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Written By Dr. Mitesh Mehta, EECP Consultant - Saaol Heart Center Surat.

What is Hypertension (High Blood Pressure)?

Exact definition of high blood pressure is difficult. But in simple way, Systolic Blood pressure more than 140mm of Hg and/or diastolic blood pressure more than 90mm of Hg or if person is taking antihypertensive drugs is known as high blood pressure (hypertension).

High blood pressure is a common condition in which long continued elevated pressure or force of blood against blood vessel (i.e. in artery) wall may eventually cause health problem, such as heart disease. Blood pressure is determined by the amount of blood heart pumps out and the amount of resistance to blood flow in blood vessels. The more blood heart pumps out and the narrower arteries, the higher will be blood pressure.

Risk factors causing high blood pressure:

Age: The risk of high blood pressure increase with age.

• Obesity or Overweight: As weight increases body demands for more oxygen and nutrients, so supply of blood to tissues increases. As the volume of blood circulated through your blood vessels increases, so does the pressure on blood vessel increases.
• Metabolic syndrome causes: elevated LDL Cholesterol (Morethan 100mg/dl), or low HDL Cholesterol (lessthan 40mg/dl), increased triglyceride (morethan150mg/dl), and Diabetes Mellitus.
• Tobacco: Use of tobacco either in form of smoking or chewing will cause blood pressure. The chemical substance in tobacco can damage the lining of blood vessels (particularly arteries) walls. This can cause narrowing of blood vessels and increases the risk of developing heart disease.
• Too much salt (sodium) in diet will cause retention of fluid in body (therefore blood volume increases), which increases blood pressure.
• Too little potassium in diet.
• Stress: High level of stress can lead to temporary high blood pressure.
• Lack of physical activity (i.e. sedentary lifestyle).

Signs & Symptoms:

One of the most dangerous aspects of hypertension is that you may not know that you have it (until some complication arises). In fact, nearly one-third of people who have high blood pressure don’t know it, as they remain asymptomatic, even if the blood pressure reaches dangerously high levels. If your blood pressure is extremely high, there may be certain symptoms to look out for, including:

• Severe headache,
• Fatigue,
• Confusion,
• Problem in vision,
• Chest pain or discomfort,
• Difficulty in breathing,
• Irregular heartbeat,
• Haematuria,
• Epistaxis, etc…

These signs and symptoms are not specific and usually don’t occur until high blood pressure has reached a severe or life threatening stage. If you have any of these symptoms, see a doctor immediately. You could be having hypertensive crisis that could lead to a life threatening condition. Untreated or uncontrolled hypertension can lead to serious diseases such as stroke, heart disease, kidney failure and eye problems.

Treatments:

• The goal of antihypertensive therapy is the reduction of cardiovascular and renal morbidity and mortality, with focus on controlling the blood pressure. 
• Pre-hypertensive patient requires health promoting lifestyle modifications to prevent the progressive rise in blood pressure and cardiovascular disease. 
• Regardless of therapy or care, hypertension will be controlled only if patients are motivated to stay on their treatment plan along with lifestyle modification measures. 
• Patient whose blood pressure suddenly increases whenever they pays visit to doctor (is known as “white coat hypertension”) should monitor their blood pressure at home. 
• Many therapeutic agents can be used for the pharmacologic management of hypertension. For treatment of hypertension drugs used are: Diuretics, ACE Inhibitors, ARBs, Beta-blockers, and Calcium channel blockers. 
• Sometimes multiple drug therapy is generally required to achieve blood pressure targets.

Instructions For Patients (LifeStyle Modificataion):

• Hypertension is a lifelong disorder. For optimal control, a long term commitment to lifestyle modification along with medicine is required (which will reduce cardiovascular risk factors).  
• Weight control: an increase in body weight and waist circumference is associated with an increased risk of developing conditions with high cardiovascular risk, such as hypertension, diabetes mellitus, and left ventricular hypertrophy.  
• Appropriate amount of aerobic physical activity at least 30 minutes daily should be done for weight reduction.  
• Diet - low in salt or salt restricted diet should be taken and avoid intake of fatty food.  
• Increase dietary intake of green leafy vegetables and fruits.  
• Say NO to alcohol consumption, smoking, tobacco chewing, and use narcotic substances such as cocaine.