What is hypertension?

Hypertension, or high blood pressure, is the most common disease of the cardiovascular system that can lead to health problems like heart disease, stroke and heart attacks. Blood pressure is measured by the amount of blood your heart pumps and the force of the flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. Normal blood pressure is 120/80 mm in a healthy adult. Blood pressure readings of 140/90 mm or higher, taken on at least two occasions, is an indication of high blood pressure.

What causes hypertension?

There are two types of hypertension, primary and secondary. Primary hypertension is a condition that develops gradually with adults and there is no one known cause. Secondary hypertension, however, can some on suddenly and have higher spike in blood pressure readings than primary hypertension. Conditions and medications can be the cause of this and include:

  •  Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs
  •  Certain defects in blood vessels you're born with (congenital)
  •  Kidney problems
  •  Adrenal gland tumors
  •  Illegal drugs, like amphetamines and cocaine

What are the symptoms of hypertension?

The scariest part about hypertension is that many do not experience any symptoms thus do not know they suffer from this disease. Visiting your physician regularly and getting your blood pressure checked is the best way to stay on top of your blood pressure health. In extreme hypertensive emergencies, your blood pressure can rise so high that it can cause damage to your organs. The readings in this case are 180/110 or higher.

Symptoms of a hypertensive emergency include:

  •  Increasing confusion or level of consciousness
  •  Increasing shortness of breath
  •  Headache or blurred vision
  •  Swelling or edema (fluid buildup in the tissues)
  •  Seizure
  •  Increasing chest pain

How is hypertension diagnosed?

Hypertension is diagnosed by applying a blood pressure cuff to the arm, inflating it, and taking a reading. The doctor or nurse uses a stethoscope to listen for the appearance and disappearance of sound produced by the pulse in your elbow region. That's how the systolic and diastolic blood pressures are determined.

  •  When the heart beats, it contracts and pushes blood through the arteries to the rest of your body. This force creates pressure on the arteries which is called systolic blood pressure.
  •  The diastolic blood pressure, or number or the bottom, indicates the pressure in the arteries when the heart rests between beats.

How is hypertension treated?

Lifestyle changes like diet and exercise are important to controlling high blood pressure. If you smoke, quit now. Reducing your sodium intake to less 1500 mg a day will help if you suffer from high blood pressure. Sometimes lifestyle changes aren't enough and your physician may recommend medication to lower your blood pressure:

  • Beta blockers : These medications reduce the workload on your heart and open your blood vessels, causing your heart to beat slower and with less force.

  • Thiazide diuretics : Diuretics, sometimes called water pills, are medications that act on your kidneys to help your body eliminate sodium and water, reducing blood volume.

  • Angiotensin II receptor blockers (ARBs): These medications help relax blood vessels by blocking the action of a natural chemical that narrows blood vessels.

  • Angiotensin-converting enzyme (ACE) inhibitors These medications help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels.

  • Calcium channel blockers: These medications help relax the muscles of your blood vessels and some slow your heart rate.

  • Renin inhibitors: Aliskiren (Tekturna) slows down the production of renin, an enzyme produced by your kidneys that starts a chain of chemical steps that increases blood pressure. Tekturna works by reducing the ability of renin to begin this process.

Medication prescribed depends on your level of blood pressure, and other conditions you may be suffering from.

Smoking is a major risk for several diseases including heart disease, stroke, and several cancers. Even low-tar cigarettes and light smoking can increase the risk of heart disease substantially. There are now several alternative approaches to helping people stop smoking. These include nicotine-replacement patches and gum as well as oral medication.

If you are able to stop smoking, your risk of a heart attack or stroke decreases within a few weeks. The risk goes down to that of a nonsmoker within about 2 years. In addition, a lot of patients comment that they feel healthier and have more energy after they've stopped smoking.

Hypothyroidism can increase blood cholesterol levels and that contributes to heart disease; however, if the hypothyroidism is being treated with a thyroid hormone, then the cholesterol returns to normal.

Birth control pills can cause a small increase in the risk of thrombosis and heart attack. That occurs mainly in people who have been on the pill for more than 10 years and who smoke cigarettes.

There is an increase in the risk of heart attack if a first-degree relative (parent or sibling) has had a heart attack or stroke. That is mainly seen when the relative has had a heart attack before the age of 45 if they are male, 55 if they are female. Obviously, you cannot change your family history, but a positive history should suggest the need to improve all the other risk factors like stopping smoking and decreasing cholesterol.

Heart disease is potentially reversible by attending to risk factors like cholesterol, blood pressure, and smoking. Several studies have shown, for example, that aggressive lowering of blood cholesterol with LDL levels below 100 can open up blocked coronary arteries at least partially. Perhaps I should explain that LDL cholesterol is the "bad" cholesterol component.

I would suggest a diet that is balanced among all the main food groups, with fat content making up no more than 30 percent of calories and most of that fat being unsaturated. I would not advise patients to eat a diet that is restricted in carbohydrates or fruits and vegetables, because this may adversely affect vitamin intake and blood cholesterol.

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