Everything You Want To Know About Hypertension

Hypertension is a health condition in which pressure against the walls of blood vessels increases to an abnormal level causing wear and tear of the body in the long run. This leads to higher-than-normal blood pressure; hence, hypertension is often referred to as high blood pressure commonly. The long-term effects of unmanaged hypertension can be life threatening. Chronic hypertension can go unnoticed until the damage is severe and can ultimately lead to strokes, heart attacks, and heart as well as kidney failure. Due to this, hypertension is sometimes called a silent killer.

Usually, people with hypertension don’t realise they have this condition as there are no tell-tell signs or symptoms, but it is quite common. According to World Health Organization, one in four adults of India is estimated to have hypertension; despite being so common, only 12% of the population have their blood pressure under control.

Let’s explore the different types of hypertension and the symptoms, causes, and treatment of hypertension along with the ways to manage the condition.

Types of hypertension

Hypertension can be divided into two major categories based on its cause.

1. Primary (or essential) high blood pressure
   When you develop hypertension due to old age and/or unhealthy lifestyle habits (such as poor diet or lack of physical activity), your doctor can diagnose you with primary high blood pressure.
2. Secondary high blood pressure
   When another medical condition (such as health problems involving kidneys and hormonal imbalance) or a particular medication causes your blood pressure to rise above the normal levels for a long period of time, you may develop secondary high blood pressure.

Apart from this classification, blood pressure can be divided into four categories on the basis of severity.

1. Normal blood pressure—between 90/60 mm Hg and 120/80 mm Hg
2. Elevated blood pressure—between 120 mm Hg and 129 mm Hg for the systolic range and lower than 80 mm Hg for the diastolic range
3. Stage 1 hypertension (considered mild)—between 130/80 mm Hg and 139/89 mm
4. Stage 2 hypertension—between 140/90 mm Hg and 179/119 mm Hg

Although rare, sometimes high blood pressure can occur just by getting a health check-up—white coat hypertension.

Please note that blood pressure above 180/120 mm Hg is a severe condition and is considered a hypertensive emergency; this condition requires immediate medical attention.

Risk factors of hypertension

The following factors increase the risk of people to develop hypertension:

1. Old age
2. Family’s medical history with hypertension
3. Obesity
4. Lack of physical activity
5. Consumption of tobacco or its products
6. Alcohol consumption
7. Diet with excessive salt
8. Potassium deficiency
9. Stress
10. Certain chronic conditions including diabetes, sleep apnoea, and kidney ailments
11. Pregnancy

Hypertension Symptoms

Although people often don’t experience any symptoms of hypertension, here are some of the common symptoms that can hint at a high blood pressure:

1. Headaches
2. Shortness of breath
3. Nosebleeds
4. Abdominal pain (in women)

A person who has a dangerously high blood pressure may additionally experience some of the following symptoms.

1. Headache (often referred as the hypertension headache)
2. Nausea and dizziness
3. Vomiting
4. Blurred or double vision
5.  Heart palpitations

Hypertension Diagnosis

Since hypertension cannot be identified with symptoms, regular blood pressure screening is crucial in diagnosing the condition. Depending on your age and overall health, you can get your BP checked during your regular health check-up. People above the age of 18 years can get their blood pressure checked once every two years, and people who are above 40 years or fall under the high-risk category should bet it checked every year. If your blood pressure is consistently at the elevated levels, your doctor might recommend slight changes to your regular diet and lifestyle.

If you have a history of hypertension, you are recommended to get an automated blood pressure monito and learn how to use it to monitor your BP.

Hypertension Causes

Hypertension or high blood pressure usually develops over time in majority of cases; however, unhealthy lifestyle, nutrition deficit diet, and lack of physical activity are some of the reasons for high BP. Additionally, conditions like diabetes, obesity, and atherosclerosis (plaque build-up in the arteries), also increase the risk of a person developing hypertension.

Primary hypertension (or essential hypertension) does not have an identifiable cause for most adults. This condition develops gradually over many years. On the other hand, secondary hypertension appears suddenly and leads to higher BP than primary hypertension does. Usually, secondary hypertension is results from an underlying condition and/or certain medicines, including:

Diseases

1. Adrenal gland tumours
2. Congenital (from birth) heart defects
3. Kidney disease
4. Obstructive sleep apnoea
5. Thyroid ailments
6. Type 2 diabetes
7. Lupus (autoimmune disease that causes damage to the body’s tissues and organs)

Medicines

1. Cough and cold medicines
2. Certain pain relievers
3. Birth control pills
4. Illegal drugs (such as cocaine and amphetamines)

Hypertension Treatment

There is no cure available for hypertension as of yet, but the condition can be managed to reduce the risk of complications with the help of first-line drugs. Here’s a list of commonly prescribed medication for hypertension that are most effective in treating the condition.

1. Angiotensin-converting enzyme (ACE) inhibitors
   These are used to block the production of angiotensin II hormone (synthesised by the body to constrict small arteries and increase blood pressure). Some examples of these drugs include lisinopril, captopril, and enalapril.
2. Angiotensin II receptor blockers (ARBs)
   These are used to block blood vessels from receiving angiotensin II hormone. The end result of these medicines is similar to that of ACE inhibitors—to stop the narrowing of blood vessels. Some example of this drug include metoprolol, Losartan, and Vallarta.
3. Calcium channel blockers
   These work by preventing calcium from entering the cells of your blood vessels and the muscles of the heart and allowing them to relax. Examples include nifedipine and ditiazem.
4. Diuretics
   Diuretics, also known as water/fluid pills, flush excess sodium from the body and consequently reduce fluid amount in the body (and blood). This reduces the fluid flowing through the blood vessels and lowers blood pressure. Examples of this drug include indapamide, chlorothiazide, and hydrochlorothiazide.

Please note that these examples are for informative purposes only, and you should always consult a doctor before starting/stopping any medication. Also, there are some medicines that should be avoided during pregnancy. If you get side effects that concern you, call your healthcare provider. They may change your dose or recommend a different medication.

Hypertension Prevention

You can lower the risk of getting hypertension by practicing the following measures.

1. Eat right: Paying close attention to what and how much you eat can be a game changer for your health. The Dietary Approaches to Stop Hypertension (DASH diet), for example, work well in preventing (and managing) hypertension. In the DASH diet, the intake of fruits, vegetables, and whole grains is increased, and consequently, the amount of sodium is limited. Since high sodium intake increases water retention in your body, reducing the amount of salt you consume can help lower the risk of developing hypertension in a long run. According to WHO, a person should consume less than 5 grams salt per day to maintain a healthy blood pressure.
2. Maintain a healthy weight: Being obese or overweight increases your blood pressure; thus, you must aim to stay in a healthy weight range according to your body mass index (BMI).
3. Include regular exercise in your routine: There are numerous benefits of exercising regularly, including a strong heart, which can pump blood relatively easily and reduce force on the arterial walls. You can enjoy the benefits of regular physical activities with basic exercises (such as walking).
4. Practice moderation in alcohol consumption: Excessive alcohol consumption can raise blood pressure to unhealthy levels in a short time span and cause hypertension in the long run.

Complications related to hypertension

If left untreated, hypertension can cause damage to the blood vessels, causing them to harden. This can further lead to health complications (some of them can be life-threatening), such as:

1. Heart attack
2. Stroke
3. Aneurysm (bulges in weakened blood vessels)
4. Heart failure
5. Kidney damage
6. Vision loss
7. Metabolic syndrome (a group of disorders disturbing the body’s metabolism)
8. Decline in cognitive abilities affecting a person’s ability to think, learn, and remember
9. Vascular dementia

Managing hypertension

If you have been diagnosed with hypertension, your doctor will likely recommend diet and lifestyle changes to help you manage the condition in the beginning. These changes may include the following:

1. Monitoring your blood pressure regularly at home with the help of manual or automatic devices, which are easily available at pharmacies, surgical stores, and even online
2. Eating a healthy diet rich in nutrition and low in salt
3. Maintaining a healthy body weight and exercise regularly
4. Abstaining from consuming tobacco or its products including smoking
5. Regulating stress and working on anger management if needed
6. Using herbs and spices to enhance flavours of the food and cutting down on salt intake, and terminating the habit of keeping salt at the dining table

Depending on your health, your healthcare provider might recommend potassium supplements in your diet.

Regular exercise plays an important role in regulating your blood pressure levels, but excess physical activity can also be counterproductive and increase your risk of heart attacks. It is better to check with your doctor before increasing physical activity (such as participating in a marathon) or starting a new routine (such as high intensity training). General aerobic activities such as walking, biking, or swimming are usually non-problematic, but it is better to consult with your doctor about these in your regular doctor visits.

Although lifestyle changes help individuals manage hypertension better, they may not work for some people. In such cases your doctor may prescribe dedicated medications to help you lower your blood pressure. First-line medicines mentioned in the “treatment” section can be coupled with other medication by your doctor to reduce blood pressure. Make sure you follow the prescription exactly and don’t alter the dosage without doctor’s consultation.

Living with hypertension

Many individuals with hypertension may not realise they have the disease as high blood pressure itself doesn’t cause evident symptoms. It is usually diagnosed in old age, during a routine general physician visit or along with some other condition. If you have primary hypertension, you will need to manage it regularly as there is no cure for the condition.

People who have secondary high blood pressure (caused by a different disease) will be able to get back to their normal life with slight adjustments after addressing the main cause. Leading a healthy lifestyle can also prevent hypertension, but you need to take extra care if you already have another ailment as you can get seriously ill with some changes that may hamper your main condition. Following your doctor’s advise and monitoring your blood pressure will suffice, but you should also pay attention to additional symptoms as they surface.