Hypertension: High Blood Pressure

 

Hypertension, also known as high blood pressure, is a condition where the force of the blood against the artery walls is consistently too high. Blood pressure is determined by the amount of blood the heart pumps and the resistance to blood flow in the arteries. When the heart pumps more blood and the arteries are narrower, blood pressure increases.

Hypertension is important because it can lead to serious health problems if left untreated. It is a major risk factor for:

  1. Heart Disease: high blood pressure can cause the arteries to harden and narrow, leading to heart disease, heart attacks, and heart failure.
  2. Stroke: hypertension can cause blood vessels in the brain to become blocked, leading to a stroke.
  3. Kidney Damage: high blood pressure can damage the arteries around the kidneys and interfere with their ability to filter blood effectively.
  4. Vision Loss: hypertension can damage the blood vessels in the retina of the eyes, leading to vision problems or blindness.
  5. Aneurysm: increased blood pressure can contribute to blood vessels weakening and bulging, leading to an aneurysm, which can be life-threatening if it bursts.

 

Hypertension can have several causes. These can be broadly categorized into two types: primary (essential) hypertension and secondary hypertension.

Primary (Essential) Hypertension

   This type of hypertension has no identifiable cause and tends to develop gradually over many years. It is influenced by several risk factors:

  1. Genetics: family history of hypertension increases the risk.
  2. Age: risk increases as one gets older.
  3. Race: hypertension is more common among certain races, particularly in people of African descent.
  4. Lifestyle Factors:
    • Diet: high salt (sodium chloride), fat, and cholesterol content can contribute to high blood pressure.
    • Physical Activity: sedentary lifestyles can lead to weight gain and higher blood pressure.
    • Obesity: excess weight accelerates atherosclerosis, resulting in narrowing of the arteries, thereby increasing the pressure on artery walls.
    • Alcohol: excessive drinking can raise blood pressure.
    • Tobacco:  smoking can raise blood pressure, and accelerate narrowing of the blood vessels.
  5. Stress: High levels of stress can lead to temporary increases in blood pressure.

 

Secondary Hypertension

   This type of hypertension is caused by an underlying condition. It tends to appear suddenly and cause higher blood pressure than primary hypertension. Causes of secondary hypertension include:

  1. Kidney Disease: conditions affecting the kidneys can lead to high blood pressure.
  2. Adrenal Gland Tumors: certain tumors can cause the adrenal glands to produce excess hormones resulting in increased blood pressure.
  3. Thyroid Problems: hyperthyroidism (over active thyroid) or hypothyroidism (under active thyroid) can lead to high blood pressure.
  4. Obstructive Sleep Apnea: this condition is associated with higher blood pressures.
  5. Certain Medications: some prescription drugs, over-the-counter medications, herbals and other substances can increase blood pressure.
  6. Congenital Defects: certain congenital conditions in the blood vessels can cause hypertension.
  7. Chronic Conditions: diabetes and other chronic conditions can increase the risk of hypertension.

 

Hypertension, is often called the "silent killer" because it typically has no noticeable symptoms until it reaches a severe or life-threatening stage. However, when symptoms do occur, they can include:

  1. Headaches: often severe and typically occurring in the morning.
  2. Shortness of Breath: difficulty in breathing, especially with exertion.
  3. Nosebleeds: frequent and unexplained nosebleeds.
  4. Chest Pain: feeling of pressure or other discomfort in the chest.
  5. Visual Changes: blurred vision or seeing spots.
  6. Dizziness: feeling lightheaded or unsteady.
  7. Blood in the Urine: this can indicate damage to the kidneys.
  8. Pounding in Chest, Neck, or Ears: a sensation of the heart pounding in these areas.

 

Managing hypertension often involves a combination of lifestyle changes and medication. Here are some effective strategies:

Lifestyle Changes

  1. Healthy Diet:
    • DASH Diet: The Dietary Approaches to Stop Hypertension (DASH) diet emphasizes fruits, vegetables, whole grains, lean proteins, and low-fat dairy while reducing salt, sugar, and saturated fats.
    • Reduce Sodium Intake: Aim to limit sodium to less than 2,300 mg per day, or even lower if advised by your doctor.
    • Increase Potassium: Potassium can help balance the amount of sodium in your cells. Good sources include bananas, potatoes, and leafy greens.
    • Regular Physical Activity: Aim for at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous activity per week, along with muscle-strengthening exercises on two or more days a week.
  2. Maintain a Healthy Weight:
    • Losing even a small amount of weight if you're overweight can help reduce blood pressure.
  3. Limit Alcohol Consumption:
    • Men should limit alcohol to two drinks per day, and women to one drink per day.
  4. Quit Smoking:
    • Smoking raises blood pressure and harms your overall cardiovascular health.
  5. Reduce Stress:
    • Engage in activities that help you relax, such as yoga, meditation, deep breathing exercises, or hobbies.
  6. Monitor Blood Pressure at Home:
    • Regular monitoring can help you keep track of your blood pressure and ensure your lifestyle changes are effective.

 

Treatment Options

  1. Medications:
    • Diuretics: help the kidneys remove excess sodium and water, reducing blood volume.
    • Angiotensin Converting Enzyme (ACE) Inhibitors: help relax blood vessels by blocking the formation of a hormone that narrows blood vessels.
    • Angiotensin II Receptor Blockers (ARBs): Help relax blood vessels by blocking the action of a hormone that narrows blood vessels.
    • Calcium Channel Blockers: Help relax the muscles of the blood vessels.
    • Beta-Blockers: Reduce the workload on your heart and relax blood vessels, causing your heart to beat slower and with less force.
    • Renin Inhibitors: Reduces the production of renin, an enzyme produced by the kidneys resulting in a chain of chemical steps which then increases blood pressure.
    • Aldosterone Antagonists: helps block the effects of a natural chemical that can lead to salt and fluid retention, which can contribute to high blood pressure.
  2. Regular Check-Ups:
    • Regular visits to the physician are essential to monitor your blood pressure, review life style and risk factors, and adjust treatment as necessary.

Combining these lifestyle changes with appropriate medication can effectively manage hypertension and reduce the risk of hypertension related health complications.

 

 

To learn more about Dr. Singh, click here.
To schedule an appointment with SIMEDHealth Primary Care, click here.