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Hypertension, a chronic cardiac medical condition, is today one of man’s worst enemy. Here are all that you need to know about this silent killer

Hypertension or high blood pressure is a chronic cardiac medical condition in which the systemic arterial blood pressure is elevated causing the heart to work harder than normal to pump blood around the body. This increases the blood pressure. Blood pressure is a measurement of the force against the arteries’ walls as the heart pumps blood through the body. It is usually given as two numbers for example, the normal blood pressure is 120 over 80, written as 120/80 mmHg. One or both of these numbers can be too high. The top number is called the systolic blood pressure while the bottom number is called the diastolic blood pressure. Normal blood pressure occurs when the blood pressure is lower than 120/80 mmHg most of the time.

Morenikeji Olawale, a medical doctor, said that high blood pressure or hypertension happens when the blood pressure is 140/90 mmHg or above almost all the time. If blood pressure numbers are 120/80 or higher but below 140/90, it is called pre-hypertension and it is more likely to worsen into high blood pressure. “People who have been treated for heart or kidney problems or have undergone treatment for stroke are still at high risk of hypertension. Their blood pressure must even be lower than that of people who do not have these conditions,” he said. High blood pressure increases chances of developing a stroke, heart attack, heart failure, kidney disease and can cause untimely death.

Factors that can cause hypertension include the level of water and salt in the body; the state of the kidneys, nervous system or blood vessels and activity of different body hormones. Factors increasing the chances of developing the disease includes obesity, stress or anxiety, excessive drinking of alcohol like more than one drink per day for women and more than two drinks per day for men, consumption of too much salt, hereditary factors, diabetes and exposure to smoke.

About 90–95 percent of cases of hypertension are classified as either primary or essential hypertension while secondary hypertension occurs in five to 10 percent of hypertensive cases. Primary hypertension means high blood pressure which develops with no obvious medical cause. Secondary hypertension is caused by other conditions that affect the kidneys, arteries, heart or endocrine system. It may be also due to disorders of the adrenal gland called pheochromocytoma or cushing syndrome, medications like birth control pills, diet pills, some cold medications, and migraine medications, narrowed artery that supplies blood to the kidney or renal artery stenosis and hyperparathyroidism.

Hypertension also has several sub-classifications, including hypertension stage I, hypertension stage II, and isolated systolic hypertension. Isolated systolic hypertension means elevated systolic pressure with normal diastolic pressure and occurs frequently among the elderly. Appropriate classification are made after averaging a patient’s resting blood pressure readings taken over a period of two or more office visits. Patients with blood pressures higher than 130/80 mmHg with concomitant presence of diabetes mellitus or kidney disease require further treatment.

People are also more likely to get hypertensive as they get older because the blood vessels become stiffer with age. When that happens, the blood pressure goes up.  But some cases of hypertension are also found in infants and children. Some signs and symptoms are especially seen in newborns and infants such as failure to thrive, seizures, irritability, lack of energy and labourious breathing. In children, hypertension can also cause headache, fatigue, blurred vision, nosebleeds and facial paralysis. Its cause in children is mainly unknown because there is scant research into that field.

Secondary hypertension is also more commonly found in pre-adolescent children and is mainly caused by renal disease while primary or essential hypertension is more common in adolescents. In the adolescents, its occurrence has multiple risk factors including obesity and a family history of hypertension.

Hypertension is also found in pregnant women. It is one symptom of pre-eclampsia which can progress to a life-threatening condition called eclampsia, the development of protein in the urine, generalised swelling and severe seizures. Some expectant mothers experience this due to the systemic vascular resistance and blood pressure decrease during pregnancy. Their body must compensate for this lapse so it increases cardiac output and blood volume to provide sufficient circulation in the utero-placental arterial bed. The increase in blood pressure as a result of this activity leads to hypertension.

Most of the time, however, no cause of high blood pressure is found. This is called essential hypertension. In some cases too, there are no symptoms and they are diagnosed with the condition when they visit their doctors or have it checked elsewhere. Such people can develop heart disease and kidney problems without knowing they have high blood pressure because there were no warning signs. If you have a severe headache, nausea or vomiting, confusion, changes in your vision or nosebleeds, you may have a chronic and dangerous form of high blood pressure called malignant hypertension. These symptoms are collectively called hypertensive encephalopathy and are caused by severe small blood vessel congestion and brain swelling, which is reversible if blood pressure is lowered.

Diagnosis entails checking the blood pressure several times at different times of the day before pronouncing a patient as hypertensive because it is normal for blood pressure to be different depending on the time of day.

If the blood pressure is found to be high, the doctor will attempt to discover the underlying reasons for the presence of the disease in a patient based on risk factors and other symptoms. Causative factors vary from one person to another. To get this, laboratory tests can be performed to identify possible causes to determine whether hypertension has caused damage to the heart and eyes.  Additional tests for diabetes and high cholesterol levels are usually performed because these conditions are additional risk factors for the development of heart disease and require treatment. The doctor may also conduct tests to check for high cholesterol levels and may also test for presence of kidney disease such as a basic metabolic panel and urinalysis or ultrasound of the kidneys to establish presence of the ailment and recommend treatment.

The goal of hypertension treatment is to reduce blood pressure so that there is a lower risk of complications. The best course of treatment is one in which the doctor and patient set a blood pressure goal. In cases of pre-hypertension, the doctor will recommend lifestyle changes to bring the blood pressure down to a normal range. Medicines are rarely used for pre-hypertension.

Hypertensive patients can also take many actions to lower their blood pressure. These includes eating a heart-healthy diet mainly including potassium and fiber probably with the aid of dieticians at hospitals, drinking plenty of water, quitting smoking and drinking including limiting salt intake to less than 1,500 milligramme per day. They must also reduce stress by trying to avoid things causing stress and anxiety probably through meditation or yoga and maintaining a healthy body weight and exercising for at least 30 minutes of aerobics daily and regularly.

But, adequate care must be taken to ensure that the proper method of exercise is decided with doctor’s advice to avoid exercise hypertension. This occurs when there is an excessively high elevation in blood pressure during exercise. The range considered normal for systolic values during exercise is between 200 and 230mmHg.

Medications for hypertension abound. Most of the time, high blood pressure can be controlled with medicine and lifestyle changes. The first line of anti-hypertensive drugs is low-dose thiazide-based diuretics. Often multiple, medications must be combined to adequately lower blood pressure. Commonly used prescription drugs include ACE inhibitors, alpha blockers, angiotensin II receptor antagonists, beta blockers, calcium channel blockers, diuretics or hydrochlorothiazide, direct renin inhibitors and Glyceryl trinitrates which has the activity of vasodilation, thus controlling high blood pressure.

Hypertensive patients must have regular appointments with doctors before using medications. It is also very important for hypertensive patients to follow medical instructions and take the medications as prescribed for them. If they notice any side effects, they must notify medical professionals who then substitute such drugs with a different medication.

Hypertensive patients can also have a blood pressure measuring kit at home for daily monitoring of their blood pressure. Blood pressure readings taken at home may be a better measure of current blood pressure than those taken at the doctor’s office. Adequate care must be taken to get a good quality, well-fitting home device which should have a proper-size cuff and a digital readout. Before use, hypertensive patients must practice with medical professionals to ensure accurate readings. Visit the hospital promptly if home monitoring shows that the blood pressure is still high.

Improper control of hypertension leads to bleeding from the aorta or the large blood vessel that supplies blood to the abdomen, pelvis, and legs, chronic kidney disease, heart attack and heart failure, poor blood supply to the legs, stroke; problems with vision and eventually, death.

To prevent this, it is important to have the blood pressure checked regularly even if a person has not been diagnosed with the disease. This is most needful if the family has a history of high blood pressure. Adults over 18 should also have their blood pressure checked regularly.

Above all, people should live healthy lifestyle including frequent exercise, good diet, getting adequate rest and avoiding cigarette or cigar smoking and drinking of alcohol to reduce the chances of developing not just hypertension but several other diseases.