What is Hypertension?

Hypertension, also called high blood pressure, is caused by the pressure due to excessive pumping of the heart. It is one of the leading causes of death in the world today. In addition to being a deadly condition, hypertension can also cause damage to vital organs like the liver, brains, kidneys and the heart. Unfortunately, people suffering from hypertension may not even be aware of that condition till it becomes too serious a problem. Blood pressure measure always has two readings, one taken when the heart is beating and the other when the heart is at rest. The normal values for these two readings are 140 and 90 respectively. In a long term it increases the risk of associated cardiovascular (heart) diseases such as stroke, myocardial infarction, failure of kidneys or heart, other vascular complications.

What are the blood pressure ranges?

Normal pressure of blood according to current guidelines is < 130 and < 85. In hypertension the treatment is influenced by the presence of other risk factors such as pre-existing heart diseases and diabetes.

A list of the hypertension ranges from normal to risk levels are given in the table below;

Category	Optimal	Normal	Borderline	Mild hypertension	Moderate Hypertension	Severe Hypertension	Isolated systolic hypertension
Systolic (mm Hg)	<120	<130	130-139	140-159	160-179	≥180	≥140
Diastolic (mm Hg)	<80	<85	85-89	90-99	100-109	≥110	<90

 

What is blood pressure?

The heart supplies oxygenated or pure blood to all parts of the body through the help of vessels called arteries. The force with which the blood pushes against the walls of the artery is known as BP.

The heart pumps blood into the arteries as it is beating. The pressure exerted on the artery walls when it is being filled with blood is known as systolic pressure and is 120 normally.

The heart relaxes between the beats or pumping the blood into the arteries. This is the time when the pressure falls and is known as diastolic pressure. The diastolic pressure is normally 80.

What causes hypertension?

Majority (about 95%) of patients have essential hypertension or primary hypertension. The main reasons behind this hypertension are known to be:

• Genetic factors: hypertension tends to run in families and children of hypertensive parents tend to have a greater tendency of hypertension
• Foetal factors: low birth weight is known to be associated with subsequent hypertension. This may be due to the fact that the foetus adapts to the intrauterine under nutrition and which may bring about long term changes in the blood vessels
• Obesity: fat people are at a greater risk of hypertension as compared with normal people. Fat or obese people also show abnormal sleep tendencies which may cause further complications of hypertension
• Alcohol intake: research has shown a close association between alcohol consumption and increased pressure
• Sodium intake (salt intake): a high sodium intake is a major factor in increased BP. A shift from rural to urban lifestyle is also associated with an increase in salt uptake and hence an increase in the risk of high BP
• Stress: acute pain or stress can rise blood pressure, but the role of chronic stress in hypertension is still unknown
• Smoking
• Ageing
• Vitamin D deficiency
• Changes in autonomic nervous system: the autonomic system is known to bring about indirect changes in the blood pressure levels
• Insulin resistance or Type II Diabetes: insulin resistance causes increased levels of insulin in blood, an intolerance of body towards glucose, decreased levels of high-density lipids and all this is known to cause an increased risk of cardiovascular diseases including hypertension

Remaining percentage of population has secondary hypertension which is caused as a result of underlying diseases. This is known as secondary hypertension and it has a cause which can be essentially treated. These are:

• Renal diseases such as diabetic nephropathy
• Hormonal disorders
• Cardiovascular diseases which are there by virtue of birth
• Use of drug e.g. oral contraceptive pills, steroids, NSAID’s, liquorice and vasopressin. These drugs may either cause hypertension or interfere in the action of drugs acting against hypertension
• Pregnancy: pregnancy induced hypertension is a disorder which goes after the delivery of the baby. Sometimes the hypertension is followed with an increased concentration of proteins in the urine. This condition is known as pre-eclampsia and may be fatal to the mother

What are the symptoms of hypertension?

Sometimes the person with high BP can go for years without showing any outwardly symptoms. Therefore, it is important that people go for regular check-ups to avoid complications later on. The symptoms if at all present are;

• Severe headache
• Fatigue
• Confusion
• Dizziness
• Nausea
• Visual problems
• Chest pain
• Breathing problem
• Irregular heartbeat
• Blood in the urine

What are the target organs affected?

The target organs that are prone to be damaged as a result of prehypertension and systemic hypertension are kidney, other cardiovascular organs, and brain & retina. Various diseases that can be caused as a result of chronic hypertension are chronic kidney disease, myocardial infarction, congestive heart failure, dementia, stroke, ventricular tachycardia and fibrillation.

What are the associated risks of Hypertension?

• Hypertension if left untreated for a period of time may start ruining the respective body from its root. Here root can be referred to heart and arteries. This further result in reduced blood supply to the bodily organs. Most of the time a part of heart become ischemic due to lack of oxygen. This causes death of that particular part and may result in Stroke or even heart attack
• Untreated or uncontrolled hypertension may damage the kidneys in future. This may result in failure of kidney
• The side effects or complications of Hypertension also includes optical nerve damage
• Insomnia is one among the associated complication of hypertension
• The person who has hypertension for a long period of time may feel debilitated and may experience loss of sexual orientation

As is always the case, prevention is better than cure. So, one must implement a regular exercise and controlled diet plan in order to lead a healthy and prosperous life.