Delving Into Hypertension

Hypertension (a.k.a. HPN, HTN, HBN) is having a blood pressure higher than normal standards. The American Heart Association classified hypertension basing on the arterial pressure reading of a sphygmomanometer.

Classification Systolic Diastolic
Normal 90-199mmHg 60-79 mmHg
Pre-hypertension 120-139 mmHg 80-89 mmHg
Stage 1 140-159 mmHg 90-99 mmHg
Stage 2 ≥160 mmHg ≥100 mmHg

Also known as the “silent killer” it is one of the major causes of mortality in the world. Attacks can come so suddenly without any warning and often times fatal. Understanding this disease is important so you will know of ways to prevent its onset or manage hypertension appropriately.

Classification

Medical professionals have categorized hypertension according to cause.

 Essential or Primary Hypertension: this type of hypertension is the most predominant type of hypertension. This is the type of hypertension where the underlying cause is not known and comprises about 90-95% of hypertensive cases.

 Secondary Hypertension: this is the type of hypertension caused by other medical conditions such as diabetes, pregnancy, adrenal tumors, and kidney disorder. Medications such as contraceptive pills and decongestants can also cause hypertension.
Risk Factors

There are certain conditions that can induce the onset of hypertension. Some risk factors can be controlled, and some cannot. It is better to know all of these factors so you can do necessary measures to prevent hypertension.

Uncontrollable Risk Factors

 Age: due to effects of ageing in the circulatory system, each person is at risk of developing hypertension.

 Race: Blacks are more at risk for developing hypertension.

 Family history: genetics also play a major role in the spread of hypertension. If your family has a history of hypertension, there is a chance that you will also suffer this condition eventually.
Modifiable Risk Factors

 Obesity: each pound of fat corresponds to a substantial lengthening of blood vessels. This would result in forcing your heart to increase its pumping pressure for blood to reach the other parts of the body.

 Stationary lifestyle: lack of adequate movement promotes venous stasis and also obesity. Lack of circulation can make your blood viscous, resulting in increased blood pressure.

 Smoking: nicotine is a potent vasoconstrictor. As a compensatory mechanism, your cardiovascular system will have to increase the blood pressue so that each part of the body will be supplied with blood.

 Too much salt and too little potassium: where there is salt, there is water. This would increase the blood volume and thereby increase blood pressure. Potassium controls the salt balance of the blood. Less potassium results in increased salt.

 Alcohol: this can cause your body to release certain hormones that promote increased blood pressure and heart rate.

 Stress: this can temporarily but gradually increase your blood pressure. The sympathetic response due to stress will always promote vasoconstriction, resulting to increased blood pressure.

 Other Medical Conditions: diabetes, pregnancy, high cholesterol level, and kidney disease are among the conditions that can cause hypertension. Before you address your hypertension, it is important that you correct the underlying problem.

Signs and Symptoms

The problem with mild to moderate essential hypertension is that it does not present any signs and symptoms. When it has reached its peak, an attack can manifest by:

 Headache: usually located in the occipital area, it is one of the classic signs of hypertensive attack.

 Altered level of consciousness: an attack can render a person confused, irritated, and even sleepy. It is important that a person having an attack must not lie down flat or sleep on it. As much as possible, calm the person. Avoid too much stimulation and place him in a calm, quiet, and dimly lit environment where you can also observe him. Place two are three pillows behind his head to prevent too much pressure from going into his brain. A hypertensive attack can lead to stroke so make sure that you stay with a person during this period.

 Visual disturbances: Auras, flashes of light and blurred vision are sometimes prelude to an attack. This is due to the pressure affecting the blood vessels of the eye.

 Nausea and vomiting.

 Hypertensive retinopathy: chronic hypertension can cause damage to the retina. This is seen as formation of exudates, hemorrhage, and papilledema (optic nerve swelling).

Treatment

There are several medical treatments available for managing hypertension.

1) Thiazide diuretics: commonly called “water pills” this medication effectively lowers blood pressure by inducing you to continually urinate. The more you urinate, the more water you lose from your circulator system. This in turn lowers blood volume, thereby effectively decreasing your blood pressure.

2) Beta blockers: this medication is often combined with a diuretic. This medication lowers blood pressure by lessening the workload and pumping action of the heart.

3) Angiotensin-converting enzyme (ACE) inhibitors – this medication works by blocking enzymes that cause constriction of blood vessels. A dilated vessel can lessen the pressure of blood in the arteries for the blood and freely flow through the lumen.

4) Calcium channel blockers – this works in the same principle as ACE inhibitors, but much more concerned in blocking calcium in the vascular muscles. Calcium is responsible for muscular contraction. If this electrolyte or mineral is blocked, the arterial muscles will not constrict but will dilate, letting blood flow freely.

Lifestyle Modification

Once you diagnosed with hypertension, your medication may not be enough to lower your blood pressure. As much as possible, you must avoid as many of the modifiable risk factors as you can. You have to lessen or quit smoking and drinking alcohol gradually and surely. Your diet must consist of low salt and low fat diet. Try to modify your diet to lower your cholesterol and calorie intake, and incorporate fiber as much as possible.

Fiber helps flush out any unwanted low density lipoproteins in your digestive system, preventing it from entering your blood stream and clogging your arteries. Get as much exercise as you can, but do not do too much especially during hypertensive attacks. Talk to your doctor and fitness trainer about the level of exercise that is ideal for your blood pressure.

Maintain your regular check up with your doctor and you must be vigilant in measuring and recording your blood pressure at least twice daily. Ideally, the best way to measure your blood pressure is once before getting up, and 30 minutes after taking your medication. This way, you and your doctor will know if the medication is working for you, or if changes have to be made. If you experience any unwanted side effects such as headache, dizziness, nausea, vomiting, and any allergic reactions while taking your medication, contact your physician immediately.

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