High Blood Pressure : Symptoms, Causes, And Treatment

Image : Blood pressure Monitor 

             

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Hypertension (high blood pressure) is one of the most widely spread modern diseases and one of the leading risk factors for heart and blood vessel diseases, particularly stroke and coronary heart disease. The prevalence of hypertension is about 25% in adults.

Blood pressure is the pressure, measured in millimeters of mercury, within the major arterial system of the body.

It is conventionally separated into systolic and diastolic determinations. Systolic pressure is the maximum blood pressure during contraction of the ventricles; diastolic pressure is the minimum pressure recorded just before the next contraction.

The blood pressure is usually written as the systolic pressure over the diastolic pressure (e.g., 120/80 mm Hg).

What is High Blood Pressure ?

High blood pressure (also referred to as HBP, or hypertension) is when your blood pressure, the force of blood flowing through your blood vessels, is consistently too high.

Table above : Blood Pressure level

High blood pressure Symptoms ?

If you are looking for a list of symptoms and signs of high blood pressure (HBP or hypertension), you won’t find them here. This is because most of the time, there are none, “silent killer” Only if it is extremely high can it result in symptoms like dizziness or vision problems.

What are the risks of High blood pressure?

Hypertension is one of the main risk factors for cardiovascular and cerebrovascular events and one of the main causes of death and disability in developed countries. The possible long-term effects of high blood pressure include the following:

• Poor blood circulation in the legs (PAD)
• Weak heart (myocardial insufficiency, heart failure)
• Heart attack
• Stroke
•  Damage to the kidneys
•  Damage to the Eye

Treatment can lower the risk of developing these kinds of problems.

What are the causes of high blood pressure?

Our bodies can regulate blood pressure as needed. It's typically low when we relax or sleep. It increases when, for example, we do hard physical work and our muscles need more blood. Stress or fear can also cause your blood pressure to go up.

So it's normal for blood pressure readings to vary; that's just a sign of an active life. But if blood pressure is too high for too long, it can damage blood vessels over time and increase the risk of various health problems.

Often no specific cause is found for high blood pressure. Then doctors call it "essential" or "primary" hypertension.

Being overweight, eating a lot of salt, drinking too much alcohol and not getting enough exercise can increase your blood pressure. But any person may also develop high blood pressure – for example, because it runs in their family.

An exact cause is only found in 5 out of 100 people. When the cause is known, doctors refer to it as "secondary" hypertension.


The ABCDE mnemonic can be used to help determine a secondary cause of hypertension :

A.  Accuracy of diagnosis, obstructive sleep Apnea, Aldosteronism,
B.  Bad kidneys (renal parenchymal disease )
C.  excess Catecholamines, Coarctation of the aorta, Cushing's syndrome,
D.  Drugs, Diet,
E. excess Erythropoietin, and Endocrine disorders.

An algorithm showing the general strategy to help screen for factors involved in secondary hypertension is presented. Routine urinalysis, complete blood cell count, blood chemistry profile (potassium, sodium, creatinine, fasting glucose, fasting lipid levels), and a 12-lead electrocardiogram are recommended for all patients with hypertension.

Any treatment for High blood pressure ?

The goal of hypertension treatment is to reduce BP to <140/90 mm Hg; however, in patients with hypertension and diabetes or renal disease, the BP goal is even lower, targeted at ≤130/80 mm Hg. Nonpharmacologic interventions should be instituted in all patients with hypertension.

When used early, lifestyle modifications can decrease other disease risks and may avoid the need for drug therapy. Maintaining a healthy lifestyle, however, is not sufficient or is difficult to comply with, and most patients will require pharmacologic interventions to control their BP.

1) Lifestyle Modifications

These modifications include : weight loss, reduced sodium intake, physical activity, limiting alcohol consumption, and eating plan.

2) Pharmacotherapy

Drug therapy is needed if lifestyle modifications cannot adequately bring BP to the goal. First-line medications used in the treatment of hypertension include diuretics, angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs), beta-blockers, and calcium channel blockers (CCBs). Some patients will require 2 or more antihypertensive medications to achieve their BP target.

Hypertension is a significant and costly public problem. It is a major, but modifiable contributor for the development of cardiovascular disease.

Written By Dr. Zenasni O.
Medical Doctor, 
Emergency Service