Hypertension

Over a billion people around the world have hypertension, also known as high blood pressure. According to the World Health Organization’s (WHO) and Imperial College London’s joint press release, the number of adults having hypertension, between the ages of 30-79, has gone up from 650 million to 1.28 billion in the last thirty years.

This study was conducted by a global network of physicians and researchers during a specific period (1990-2019). It used the blood pressure measurements of over 100 million people aged 30-79 years and spanned across 184 countries (the most comprehensive review of global trends in hypertension). These numbers show that hypertension has to be dealt with with the utmost urgency.

What is Hypertension?

Hypertension is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. Hypertension is represented by two numbers. The top number is the systolic blood pressure, which is the arterial pressure when the heart is contracting, and the lower number is the diastolic blood pressure, which is the arterial pressure when the heart is relaxing.

Most of the time, the blood pressure is often measured in the brachial artery because if the pressure is high there, it means it is high throughout all the arteries. Normal systolic blood pressure is defined as <120mmHg and a normal diastolic pressure is <80mmHg. Stage 2 hypertension has systolic pressure at >140mmHg and >90mmHg on the diastolic side.

High blood pressure causes serious problems to the blood vessels. It causes wear and tear on the endothelial cells that line the inner side of the blood vessels. Under constant pressure, the blood vessels can develop tiny cracks and tears that can lead to dangerous issues like myocardial infarctions, aneurysms, and strokes.

Primary Hypertension: It is still unclear why and what causes the development of primary hypertension. Over a period of time, the pressure in the arteries silently creeps up.

Risk factors that may cause primary hypertension are:

• Old age
• Obesity
• Ingesting foods high in salt
• Inactive lifestyle

With the exception of age, all the other risk factors can be improved with lifestyle changes.

Secondary Hypertension: In about 10% of cases, a specific, identifiable underlying condition is causing hypertension (known here as secondary hypertension). Anything that limits the blood flow to the kidneys (renal blood flow) can cause hypertension and conditions like atherosclerosis, vasculitis, or aortic dissection.

Kidneys play an important role in blood flow regulation. When there is not enough blood flowing to the kidneys, the kidneys secrete the hormone renin which prompts the body to retain more water. This contributes to more fluids in the arteries — making them full and leading to higher pressures.

Other diseases have similar hypertension-inducing effects like fibromuscular dysplasia causes the walls of the large- and medium-sized arteries to thicken. If it involves the renal artery and limits blood flow to the kidneys, more renin is released leading to higher secondary hypertension. Another example is a tumor that produces aldosterone. This leads to fluid retention as well.

If the blood pressure gets high quickly, it is referred to as a hypertensive crisis. It involves a systolic pressure greater than 180mmHg or diastolic pressure greater than 120mmHg. Hypertensive crises can be split into two kinds:

• Hypertensive Urgency: There hasn’t been damaged to the end organs yet (brain, kidneys, heart, and lungs)
• Hypertensive Emergency: Damage has been done to the end organs

Who is at risk of getting hypertension?

Those that:

• Are overweight
• Eat too much salt and/or do not have enough fruits and vegetables in their diet
• Drink too much alcohol or caffeine-based drinks
• Are smokers
• Are over 65 years of age
• Experience insomnia/irregular sleep patterns

Symptoms of Hypertension

Primary hypertension does not present any symptoms hence, it is referred to as a “silent killer.” Secondary hypertension might involve a variety of symptoms associated with underlying causes. Hypertensive crises may involve symptoms like confusion, drowsiness, chest pain, and breathlessness.

Treatment of Hypertension

Lifestyle changes such as altering your diet, exercising regularly, and practicing stress reduction techniques are key.

There are a variety of antihypertensive medications that might be prescribed by your doctor in addition. Common blood pressure medicines include:

• ACE inhibitors (enalapril, ramipril)
• Calcium channel blockers (felodipine, nifedipine, verapamil)
• Diuretics (indapamide, bendroflumethiazide)
• Alpha-blockers (doxazosin)
• Angiotensin-2 receptor blockers (ARBs)  (olmesartan, losartan, candesartan)

Medication choice depends on blood pressure amount, age, and ethnicity.

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FAQ

1. What blood pressure measurement is said to be dangerous for your health? Ideal blood pressure is 120/80 mmHg and high blood pressure is diagnosed at or above 140/90mmHg. The higher the blood pressure, the higher the risk of illness later on.
2. Which number is most important, the top or the bottom? The top number is more important since it gives you a better idea of whether you are at risk of heart attack or stroke.

Healthier Me Today is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Never ignore professional medical advice in seeking treatment, always consult with your healthcare professional. Stay healthy!