High Blood Pressure – Description, Causes and Risk Factors:
High blood pressure (HBP) or hypertension means high pressure (tension) in the arteries. Arteries are vessels that carry blood from the pumping heart to all the tissues and organs of the body. High blood pressure does not mean excessive emotional tension, although emotional tension and stress can temporarily increase blood pressure. Normal blood pressure is below 120/80; blood pressure between 120/80 and 139/89 is called prehypertension, and a blood pressure of 140/90 or above is considered high.
The top number, the systolic blood pressure, corresponds to the pressure in the arteries as the heart contracts and pumps blood forward into the arteries. The bottom number, the diastolic pressure, represents the pressure in the arteries as the heart relaxes after the contraction. The diastolic pressure reflects the lowest pressure to which the arteries are exposed.
An elevation of the systolic and/or diastolic blood pressure increases the risk of developing heart (cardiac) disease, kidney (renal) disease, hardening of the arteries (atherosclerosis or arteriosclerosis), eye damage, and stroke (brain damage). These complications of hypertension are often referred to as end-organ damage because damage to these organs is the end result of chronic (long duration) high blood pressure. For that reason, the diagnosis of high blood pressure is important so efforts can be made to normalize blood pressure and prevent complications.
It was previously thought that rises in diastolic blood pressure were a more important risk factor than systolic elevations, but it is now known that in people 50 years or older systolic hypertension represents a greater risk.
High blood pressure usually causes no symptoms. Even if high blood pressure does cause symptoms, the symptoms are usually mild and nonspecific (vague, or suggesting many different disorders). Thus, high blood pressure often is labeled “the silent killer.”People who have high blood pressure typically don’t know it until their blood pressure is measured.
Sometimes people with high blood pressure have the following symptoms:Headache, dizziness, blurred vision, and nausea.
People often do not seek medical care until they have symptoms arising from the organ damage caused by chronic (ongoing, long-term) high blood pressure. The following types of organ damage are commonly seen in chronic high blood pressure:
4. Blurred vision.
5. Bleeding of nose.
6. Headache lasting for several days.
7. Palpitations or irregular heartbeats.
8. Shortness of breath (11).
9. Excessive sweating.
10. Paleness of skin.
11. Ringing or buzzing in ears.
12. Erectile dysfunction (impotence).
13. Anxiety or nervousness
Patients with hypertension should work with their doctors to set blood pressure goals based on individual risk factors. Lifestyle and medication programs need to be planned on an individual basis.
Healthy life style changes are imperative for anyone, and are critical for people with even normal blood pressure (120/80 mm Hg) and above. In appropriate patients, aggressive drug treatment of long-term high blood pressure can significantly reduce the incidence of mental decline and death from heart disease and other serious physical effects of hypertension. In people with diabetes, controlling both blood pressure and blood glucose levels prevents serious complications of that disease. Anti-hypertensive drugs may even prevent mental decline, including in people genetically susceptible to Alzheimer’s disease. Nevertheless, only slightly over half of patients with hypertension are treated at all, and only a quarter have adequately controlled pressure.
High Blood Pressure – Causes and Risk factors:
Age is the major risk factor of hypertension. Blood pressure increases with age in both men and women, and in fact, the lifetime risk for hypertension is nearly 90%. Two-thirds of Americans over age 60 have hypertension. Older women (60 years and above) currently have the highest rates of hypertension, and mortality rates from hypertension are higher in women than in men. Hypertension is also becoming more common in children and teenagers.
Certain traits, conditions, or habits are known to raise the risk for HBP. These conditions are called risk factors.
Older Age: Blood pressure tends to rise with age. If you’re a male older than 45 or a female older than 55, your risk for HBP is higher.
Isolated systolic hypertension (ISH) is the most common form of HBP in older adults. ISH occurs when only systolic blood pressure (the top number) is high. About 2 out of 3 people over age 60 who have HBP have ISH.
HBP doesn’t have to be a routine part of aging. You can take steps to keep your blood pressure at a normal level.
Race/Ethnicity: HBP can affect anyone. However, it occurs more often in African American adults than in Caucasian or Hispanic American adults. In relation to these groups, African Americans:
Overweight or Obesity: You’re more likely to develop prehypertension or HBP if you’re overweight or obese. Overweight is having extra body weight from muscle, bone, fat, and/or water. Obesity is having a high amount of extra body fat.
Unhealthy Lifestyle Habits: A number of lifestyle habits can raise your risk for HBP, including:
1. Eating too much sodium (salt).
2. Drinking too much alcohol.
3. Not getting enough potassium in your diet.
4. Not doing enough physical activity.
Other Risk Factors: A family history of HBP raises your risk for the condition. Long-lasting stress also can put you at risk for HBP. You’re also more likely to develop HBP if you have prehypertension. Prehypertension means that your blood pressure is in the 120-139/80-89 mmHg range.
Risk Factors for Children and Teens: Overweight is on the rise in youth younger than 18 years. As a result, prehypertension and HBP also are becoming more common in this age group.
Different diagnostic methods are which used to detect HBP/hypertension include:
Patient’s medical history: During a formal chat with the patient, the doctor seeks information about the medical history of the patient’s parents or relatives, as well as lifestyle habits, diet, exercise and stress.
Physical Examination: Blood pressure is measured with the help of a “Sphygmomanometer” (Blood Pressure Cuff) by wrapping an inflatable cuff around the patient’s arm.
Echocardiogram: This painless and harmless non-invasive test uses sound waves to visualize the structure and functioning of the heart.
Electrocardiogram (EKG): This test is used to detect the electrical activity of the heart and is used to detect and record heart related problems associated with HBP. Doppler studies can also be used to detect abnormalities in heart relaxation (diastolic dysfunction).
Chest X-Ray: A chest x-ray can rule out (or in) the possibility of an enlarged of heart.
Urine Analysis: Presence of blood cells and albumin in urine indicate a damaged kidney.
Blood Test: Cholesterol and blood sugar levels.
Evaluation: Evaluation of patients with high blood pressure consists primarily of the following:
1. Focused history to collect important data including symptoms like chest pain.
2. Family history of high blood pressure.
3. Medical history of co-existing conditions like diabetes.
4. Physical examination.
5. Blood tests.
The doctor or nurse will ask the patient if he or she has ever been told they have high blood pressure; if high blood pressure runs in their family; what medications they are taking (certain prescription drugs and over-the-counter medicines can cause hypertension); if they have experienced symptoms such as sweating, palpitations, headaches, dizziness, or weight loss (which can suggest a glandular cause or, rarely, a tumor); and if there are other medical conditions.
During the physical examination, the doctor usually checks the blood pressure in both arms (rare conditions produce different blood pressures in each arm); feels the thyroid gland in the neck to see if it is enlarged or nodular; listens to the heart for “extra” heart sounds; and listens over the neck, abdomen, and groin area for sounds created by turbulent blood flow through diseased or blocked arteries. The health care specialist may also take a careful look at the back of the eyes with an ophthalmoscope, examining the small blood vessels for signs of damage from chronic high blood pressure.
Several blood tests are usually performed to check for evidence of kidney dysfunction, which can cause high blood pressure, and abnormal mineral levels, which may suggest glandular problems. An electrocardiogram (ECG) is often obtained to determine whether the heart walls or chambers are thickening or becoming enlarged as a result of chronic, untreated hypertension, or whether a person has previously suffered a heart attack (myocardial infarction).
Medicine and medications:
Many medications known as antihypertensives are available to lower high blood pressure.
Diuretics rid the body of excess fluids and salt (sodium) and should be used as initial therapy for most patients.
Other medications called beta-blockers reduce the heart rate and the heart’s output of blood.
Another class of antihypertensives is called sympathetic nerve inhibitors. Sympathetic nerves go from the brain to all parts of the body, including the arteries. They can cause the arteries to constrict, raising blood pressure. This class of drugs reduces blood pressure by inhibiting these nerves from constricting blood vessels.
Another group of drugs is the vasodilators. These can cause the muscle in the walls of the blood vessels (especially the arterioles) to relax, allowing the vessel to dilate (widen).
Other classes of drugs used to treat high blood pressure are the angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers and the calcium antagonists (calcium channel blockers).
The ACE inhibitors interfere with the body’s production of angiotensin, a chemical that causes the arteries to constrict. The angiotensin II receptor blockers block the effects of angiotensin. The calcium antagonists can reduce the heart rate and relax blood vessels.
Treating high blood pressure may require lots of time, patience and care by both doctor and patient. It may be annoying to take pills and possibly have side effects, especially if you felt fine before treatment. Don’t be discouraged if you must be treated indefinitely. Some people can reduce their drug dosages after achieving normal blood pressure and maintaining it for a year or more. (You usually can’t stop treatment entirely.) Coping with the inconvenience of medication is still much better than suffering a stroke or heart attack. Most people who are treated successfully live a long and healthy life.
Everyone with high blood pressure doesn’t need to be treated with the drugs listed here. Some people may do just as well by reducing weight, eating properly and getting the right amount of physical activity. Don’t insist that your doctor use a certain drug because you’ve read or heard about its effect on other people. You can have a serious side effect if you take a “wonder drug” that isn’t right for you. Let your doctor decide what drug, if any, to use.
If your doctor recommends medication, remember that people respond very differently to these medications. That’s why you might have to go through a trial period to find out which medications work best with the fewest side effects. Your blood pressure is only lowered while you are taking these medications. That’s why medication can’t be stopped, in most cases, even after blood pressure is lowered. Some treatment must be continued over a lifetime for good results.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.