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    Hypertension

    Overview
    Causes
    Risk Factors
    Symptoms
    Diagnosis
    Treatment
    Where to Seek Treatment


    Contributed by Dept of Cardiology

    Overview


    Older people and women after menopause are at higher risk.Hypertension, also known as high blood pressure, is one of the major risk factors for cerebrovascular disease such as stroke and coronary heart disease.

    Your blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. High blood pressure indicates that the heart is working harder than it should and the arteries are under great strain.

    Causes

    In most cases of hypertension in adults, there is no known cause. This type of hypertension is called primary or essential hypertension and it has usually developed over many years.

    In 5 to 10 percent of cases, hypertension is caused by other underlying medical conditions.

    Risk Factors

    Factors you cannot control

    Age. Older people are at a higher risk of developing hypertension. Women are at higher risk after menopause.

    Family history. Hypertension tends to run in families.

    Factors you can control

    Smoking. Chemicals in cigarettes cause the heart to pump faster and lead to higher blood pressure.

    Alcohol. Your blood pressure can be elevated by alcohol consumption as the body releases hormones that increase blood flow and heart rate.

    Overweight. The heart needs to pump harder to supply a person who is overweight. You can reduce your risk of getting high blood pressure by keeping your body mass index (BMI) between 18.5 and 22.9.

    Too much salt in diet. Blood pressure is increased as salt causes the body to retain too much fluid.

    Inactive lifestyle. People who are physically inactive often have higher heart rates, which means that the heart must work harder and exert more force on the arteries.

    High blood cholesterol. Your blood vessels become more rigid due to atherosclerosis, a process where fatty substances are deposited in blood vessel walls.

    Other health conditions. About 10 percent of people with high blood pressure have underlying kidney diseases or hormonal disorders.

    A healthy lifestyle can help control hypertension.Prevention

    • Know your blood pressure and monitor it regularly
    • Lose weight if you are overweight
    • Eat a healthy diet that is low in saturated fat, cholesterol and salt
    • Quit smoking
    • Take your medication as prescribed
    • Follow your doctor’s advice and take up a physical activity that you enjoy
    • Manage your stress level
    • Control your alcohol intake
    • Manage your stress level

    Symptoms

    Hypertension usually occurs without any symptoms. However, if left untreated and uncontrolled, hypertension can lead to damage of the heart and blood vessels, and cause stroke, heart attack or kidney failure.

    When blood pressure is extremely high, you may experience headaches, dizziness or changes in vision.

    Diagnosis

    You should have your blood pressure checked at least once a year.

    If you are diagnosed with high blood pressure or hypertension, your doctor may recommend that you take the following tests to detect damage to the heart or blood vessels.

    Electrocardiogram (ECG). A noninvasive test that helps to assess the extent of damage, if any, of heart muscle.

    Echocardiogram. An ultrasound examination of the heart that helps to assess the blood supply to heart muscles indirectly. It also measures the strength of the heart muscle.

    Treatment

    Marginally elevated blood pressure may improve with changes in lifestyle such as weight loss, more exercise and reduction in salt intake. If these measures are not successful, then drug treatment may be needed.

    However, once medication has started, it is essential to continue with the treatment on a long-term basis, which is likely to be life-long for most people.

    It is also important to complement the treatment with a healthy lifestyle. Drugs used to treat high blood pressure include:

    • Diuretics
    • Calcium channel blockers
    • Angiotension-converting enzyme (ACE) inhibitors or Angiotensin II receptor blockers
    • Beta blockers
    • Alpha blockers
    • Central acting agents
    • Direct vasodilators

    What is normal blood pressure?

    Normal blood pressure can vary from 90/60 mmHg to 120/80 mmHg in a young and healthy person. Hypertension is present when a person’s blood pressure is persistently above 140/90 mmHg.

    If you have diabetes or kidney disease, you must try to keep your blood pressure at around 120/80 mmHg because even a marginally high blood pressure will increase your risk of developing complications.

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