HYPERTENSION
BY – OMKAR B. SHIVALKAR
HYPERTENSION
Hypertension (high blood pressure) is when the pressure in your blood vessels is
too high (140/90 mmHg or higher). It is common but can be serious if not
treated. People with high blood pressure may not feel symptoms. The only way
to know is to get your blood pressure checked.
Things that increase the risk of having high blood pressure include:
Older age
Genetics
Being overweight or obese
Not being physically active
High-salt diet
Drinking too much alcohol
Lifestyle changes like eating a healthier diet, quitting tobacco and being
more active can help lower blood pressure.
Some people may still need to take medicines.
Blood pressure is written as two numbers. The first (systolic) number
represents the pressure in blood vessels when the heart contracts or beats.
The second (diastolic) number represents the pressure in the vessels when the
heart rests between beats.
DIAGNOSIS
Hypertension is diagnosed if, when it is measured on two different days, the
systolic blood pressure readings on both days is ≥140 mmHg and/or the diastolic
blood pressure readings on both days is ≥90 mmHg.
The only way to detect hypertension is to have a health professional measure
blood pressure. Having blood pressure measured is quick and painless. Although
individuals can measure their own blood pressure using automated devices, an
evaluation by a health professional is important for assessment of risk and
associated conditions.
Risk Factors
Modifiable risk factors include unhealthy diets (excessive salt consumption, a
diet high in saturated fat and trans fats, low intake of fruits and vegetables),
physical inactivity, consumption of tobacco and alcohol, and being overweight
or obese.
Non-modifiable risk factors include a family history of hypertension, age over
65 years and co-existing diseases such as diabetes or kidney disease.
SYMPTOMS
Most people with hypertension don’t feel any symptoms.
Very high blood pressures can cause headaches, blurred vision, chest pain and
other symptoms. Checking your blood pressure is the best way to know if you
have high blood pressure.
If hypertension isn’t treated, it can cause other health conditions like kidney
disease, heart disease and stroke.
People with very high blood pressure (usually 180/120 or higher) can
experience symptoms including:
severe headaches , chest pain , dizziness, difficulty breathing , nausea,
vomiting, blurred vision or other vision changes, anxiety , confusion , buzzing in
the ears , nose bleeds , abnormal heart rhythm
If you are experiencing any of these symptoms and a high blood pressure, seek
care immediately.
KEY FACTS
An estimated 1.28 billion adults aged 30–79 years worldwide have
hypertension, most (two-thirds) living in low- and middle-income countriesAn
estimated 46% of adults with hypertension are unaware that they have the
condition.
Less than half of adults (42%) with hypertension are diagnosed and treated.
Approximately 1 in 5 adults (21%) with hypertension have it under control.
Hypertension is a major cause of premature death worldwide.
One of the global targets for noncommunicable diseases is to reduce the
prevalence of hypertension by 33% between 2010 and 2030.
Complications of Uncontrolled
Hypertension
Hypertension can cause serious damage to the heart. Excessive pressure can
harden arteries, decreasing the flow of blood and oxygen to the heart. This
elevated pressure and reduced blood flow can cause: Chest pain, also called
Angina; heart attack, which occurs when the blood supply to the heart is
blocked and heart muscle cells die from lack of oxygen.
The longer the blood flow is blocked, the greater the damage to the heart;
heart failure, which occurs when the heart cannot pump enough blood and
oxygen to other vital body organs; and irregular heart beat which can lead to
a sudden death.
Hypertension can also burst or block arteries that supply blood and oxygen to
the brain, causing a stroke.
In addition, hypertension can cause kidney damage, leading to kidney failure.
PREVENTIONS
Lifestyle changes can help lower high blood pressure and can help anyone
with hypertension. Many who make these changes will still need to take
medicine.
These lifestyle changes can help prevent and lower high blood pressure.
Reducing hypertension prevents heart attack, stroke and kidney damage, as
well as other health problems.
Reduce the risks of hypertension by: reducing and managing stress , regularly
checking blood pressure , treating high blood pressure , managing other
medical conditions.
DO DON’T
Eat more vegetables and fruits. Eat too much salty food (try to stay
under 2 grams per day)
Sit less. Eat foods high in saturated or trans
fats
Be more physically active, which can Smoke or use tobacco
include walking, running, swimming,
dancing or activities that build
strength, like lifting weights.
Get at least 150 minutes per week of Drink too much alcohol (1 drink daily
moderate-intensity aerobic activity max for women, 2 for men)
or 75 minutes per week of vigorous
aerobic activity
Do strength building exercises 2 or Miss or share medication.
more days each week. Lose weight if
you’re overweight or obese.
Take medicines as prescribed by your
health care professional. Keep
appointments with your health care
professional.
TREATMENT
Lifestyle changes can help lower high blood pressure.
These include: Eating a healthy
Low-salt diet
Losing weight
Being physically active
Quitting tobacco
If you have high blood pressure, your doctor may recommend one or more
medicines.
Your recommended blood pressure goal may depend on what other health
conditions you have.
Blood pressure goal is less than 130/80 if you have:
cardiovascular disease (heart disease or stroke)
diabetes (high blood sugar)
chronic kidney disease
high risk for cardiovascular disease.
For most people, the goal is to have a blood pressure less than 140/90.
There are several common blood pressure medicines:
1) ACE inhibitors including enalapril and lisinopril relax blood vessels and prevent
kidney damage.
2) Angiotensin-2 receptor blockers (ARBs) including losartan and telmisartan relax
blood vessels and prevent kidney damage.
3) Calcium channel blockers including amlodipine and felodipine relax blood
vessels.
4) Diuretics including hydrochlorothiazide and chlorthalidone eliminate extra
water from the body, lowering blood pressure.
Pharmacological Approach
2017 Guidelines given by American Heart
Association & American college of Cardiology
Blood pressure Systolic Diastolic Prevention or
category (mm of Hg) (mm of Hg) Treatment
NORMAL lower than 120 lower than 80 No need of
( 90 can be ) ( 60 can be ) medication
Stage 1 130 – 139 mm Hg 80 – 89 mm Hg 1)No need of
Hypertension medication
2) Diet modify :
Avoid salt diet
No smoking , no
alcohol
3)Daily exercise
4) Weight loss
Stage 2 140 and above 90 and above Common
Hypertension medication like
Telmisartan
Amlodipine
