the blood pressure – the top number called systolic blood pressure (when the heart pumps blood) and the bottom number called diastolic blood pressure.

Blood Pressure is measured in mm Hg. The normal blood pressure is 120/80 or less.

What is High Blood pressure?

The High Blood pressure used to be defined as more than 140/80 but according to new guidelines published by the American Heart Association in November 2017, pressure over 130/80 is now considered as High Blood pressure.

Stages of Hypertension

• Normal BP: Less than 120/80 mm Hg.
• Elevated BP: Systolic between 120-139 and diastolic less than 80
• Stage 1:  Systolic between 130-139 or diastolic between 80-89
• Stage 2: Systolic at least 140 or diastolic at least 90

When Should I start getting BP checked?

USPTF (US Preventive Task Force) recommends BP check to start at age of 18 years.

• If you have risk factors for developing Hypertension, then BP should be checked at least once a year
• If No risk factors for hypertension, then every 3-5 years for adults between 18 and 40 years old.

Risk factors for Hypertension

Most of the time there is no single reason leading to Hypertension. There are several factors which increase the risk of Hypertension

• Older Age
• Family history of hypertension
• Sedentary Lifestyle
• Physical or mental stress
• High Salt Diet
• Smoking and Alcohol Intake
• Obesity
• Medical Diseases like Diabetes, Thyroid problems.
• Body Pain

Types of Hypertension

Essential Hypertension: When there is no underlying cause. This is the most common type.

Secondary Hypertension: When BP is high due to another medical problem like hormone imbalance, blockage in kidney arteries (Renal artery stenosis), etc.

Symptoms of Hypertension

Hypertension is also called silent Killer as it usually does not cause any symptoms. Some people may experience symptoms like

• Headache
• Shortness of Breath
• Leg swelling
• Blurry vision
• Dizziness

Complications of Untreated Hypertension

Hypertension is the leading cause of cardiovascular and kidney disease. The untreated blood pressure can damage several organs causing

• Heart Attack
• Congestive Heart Failure
• Stroke
• Kidney Failure
• Eye damage

Treatment for Hypertension

The first step in the treatment of High blood pressure is to make healthy lifestyle changes

• Regular Exercise: At least 30 minutes a day can drop pressure by an average of 5mm Hg
• Maintain normal weight
• Reducing salt and fat intake in the diet
• Quit Smoking and limit alcohol intake
• Stress reduction techniques

If Blood pressure remains high, then it will be treated with one or a combination of medications.

• Diuretics or Water pills: These medications work on kidneys and eliminate salt and water from the body. The common side affect is leg cramps due to low potassium in the body.
• Angiotensin-Converting Enzyme Inhibitors (Lisinopril, captopril, Ramipril): These medications also work on the kidneys. They block the action of angiotensin enzyme which causes high blood pressure by constricting arteries. They have a common side affect of cough.
• Angiotensin Receptor Blockers (losartan, valsartan, irbesartan): These medications also work on the kidneys and block angiotensin receptor.
• Calcium Channel Blockers: These agents reduce blood pressure by relaxing the arteries by reducing calcium in the blood vessels. They have a common side affect of leg swelling.
• Beta-blockers (Metoprolol, carvedilol, Bisoprolol): These medications slow down the heart and reduce the force with which the heart pumps blood. Their common side effect is fatigue.

There are other medications like clonidine, minoxidil, hydralazine used in case of resistant hypertension, and not responding to the above medications. You must follow up with your doctor regularly for the management of Hypertension.

Did you know that drinking sugary drinks can also greatly increase your chance of hypertension?

Resources:

• ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults. http://www.onlinejacc.org/content/early/2017/11/04/j.jacc.2017.11.006?_ga=2.191287850.1898908229.1521857607-1602986152.1521857607