Hypertension, its causes, diagnosis and management

The blood vessels that carry oxygenated blood are called arteries. Blood pressure is a measure of the pressure or force of the blood inside your arteries. Every time our heart beats, the arteries supply oxygenated blood to the entire body. Our heart beats every second for 24 hours, and during this time, there is pressure inside the arteries. Arteries carry oxygenated blood while veins carry non-oxygenated blood. Our heart beats 60 to 100 times per minute. When the force of blood flow in the arteries remains too high continuously, that condition is called Hypertension.

As our age increases, due to some reasons, the diameter of these arteries decreases, and due to this, blood pressure increases, and we get complaints of high blood pressure. Due to these complaints of high blood pressure, many other heart diseases occur, about which we will know today.

Earlier, Hypertension was considered a disease of Western countries, but nowadays, complaints of high blood pressure have increased in India, and heart disease and its related diseases have emerged as the most significant cause of death.

Blood pressure disease occurs gradually, and sometimes, we come to know about it suddenly when we go to the doctor for regular check-ups or to seek advice from him due to some other disease. Then we come to know that we are suffering from blood pressure.

Many times, we do not see the symptoms of blood pressure in the initial days, but due to blood pressure, many parts of our body keep getting damaged. Mainly due to high blood pressure, our heart, brain, eyes and kidneys get damaged a lot. Therefore, it is advised that after the age of 25, one should consult a doctor regularly and get tested.

By detecting blood pressure-related diseases in time, we can avoid complex heart-related diseases in the future. When we find out that our blood pressure is constantly above 140/90 mm of Hg, the doctor advises us to check BP regularly for a few days. If our blood pressure decreases on its own in a few days, then no blood pressure medicine is started, but if it remains constantly high, then we are given medicine.

In the case of blood pressure, apart from medicines, some tests like ECG and lipid profile are also done, and medicines are given based on these tests. Apart from blood pressure medicines, blood pressure patients are advised to change their lifestyle. If blood pressure is not controlled for a long time, the risk of other heart-related diseases increases, and our lifespan decreases.

Symptoms of Hypertension

Most blood pressure patients come to know that they have blood pressure when they go to the doctor for a checkup for some other reason. It is usually seen that blood pressure patients do not have any problem despite increased blood pressure. Some patients show these symptoms:

1. Headache
2. heaviness in the head
3. Dizziness
4. Blood spots in the eyes (subconjunctival hemorrhage)

In a country like India, there is no system of annual health checkup and due to poverty, poor people cannot afford health checkup and due to this the risk of diseases caused by blood pressure has increased. If we want to avoid this, we have to make it a habit to check blood pressure regularly. If your ancestors have had blood pressure disease, then such people especially need to get blood pressure checked regularly.

Types of Hypertension:

1. Primary Hypertension.
2. Secondary Hypertension.

Primary Hypertension: 

Most people have no apparent cause for high blood pressure. In such people, high blood pressure develops over time. This type of high blood pressure is called primary Hypertension or essential Hypertension.

Secondary Hypertension:

Secondary Hypertension is defined as high blood pressure (BP) due to an identifiable cause. In this case, there is already an underlying cause for the high blood pressure, and the underlying cause is treated first.

Causes of Hypertension:

Primary Hypertension: 

Primary Hypertension develops over time and has no apparent cause, but several factors play a role in the development of this Hypertension, which are given below:

1. Genetics: Some people are genetically prone to high blood pressure. In this situation, the risk of developing high blood pressure increases due to genetic abnormalities or mutations.
2. Age: The risk of high blood pressure increases as you age, especially after age 65.
3. Race: Black people have a higher risk of high blood pressure than other race.
4. Drinking alcohol: According to the American Heart Association, drinking more than 60 ml of alcohol per day increases the risk of heart disease and high blood pressure.
5. Smoking: Smoking cigarettes increases the risk of heart disease
6. Sedentary lifestyle: People who don’t exercise are more likely to have high blood pressure
7. Obesity: People who are obese are more likely to develop diseases like heart disease and high blood pressure.
8. Diabetes: People who already suffer from diseases like diabetes or metabolic syndrome have a higher risk of developing diseases like heart disease and high blood pressure
9. Salt in food: People who use more salt in their food are more likely to suffer from high blood pressure

Secondary Hypertension: 

Secondary Hypertension is completely different from primary Hypertension. In primary Hypertension, the disease increases with age and its cause is unknown, whereas in secondary Hypertension, blood pressure increases suddenly and this happens due to some disease. If the cause of increased blood pressure is identified and treated, then both the disease and blood pressure can be cured. Suppose secondary Hypertension and its cause are not treated. In that case, our condition can deteriorate very rapidly and many other complications can also occur.

If these symptoms appear in patients with high blood pressure, then it can be said that it may be due to secondary Hypertension:

1. Patients with high blood pressure who used to be cured with high blood pressure medication and are no longer getting better
2. Blood pressure is above 180/120 mm Hg.
3. There is no family history of Hypertension.
4. is not obese
5. Age is less than 30 years.

Several health conditions can cause secondary Hypertension:

1. Diabetic complications (diabetic nephropathy).
2. Glomerular disease.
3. Thyroid problems.
4. Cushing’s syndrome.
5. Aldosteronism.
6. Pheochromocytoma.
7. aortic stenosis.
8. Obstructive sleep apnea
9. obesity.
10. Pregnancy.
11. Side effects of drugs
12. Use of illicit drugs
13. Frequent alcohol consumption

High Blood Pressure

The American Heart Association divides blood pressure into four categories:

1. Normal blood pressure- Blood pressure is less than 120/80 mm Hg.
2. Increased blood pressure- systolic will be between 120 to 129 mm Hg and diastolic will be less than 80 mm Hg.
3. Stage 1 hypertension—systolic will be between 130 to 139 mm Hg or diastolic will be between 80 to 89 mm Hg.
4. Stage 2 hypertension – blood pressure greater than 140/90 mm Hg.

A blood pressure reading greater than 180/120 mmHg is considered a hypertensive emergency or crisis.

Diagnosis of Hypertension:

Most of the time, hypertension is detected for the first time when the patient visits the hospital for some other ailment. However, if the blood pressure is found to be high, the patient is instructed to check the blood pressure for the next 6 to 7 days and after that it is observed that if the blood pressure remains high continuously, then we start treatment as a patient with hypertension.

Method of checking blood pressure:

1. Manual method with sphygmomanometer and stethoscope
2. Automatic method with automatic machine.

If the blood pressure is found to be very high, some simple tests are also done such as: 

1. ECG 
2. lipid profile 
3. Other routine check-ups.

Treatment of Hypertension:

The treatment of blood pressure or Hypertension depends on what type of high blood pressure you have and what is the cause. If we treat the cause, both high blood pressure and the cause are cured. Besides medication, lifestyle changes also play an important role in treating high blood pressure.

Primary Hypertension: 

If you are suffering from primary Hypertension, you are advised to make lifestyle changes. If lifestyle changes do not help you, then medicines are also included in it. Initially you will be started with one medicine. Suppose one medicine does not improve your blood pressure. In that case, you may be given two medicines or a combination of medicines.

Secondary Hypertension: 

If you are suffering from secondary Hypertension, then apart from Hypertension, you will have to pay more attention to the disease due to which your blood pressure is high, that is, your doctor tries to find out the cause of your Hypertension and treats it. Apart from treating hypertension and its cause, attention is also paid to changes in lifestyle.

Lifestyle Modifications:

In case of primary Hypertension, doctors suggest lifestyle changes that help control blood pressure in the early days. Although, in most cases, lifestyle changes alone do not reduce blood pressure, lifestyle changes have been found to be very beneficial for high blood pressure in the long run. You can strengthen your heart by making some of the lifestyle changes given below.

1. eating a low-salt diet
2. maintaining a healthy weight
3. getting 40 minutes of regular physical activity
4. Getting 7 to 8 hours of sleep every day
5. Smoking cessation
6. limiting alcohol intake
7. stress management
8. balanced diet

Eating a low-salt diet:

For people who suffer from high blood pressure or have a high risk of heart disease, doctors suggest that they should keep their sodium intake between 1500 mg to 2300 mg per day. Usually packaged food contains high amounts of salt. In a country like India, people eat less packaged food but eat more papads and pickles, which contain a lot of salt. Apart from this, they also like to add salt to salads. If we reduce the amount of salt in our food, it is very beneficial for our heart.

Maintaining a healthy weight:

Obesity is very dangerous for hypertension and heart related diseases. It is often seen that obese people have very high Hypertension and heart related problems. According to dieticians, controlling food intake and physical activities to maintain a healthy weight becomes very important. If food intake is controlled, obesity reduces by 80%. Controlling food intake is the most important way to control obesity. Apart from this, physical activity is also very important, and it helps control your weight.

Doing 40 minutes of regular physical activity:

Doctors recommend 40 minutes of regular physical activity for patients with heart disease and high blood pressure. 40 minutes of physical exercise is very beneficial for our heart and is very beneficial in the long run in treating high blood pressure. 40 minutes of physical exercise five days a week, along with diet control, makes our heart stronger.

Getting 7 to 8 hours of sleep every day:

People who sleep less than 6 hours have an increased risk of having high blood pressure and if you are already suffering from high blood pressure and are not sleeping well, you are promoting your high blood pressure and heart diseases. It is believed that getting 7 to 8 hours of good sleep balances your hormones well, keeping stress and metabolism right and keeping blood pressure under control. Therefore, it is advised by doctors that you should regularly get 7 to 8 hours of good sleep and keep a fixed time to sleep every day.

Stopping smoking:

Doctors recommend that patients who are suffering from high blood pressure should not smoke at all because some of its chemicals damage the endothelial cells of the blood vessels thereby increasing the process of atherosclerosis due to which blood pressure rises rapidly and Hypertension worsens further.

Limiting alcohol consumption:

Doctors suggest that drinking more than 60 ml of alcohol is harmful for our body, especially for blood pressure. Drinking more than three pegs of alcohol increases high blood pressure. It is suggested that patients with high blood pressure should limit alcohol consumption or stop it completely.

Stress management: 

Stress management is an important way to manage your stress to control high blood pressure. Exercise is the best way to manage your stress, but there are other ways to manage it as well, such as 

1. to sum, 
2. relaxing the muscles, 
3. take a deep breath,

Balanced diet: 

Patients with high blood pressure should follow a balanced diet. Dieticians also recommend that heart patients follow a balanced diet. We need to be careful about how much fat is in our food and how we can keep our hearts healthy by increasing our fiber and protein intake and reducing the fat content.

Medication:

In the early stages of primary Hypertension, blood pressure can be reduced by making lifestyle changes, but if blood pressure does not remain under control for a long time even after lifestyle changes, then medication is needed. The details of the medicines used to control blood pressure are given below:

1. Beta-blockers
2. Diuretics 
3. ACE Inhibitors
4. Angiotensin II receptor blockers ( ARBs )
5. Calcium Channel Blockers
6. Alpha-2 Agonists

Disclaimer: This post is written by a doctor, yet you are advised to consult your nearest doctor if you have high blood pressure and only then start your treatment. This article is given for your information only.