Hypertension or high blood pressure

What is hypertension?

Hypertension is a condition when blood pressure remains above normal values.

What is blood pressure?

It is the pressure of our blood as it moves inside our arteries. The heart pumps blood through our arteries in a cycle that alternates cardiac contractions (systole), which pumps the blood forward, and relaxation periods of the cardiac muscle (diastole). This cycle is repeated from 70 to 90 times per minute under normal conditions. The number of cycles per minute is called the heart rate. Blood is pumped from the heart into the arteries and is distributed throughout the body. This “tidal” blood is perceived as a pulse. There is a range of pressure levels inside arteries. The maximum value is produced at the moment the artery is less filled with blood and corresponds to what we know as diastole; this is called diastolic or minimum blood pressure. Blood pressure also depends on other factors including the amount of blood pumped by the heart, the diameter of the arteries, and the condition of the arteries.

Measuring blood pressure.

Normal values. Blood pressure, which is typically measured by physicians by placing a small hose or blood pressure cuff around the arm, is expressed in millimeters of mercury (mm Hg). In normal adults, these values should be lower than or equal to 139 for systolic pressure and 89 for diastolic pressure. However if a patient has values above these mentioned on one occasion, it does not necessarily mean they have hypertension. Emotional, psychological or certainly physical agitation can produce a higher reading. In order to accurately diagnose high blood pressure, physicians need to measure a patient’s blood pressure after 5 to 10 minutes of physical rest with the patient as calm as possible. Measurements should be taken in both arms and with the patient both sitting down and lying down. Blood pressure measurements should be conducted at least three times, on two different occasions. While the maximum healthy blood pressure is at 139/89 mm Hg, it is best if the patient to has values that are lower than these. Blood pressure for an adult is considered to be optimal when it is below 120/80 mm Hg, normal when it is below 130/85 mm Hg and high normal when it is between 130-139 mm Hg for systolic pressure and 85-89 mm Hg for diastolic pressure.

Fundoscopy.

This is an examination that allows the doctor to see the blood vessels of the eye. The condition of the ocular blood vessels is a good indication of the overall condition of a patient’s smaller blood vessels. The fundoscopy does not diagnose hypertension, but rather evaluates what effect if any hypertension has had on the vascular bed.

Hypertension as a condition.

High blood pressure should be considered not only as a condition in itself, but also as an indicator about the likely future development of cardiovascular, cerebrovascular and kidney disease. Values above normal ones, even if they barely exceed them, reduce the life expectancy of people of both sexes and across all ages.

Types of hypertension

There are two types of hypertension: essential hypertension and secondary hypertension.

Essential blood pressure.

Also known as primary or idiopathic hypertension. Its cause is unknown. It is the most frequent of all types of hypertension (95% of people suffering from hypertension show essential hypertension). Factors which predispose people to develop primary hypertension include: age, obesity, cigarette smoking, alcohol, excessive consumption of sodium as well as genetic and personality factors (aggressiveness and hyperactivity favor hypertension). There are also environmental factors that have a bearing upon hypertension: a high stress environment increases the risk of suffering from high blood pressure. A particular type of essential hypertension is known as malign hypertension. The blood pressure of patients with malign hypertension is very high and can easily reach diastolic values ranging from 130 to 170 mm Hg.

Secondary hypertension.

In secondary hypertension, hypertension is the result of another preexisting disease. These diseases can include: kidney disorders (vascular or pertaining to the kidney itself), a disease of the adrenal glands, or atherosclerosis and coarctation of the aorta (the aorta is the artery that leaves the heart directly and distributes blood to the rest of the body; coarctation means that there is a narrowing of the artery).

Complications

Hypertension that is not treated leads to complications in different organs. There is a direct correlation between hypertension and atherosclerosis: hypertension accelerates the course of atherosclerosis. Atherosclerosis is a condition of the walls of the arteries which get narrowed down due to fat deposits and a hardening of the artery wall.

Complications that can occur due to hypertension are: hypertensive cardiac disease, coronary failure, congestive heart failure, vascular damage, aortic dissection, kidney damage and even kidney failure, acute stroke, brain damage and loss of vision.

Treatment

Although essential hypertension has no definite cure, proper treatment and control of the condition greatly improve the patient’s quality of life and stave off many of the conditions we discussed above. The treatment for essential hypertension is made up of two parts: health and diet measures and pharmacological treatment.

Health and diet measures.

In hypertension grade 1, the following measures may return a person’s blood pressure to normal levels:

  1. Stopping smoking.
  2. Additional rest, maintaining a healthy body weight, restriction of sodium intake and alcohol consumption, and moderate exercise.

If hypertension is controlled by these measures, the patient should continue to follow their health regime indefinitely. If these measures are not enough, then your doctor will consider a pharmacological treatment plan.

Pharmacological treatment.

There are several drugs that are used to treat high blood pressure. Your physician will prescribe the appropriate medicine based on your individual situation.