Hypertension

WHAT IS HYPERTENSION

Hypertension or high blood pressure means that the pressure blood exerts on the arteries that carry the blood to various organs of the body is higher than normal. High pressure is a risk factor to various diseases of heart including heart attacks and heart failure, stroke or brain attack and kidney.

As per WHO estimation, the prevalence of hypertension in India at present ranges from 25-30% in urban population and 15-20% in rural population. It is rising as the time is progressing. Though it is more prevalent in old age, the prevalence is rising in younger age groups because of faulty food habits, sedentary lifestyle and stressful job atmosphere.

MEASUREMENT OF BLOOD PRESSURE

A person has hypertension, if the value of systolic blood pressure is more than 140 mmHg and diastolic more than 90 mmHg. Measurement of blood pressure should be done in a calm setting after minimum 10 minutes of rest. Patient should not have consumed tea/coffee and smoked in last 30 minutes.

CLASSIFICATION OF HYPERTENSION

Hypertension is generally classified in two types depending on cause.

1. PRIMARY HYPERTENSION is when the cause is unknown and generally is age dependent.
2. SECONDARY HYPERTENSION is when the rise in blood pressure is due to some other disease like kidney disease or phaeocytochroma.

WHITE COAT HYPERTENSION

Some people are found to have high blood pressure when they come to a clinic. But the readings taken at home are perfectly normal. This situation is called white coat hypertension as the persons may become anxious or stressed in front of healthcare professionals.

RISK FACTORS FOR HYPERTENSION

Persons with certain risk factors are at a higher risk of developing high blood pressure. The common risk factors are –

1. AGE – as the age progresses the blood pressure of individual rises. The blood vessels stiffen and exert more pressure.
2. Sedentary life style- lack of exercise is another reason for rising blood pressure.
3. Smoking – Smoking in active and passive forms is a major cause.
4. Excess alcohol intake – Alcohol is a trigger for blood pressure rise.
5. Obesity – A higher BMI resulting in obesity can hinder a normal blood pressure.
6. Stress – Another main trigger is stress and anxiety.
7. Other comorbid conditions like diabetes, renal disease, dyslipidaemia, etc.

SIGNS AND SYMPTOMS

In many cases, there are often no symptoms of hypertension and it is discovered on routine examination for some other reason. Hypertension is frequently called as the silent killer. In other cases when the symptoms are present, these are headache, giddiness, visual disturbance, tachycardia or fast heart rate, anxiety or insomnia. On rare occasions, patients present with very high blood pressure causing bleeding and altered behaviour known as hypertensive emergency.

DIAGNOSIS

The diagnosis of hypertension requires multiple readings to be taken at different times in a calm atmosphere as described above. A single high blood pressure reading could be due to situations involving stress, anxiety or physical exercise.