WHAT IS HYPERTENSION (HTN)?
When blood pressure is increased to the point where lowering it would be beneficial, the condition is known as hypertension. Blood pressure levels do not clearly distinguish between those with normal and those with hypertension. The degree to which blood pressure is raised affects the likelihood of problems. According to the World Health Organization, hypertension is one of the major avoidable causes of early morbidity and mortality. Blood pressure measurement includes systolic and diastolic components.
Causes or etiology of HTN?
- Primary hypertension is also called Essential hypertension. 90–95% of hypertensive patients have primary HTN, but its actual cause is still unknown.
- Secondary hypertension (5–10%)
- Renal diseases
- Endocrine diseases
- Steroid excess: hyperaldosteronism (Conn’s syndrome); hyperglucocorticoidism (Cushing’s syndrome)
- Growth hormone excess: acromegaly
- Catecholamine excess: phaeochromocytoma
- Others: pre-eclampsia
- Vascular causes – Renal artery stenosis: fibromuscular hyperplasia; renal artery atheroma; coarctation of the aorta
- Drugs
- Sympathomimetic amines
- Oestrogens (e.g. combined oral contraceptive pills)
- Ciclosporin
- Erythropoietin
- NSAIDs
- Steroids
Complications of hypertension
- Myocardial infarction
- Stroke
- Cerebral/brainstem infarction
- Cerebral haemorrhage
- Lacunar syndromes
- Multi-infarct disease
- Hypertensive encephalopathy/malignant hypertension
- Dissecting aortic aneurysm
- Hypertensive nephrosclerosis
- Peripheral vascular disease
SYMPTOMS
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
- nosebleeds
- abnormal heart rhythm
Diagnosis
High blood pressure (hypertension) is diagnosed if the blood pressure reading persistently is equal to or greater than 130/80 millimetres of mercury (mm Hg).
BP is checked via a sphygmomanometer and stethoscope.
Treatment or management of hypertension :
For Blood pressure control, there are two different approaches: the first is Non-pharmacological or modifications to lifestyle, and the second is pharmacological or drug therapy.
A- Non-pharmacological Management
- A low sodium intake lowers the amount of sodium in your diet to 2300 milligrams (mg) daily. Lowering sodium to 1500 mg a day reduces BP even more.
- Diet includes more proteins since it includes poultry and fish and emphasises the consumption of free‐ or low‐fat dairy products (two or three servings per day).
- Concerning dairy products, in particular, the addition of conventional non‐fat dairy products to the routine diet has hypotensive effects.
- Intermittent Fasting is another method that can be implemented easily by the patients.
- Adults should practice moderate to vigorous aerobic physical activity at least 4 times per week for an average of 40 minutes per session to lower BP
- Tobacco cessation :
- Tobacco causes an immediate increase in sympathetic nervous activity, which in turn increases myocardial oxygen demand through increased BP, heart rate, and myocardial contractility
- Dietary supplement
- Garlic, as a dietary supplement, can lower BP.
- Cocoa has also shown a small but statistically significant BP‐lowering effect.
- Vitamin C, coenzyme Q10, omega‐3 fatty acids, and magnesium have been used for lowering BP, but there is very little evidence to support their use in the management of hypertension.
