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What is Hypertension?

Hypertension, also known as high blood pressure is a long term medical condition in which the blood pressure in the arteries is persistently elevated.

Blood pressure is expressed by two measurements, the systolic and diastolic pressures. Normal blood pressure at rest is within the range of 100–140 millimeters mercury (mmHg) systolic and 60–90 mmHg diastolic.

You can have high blood pressure (hypertension) for years without any symptoms. Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels. Despite lack of symptoms, long term high blood pressure is a major risk factor for coronary artery disease, stroke, heart failure, peripheral vascular disease, vision loss, and chronic kidney disease.

What are the causes of Hypertension ?

High blood pressure is classified as either primary (essential) high blood pressure or secondary high blood pressure.

Primary (essential) hypertension :

Primary Hypertension accounts for about 90–95% of cases and is due to genetic and lifestyle factors, including excess salt, excess body weight, smoking, and alcohol.

Secondary hypertension :

Secondary Hypertension accounts for 5–10% of cases. It is defined as high blood pressure due to an identifiable cause, such as chronic kidney disease, Adrenal gland tumors, Obstructive Sleep Apnea, kidney disease, Abuse or chronic use of alcohol, medications such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers, some prescription drugs and Illegal drugs, such as cocaine and amphetamines.

What are the symptoms of Hypertension ?

Hypertension is rarely accompanied by symptoms, and its identification is usually incidental or through screening. Some people with high blood pressure report headaches,  lightheadedness, vertigo, tinnitus (buzzing or hissing in the ears), altered vision or fainting episodes.

Fortunately, high blood pressure can be easily detected. And once you know you have high blood pressure, you can work with your doctor to control it.

What are the complications of Hypertension ?

The excessive pressure caused by hypertension can damage the blood vessels, as well as organs in the body. The higher your blood pressure and the longer it goes uncontrolled, the greater the damage. Uncontrolled Hypertension can lead to:

1- Heart attack or stroke : High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack and Stroke.

Increased blood pressure can cause the blood vessels to weaken and bulge, forming an aneurysm. This can be a life-threatening condition.

2- Heart failure : Hypertension weakens the heart muscles which may have a hard time pumping enough blood to the body leading to heart failure.

3- Renal Failure : Hypertension can be the cause of weakened blood vessels in the kidneys which can prevent them from functioning normally.

4- Vision Loss : Hypertension can result in vision loss.

5- Metabolic syndrome : This syndrome is a cluster of disorders of your body’s metabolism. This includes increased waist circumference, high triglycerides, low levels of “good Cholesterol” the high-density lipoprotein (HDL) cholesterol, high blood pressure and high insulin levels.

When to screen for Hypertension ?

Blood pressure reading should be checked at least every two years starting at age 18. You’ll likely have your blood pressure taken as part of a routine doctor’s appointment. Your doctor will likely recommend more frequent readings if you have other risk factors for cardiovascular disease.

What can I do?

Make healthy lifestyle changes, such as quitting smoking, eating healthy foods with less salt or DASH diet (the Dietary Approaches to Stop Hypertension diet), maintaining a healthy weight or losing weight if you’re overweight or obese, limiting the amount of alcohol, and becoming more physically active.

 What are the Blood pressure treatment goals?  
Although 120/80 mm Hg or lower is the ideal blood pressure goal, doctors are unsure if you need treatment (medications) to reach that level.
Less than150/90 mm Hg If you’re a healthy adult age 60 or older
Less than140/90 mm Hg If you’re a healthy adult younger than age 60
Less than140/90 mm Hg If you have chronic kidney disease, diabetes or coronary artery disease or are at high risk of coronary artery disease

Your doctor may suggest medications

If lifestyle changes are not sufficient then blood pressure medications are used.

Several classes of medications, collectively referred to as antihypertensive medications, are available for treating hypertension.

First line medications for hypertension include thiazide-diuretics, calcium channel blockers, angiotensin converting enzyme inhibitors and angiotensin receptor blockers. These medications may be used alone or in combination. Most people require more than one medication to control their hypertension.

References

American Heart Association. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/AboutHighBloodPressure/What-is-High-Blood-Pressure_UCM_301759_Article.jsp. Accessed March 19, 2015.

U.S. Preventive Services Task Force. Screening for high blood pressure: U.S. Preventive Services Task Force reaffirmation recommendation statement. Annals of Internal Medicine. 2007;147:783.

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