What exactly is high blood pressure? 

High blood pressure or hypertension, occurs when the blood pressure goes up to levels which are termed unhealthy by medical practitioners. Blood pressure measurements consider the levels of blood passing through the blood vessels, and also the resistance that your blood meets while your heart is pumping.  Blood pressure is termed primary or essential when there are no apparent causes for it, as occurs in large majority of adults; and secondary when it is associated with an underlying disease as occurs in chronic kidney diseases.
Here are some key factors that you should take into account while learning more about high blood pressure: 

  • The narrower your arteries, the higher the blood pressure since resistance will be higher because of it. In the long haul, a higher pressure may lead to several issues with your health which includes heart ailments/diseases
  • Hypertension is a common ailment; in fact, it is one of the most typical diseases there could be. As per recent reports, around 30% of citizens in India are expected to be diagnosed with hypertension
  • Hypertension usually forms throughout many years. Symptoms are usually not visible in most cases. However, high blood pressure may lead to more severe damages for the organs and blood vessels, particularly the heart, brain, kidneys and eyes. 
  • Detection of the same at a very early stage is quite essential. Regular readings of blood pressure will enable you and the doctor to track any such vital changes. In case of high blood pressure, the doctor tells you to check it over the period of some weeks. This is to ascertain whether the number stays high or comes back to normal thresholds in that stipulated time.
  • Hypertension treatments cover changes which foster healthier lifestyles. In case, the condition stays untreated, it may spur health problems like strokes and heart attacks.

Workings of the circulatory system and blood pressure

For normal functioning and survival of your body, the organs and tissues require blood. Blood is carried throughout your body via the circulatory system. Whenever your heart beats, it leads to pressure creation that directly pushes blood via a network of multiple blood vessels. The blood vessels are tube-shaped and include veins, arteries and capillaries. Typically blood pressure refers to the pressure of blood in major arteries. The blood pressure comes from two forces, namely systolic pressure and diastolic pressure. Systolic pressure occurs when blood is pumped out from the heart and into the arteries, the major component of your circulatory system. The second force is diastolic pressure, which occurs when the heart is relaxing in between heartbeats. These are measured in blood pressure readings and expressed in milimeters of mercury (mm Hg) with reference to the practice of measuring the pressure through the blood pressure machine (also called a sphygmomanometer) against a column of mercury.
Here are some key aspects worth noting in this regard: 

  • Damages usually start with the heart and arteries. 
  • Blood pressure usually harms you since it makes the overall workload go up considerably for your blood vessels and heart, leading to lesser efficiency in the body. 
  • With time, the high blood pressure forces and overall friction lead to damages of the delicate tissues placed within the arteries. Deposition of bad cholesterol within the arteries leads to plaque formation through miniscule tears on artery walls, thereby inducing hardening of arteries termed as atherosclerosis. The larger the plaque and overall damage, the smaller/narrower will the artery interiors become, leading to higher blood pressure and greater damage of your heart and arteries. This may lead to heart attacks, strokes and arrhythmia (irregular beating of heart). 
  • Blood pressure problems may not always come with immediate symptoms, but quietly, they may harm your heart and overall health. 

How to decode blood pressure figures 

  • Normal- Systolic BP of 110 – 130 mm Hg / Diastolic BP of 70 – 90 mmHg is termed as normal 
  • If your systolic BP is in excess of 130 mm Hg and diastolic BP in excess of 90 mm Hg in 3 consecutive readings, then consult a physician for further evaluation and management
  • • Hypertensive Crisis (immediate doctor’s consultation) – systolic BP more than 180/ Diastolic BP more than 120.  Understanding these readings- 
  • Systolic pressure- This is the upper number which indicates the arterial pressure when your heart beats and the blood is pumped out. 
  • Diastolic pressure- This is the lower number which indicates pressure readings in the arteries between heartbeats. 
  • A blood pressure cuff is used for taking these readings. For more accuracy, you should have one that fits perfectly. A arm band which does not fit suitably may lead to results being inaccurate. 
  • Blood pressure readings can differ in the case of teenagers and children. The healthy range for a child should be ascertained from the doctor in case you have to track the blood pressure levels. 

Types:

Primary Hypertension- This is also known as essential hypertension. This type is developed with time, and there is no particular identifiable cause towards it. Most people suffer from this kind of high blood pressure. 
Reasons for primary hypertension may include the following: 

  •  Genetic factors- Many people have a genetic predisposition towards hypertension. This may result from genetic mutations/abnormalities which you have inherited from your parents/family members. 
  •  Physical factors- Body changes may lead to issues like high blood pressure. Any changes in the functioning of kidneys on account of ageing may lead to disruption in the natural salt and fluid balance of the body, thereby leading to higher blood pressure. 
  •  Environmental aspects- With time, unhealthy choices in terms of one’s lifestyle, such as no physical activity and a poor diet plan may lead to the body becoming overworked. Lifestyle aspects may lead to weight gain. Obesity can increase hypertension risk factors. 
  • Smoking has been shown to be associated with Hypertension Secondary Hypertension- This usually happens fast and can be more severe as compared to primary hypertension. There are many reasons for the same: 
  •  Kidney ailments
  • Obstructive sleep apnea 
  •  Thyroid problems
  •  Congenital heart issues
  • Medication side effects 
  • Adrenal gland issues 
  •  Specific endocrine tumours

Complications of Hypertension:


Prolonged hypertension may lead to the following problems over a period of time

1. Hypertensive Heart Disease :
a. Increase in size of the heart, particularly the left side (left ventricular hypertrophy) ;eading to heart failure
b. Heart attacks
c. Disturbances of heart rhythm: Cardiac Arrythmia
2. Hyepertensive brain disease: Stroke due to bleeding inside the brain
3. Hypertensive eye disease
4. Hypertensive chronic kidney disease : May lead to end stage kidney disease requiring continuous dialysis and kidney transplantation


Diagnosis of high blood pressure 

The most accurate method to diagnose high blood pressure is measuring blood pressure manually through a mercury sphygmomanometer. It can also be measured with an electronic digital machine t. 

  • A pressure cuff is used for taking the blood pressure reading which is tightly applied around the arm before inflating it manually/electronically
  • Upon inflation, the cuff leads to compression of the brachial artery, stopping blood flow for a moment. 
  • After that, the air in the cuff is released slowly while the individual taking the measurement tracks the electronic readout or listens via a stethoscope. 

In case the blood pressure reading is regular, you should keep checking blood pressure on a yearly basis, in case you are 20 years or older. In case you have high blood pressure, the doctor may recommend periodic tracking of the numbers at home along with regular visits. A treatment plan will also be provided, which will have prescription medicines, if required, and other changes in your lifestyle. 

Symptoms of Hypertension  

Hypertension is usually labelled as a silent killer, and hence, there may not be any symptoms experienced by most individuals. It may take years or even decades of time before you realize that you have a blood pressure ailment. However, symptoms are as follows:

  • Shortness of breath
  • Headaches
  • Dizziness
  • Flushing
  • Nose bleeds
  • Chest Pain 
  • Blood in Urine
  • Visual Changes 

Medical attention is required immediately after such symptoms surface. They do not show in all the people with hypertension, although waiting for such a condition to occur may be fatal. The best way to learn about hypertension is to take regular blood pressure readings. Most doctors take blood pressure readings at each appointment. In case you get medical check-up done once a year, have a talk with your doctor concerning hypertension risks and other things that you should watch out for. 
For instance, if you already have a history of heart diseases in the family or any other risk factors worth worrying about, your doctor may prescribe you to check blood pressure twice every year. This will help you stay aware of any issues in the reckoning before they balloon up to unmanageable levels. 

High blood pressure Management 

Your doctor can work out the best possible treatment choices for your needs based on several aspects like the type and causes of hypertension.  In the case of primary hypertension, the doctor will recommend minor changes to your lifestyle for lowering high blood pressure. If these are not enough when it comes to lowering blood pressure, you will require medication alongside. There are treatment choices available for secondary hypertension. In case the doctor finds out any underlying aspect leading to hypertension, the treatment will emphasize on this above everything else. For instance, in case you have started taking a medicine which is leading to higher blood pressure, other options will be tried by the doctor to minimize such side effects. In some cases, hypertension is a persistent issue in spite of the treatment being provided for the major cause. Your doctor will be working in tandem with you in changing lifestyle factors, and prescribe you medicine for lowering blood pressure. Treatment plans for hypertension evolve periodically. What was useful earlier may not be so in contemporary times. 

Medicines for HBP

There are several trial and error stages that you might encounter in terms of trying medication for blood pressure. Some of the medicines that are used for treatment by doctors usually include following: 

  • Diuretics- Diuretics help your kidney remove any extra sodium from the body. With the exit of excess sodium, the additional fluids in the bloodstream come into the urine, reducing blood pressure, as a result. 
  • Beta-blockers- These help your heart beat slower and with lower force, thereby lowering the blood amount that is pumped via the arteries with every beat. This reduces blood pressure considerably while blocking specific hormones present in the body which have the potential to elevate blood pressure. 
  • ACE inhibitors- The narrowing and tightening of artery walls and blood vessels is caused by Angiotensin . ACE Inhibito or angiotensin converting enzyme inhibitors prevent the human body from higher production of Angiotensin chemical. This enables blood vessels to attain higher relaxation and lowering of blood pressure. 
  • Calcium channel blockers- These specific medications enable blocking calcium from coming into your heart’s cardiac muscles. This leads to heartbeats of lesser force and reduced blood pressure. These medicines also work to relax the blood vessels and reduce pressure. 
  • ARBs (Angiotensin II receptor blockers)- ARBs block the angiotensin from binding within receptors. Blood vessels will not witness any tightening minus the chemical. This will relax the blood vessels and reduce overall blood pressure. 
  • Alpha-2 agonists- This kind of medication changes impulses of the nerves which leads to tightening of the blood vessels. This enables relaxation of blood vessels and reduction of blood pressure.  The doctor will take into account your age, duration of the disease and existing co-morbidities (especially diabetes or any other heart disease) to prescribe suitable medications. The combination and dosage may be adjusted over a period of time depending on the control and tolerance.


Disclaimer : The details provided herein is meant for informative purposes only. For detailed information related to the disease and its treatment please consult a relevant qualified specialist.

Adopting healthier habits modifies outcome:

  • GIVE UP SMOKING
  • Regular blood pressure monitoring
  • Healthier Diet- A diet healthy for the heart is vital for lowering blood pressure levels. This is also vital for smooth management of hypertension and to lessen any complications or risks. A healthier diet includes vegetables, fruits, and lean protein such as fish and whole grains. 
  • More physical activity- Lowering weight and physical activity are two vital components in this regard. Exercising regularly will help you lower blood pressure, stress and combat other ailments. 
  • Stress management- Managing stress through relaxing muscles, meditation, yoga, deep breathing and massages is a great way to lower blood pressure.