Hypertension / high blood pressure:-
Hypertension is nothing but high blood pressure. in us adults one among three have high blood pressure. it is one of the silent killer. those who attain an age of 30 should undergo for medical check up to find it. if it early find out, it can be well controlled. an undiagnosed high blood pressure prolongs for long time may cause damage to our heart, kidneys and brain.
What is blood pressure?
it is the pressure exerted by the blood against the blood vessels as it is pumped by the heart. when the pressure exerted by the blood increased, is known as high blood pressure or hypertension. this high blood pressure develops without showing any signs and symptoms.so early check up is better to find it and we can prevent complications. the blood pressure is checked by a device known as sphygmomanometer, with the help of stethoscope.
the normal blood pressure of an healthy individual is 120/80 mm of Hg.
the pressure exerted by the blood when the heart contracts is known as systolic blood pressure and the pressure exerted when the heart dilates is known as diastolic blood pressure.
Definition of Hypertension:-
” hypertension is the persistent high blood pressure, in which the systolic is more then 140mm of Hg, and diastolic is more then 90mm of Hg which are measured in two or more consecutive days in a week”.
In patients with diabetes or kidney disease studies have shown that blood pressure over 130/80 mm Hg should be considered high and warrants further treatment.
Type of hypertension:-
There are the two major type of hypertension,
1. essential hypertension ( primary ) : accounts for 95% of hypertension. The cause of essential hypertension is multi factorial, that is, there are several factors whose combined effects causes this. Essential hypertension affects approximately 75 million Americans, yet its basic causes or underlying defects are not always known. Approximately 30 % of cases of essential hypertension are attributable to genetic factors. they have an increased resistance (stiffness or lack of elasticity) in the tiny arteries that are most distant from heart.
2. non essential or secondary hypertension : which accounts for 5% of hypertension, the high blood pressure is secondary to (caused by) a specific abnormality in one of the organs or systems of the body.
Other types of hypertension :-
1) accelerated hypertension :it is the progressive hypertension with the funduscopic vascular changes.
2) adrenal hypertension : that associated with an adrenal tumor which secretes mineralocorticoids.
3) borderline hypertension : in which the arterial blood pressure is sometimes within the normal range and sometimes within the hypertensive range.
4) gestational hypertension : it develops in the pregnant mothers.
5) malignant hypertension : a severe hypertensive state with papilledema of the ocular fundus and vascular hemorrhagic lesions, thickening of the small arteries and arterioles, left ventricular hypertrophy, and poor prognosis.
6) ocular hypertension : it develops in the intraocular region, without signs of glaucoma.
7) portal hypertension : abnormally increased pressure in the portal veins which brings blood to the liver.
renal hypertension : that associated with or due to renal disease with a factor of parenchymatous ischemia.
9) pulmonary hypertension : it is the pressure exerted in the pulmonary arteries.
10) systemic venous hypertension : elevation of systemic venous pressure, usually detected by inspection of the jugular veins.
Causes of hypertension:-
2. excess salt intake.
3. sedentary life style
4. vascular diseases
5. renal diseases
6. adrenal gland tumor
7. genetic factor
8. Coarctation of the aorta
9. The metabolic syndrome
10. unknown cause.
Symptoms of hypertension:-
– night sweating
– hearing own heart sound.
– measurement of bp above 140/90mm of Hg
While elevated blood pressure alone is not an illness, it often requires treatment due to its short- and long-term effects on many organs. The risk is increased for:
1. HYPERTENSIVE CARDIOMYOPATHY.(heart failure)
2. RENAL DAMAGE.
3. CEREBRO VASCULAR ACCIDENT (STROKE)
4. RETINAL DAMAGE. (retinopathy)
5. MYOCARDIAL INFRACTION.(heart attack)
investigations done in newly diagnosed hypertension.
Common blood tests are:-
– creatinine :to identify any underlying kidney diseases or to check any damage to kidney due to hypertension.
– electrolytes (sodium and potassium)
– electrocardiogram (ECG)
Treatment of hypertension:-
LIFE STYLE MODIFICATION : don’t become slave to the snacks and spices. because these leads to increased cholesterol level in the body. the regular exercises are very helpful to control hypertension. the doctor usually recommend to reduce your weight or to reduce obesity. how to reduce weight? we should reduce the fat intake in the food. use more vegetables foods. avoid food stuffs such as chicken, mutton,egg, cheese, etc. the recommendation is to give up SMOKING and Alcohol .smoking leads to changes in the blood vessels and alcohol damages the organs. instead of using lifts use stair cases. avoid sedentary life styles. cultivate an habit of walking every day morning or evening. do an half an hour exercises at least 3 days a week if you are busy. otherwise do the regular exercises it keeps you healthy and freshness as it enhances the easy blood flow in the body.
reduce the amount of SALT in the diet.the regular intake of calcium has an effect in reducing hypertension.use the fruits and vegetable rich diet, low fat or reduced fat,low sodium diet. This diet is known as the DASH diet(Dietary Approaches to Stop Hypertension), and is based on National Institutes of Health sponsored research. the fruits, vegetables, and nuts have the added benefit of increasing dietary Potassium, which offsets the effect of sodium and acts on the kidney to decrease blood pressure.
the stress situation should be avoided, such as avoiding high sound levels or high illuminations helps in reducing blood pressure. to avoid stress condition the Meditation is preferred.
Avoid heavy workload and be tension free.
there are number of drugs to treat hypertension called antihypertensive drugs. which lowers the blood pressure. Evidence suggests that reduction of the blood pressure by 5-6 mm Hg can decrease the risk of stroke by 40%, of coronary heart disease by 15-20%, and reduces the likelihood of dementia, heart failure, and mortality from vascular disease.
Commonly used drugs are:-
1. ace inhibitors : such as captopril, enalapril etc
2. angiotensin receptor antagonist : such as irbesartan ,
3. alpha blockers : Eg. prazosin
4. beta blocker ; such as metoprolol, atenolol, labetalol.
5. calcium channel blocker such as amlodipine verapamil etc.
6. diuretics: hydrochlorothiazide.
7. direct renin inhibitor: tekturna.
this type of many medications should be used initially for hypertension. then the combination of drugs is given.