HYPERTENSION

Hypertension can exist in silence for a long time and only begin to show signs and symptoms when complications occur. Hence, adequate knowledge and routine monitoring are necessary for early detection and control.

What is Hypertension?

Imagine a straw in a bottle of soft drink. If you simply place your mouth at the tip of the straw, will the drink flow into your mouth? No. However, if you suck on the straw, the drink will flow into your mouth. Now, imagine there is a kink in the straw; you will need to suck harder to get the drink into your mouth. Like this illustration, blood flows through the body and heart at a certain pressure range. However, some abnormalities in the body can cause it to require greater pressure.

If you have ever had your blood pressure measured, you may have noticed that it is recorded as two numbers, e.g., 110/75mmHg. The first number is called the systolic blood pressure, and the second is the diastolic blood pressure. Both numbers are important and have a normal range. Generally speaking, the optimal systolic blood pressure is equal to or less than 120mmHg, and the optimal diastolic blood pressure is equal to or less than 80mmHg.

However, medically speaking, there is a grading system for blood pressure.

Hypertension is commonly known as High Blood Pressure, but in many cases, hypertension is actually sustained high blood pressure. This is because a single blood pressure reading is often not high enough to diagnose hypertension. Hence, the diagnosis of hypertension is often made after two to three consecutive blood pressure measurements about six hours apart. However, if a single blood pressure reading is greater than or equal to 180/110mmHg with evidence of cardiovascular disease, a person may be diagnosed as hypertensive.

In some people with hypertension, both systolic and diastolic blood pressures are markedly elevated, e.g., 140/100mmHg. In some others, only the systolic blood pressure is high, e.g., 145/72mmHg; this is known as Isolated systolic hypertension. Yet some others have normal systolic blood pressure, but elevated diastolic blood pressure, e.g., 110/90mmHg. All these cases are Hypertension and should be managed as such.

Types of Hypertension

• Primary Hypertension (also known as Essential Hypertension)
• Secondary Hypertension

Hypertension without any specific underlying cause is known as Primary or Essential hypertension. This is what most people have, and it is usually attributed to advanced age. However, age is not the only factor that contributes to primary hypertension. Other factors such as race, genetics, family history of hypertension, salt intake, alcohol consumption, sedentary lifestyle, and prolonged stress also contribute to the incidence of primary hypertension.

When hypertension occurs due to a pre-existing medical condition, it is known as secondary hypertension (that is, the hypertension is secondary to an underlying condition). Some examples of diseases that can cause hypertension include kidney disease, thyroid disease, alcoholism, obesity, pregnancy, and the use of certain drugs.

How To Know If You Have Hypertension

As mentioned earlier, hypertension is a predominantly asymptomatic condition (it rarely shows any sign or symptom). Therefore, routine blood pressure monitoring is the most important and effective way to detect hypertension early. This can be done at home or during clinic visits.

People who do not routinely check their blood pressure may have undiagnosed hypertension for a long time. As the condition worsens, they may experience blurred vision, disorientation, reduced urination, etc. These signs and symptoms are usually warning signs of organ damage due to prolonged uncontrolled hypertension. So, if you ever notice any of these signs and symptoms, please visit the hospital as soon as possible.

What Happens at The Hospital?

You will be asked some questions at the hospital, and it is very important that you answer clearly and honestly. Your physician will examine you and check your blood pressure. Some tests may also be done, including blood tests, x-rays, electrocardiography (this one involves placing some leads on your body to monitor the electrical activity of your heart), and so on. These tests help to identify any underlying diseases or developing complications. Your physician will discuss their findings with you, and together, you can decide on the best line of management.

Complications of Hypertension

If left untreated for too long, hypertension can cause stroke, renal failure, heart failure, blindness, aortic aneurysm, amongst others.

Management of Hypertension

Non-pharmacologic Approach: Lifestyle modifications such as reduced salt intake (less than 2.3g or 1 teaspoon of salt per day). A DASH (Dietary Approaches to Stop Hypertension) diet is also available to people who want to incorporate lifestyle modifications into their management. The DASH diet encourages eating fruits, vegetables, dairy, and lean meat and reducing the consumption of processed food. Thirty minutes of moderate exercise three or four times a week has also been found to be helpful.

Pharmacologic Approach: Managing hypertension with medications is often a lifelong commitment. Antihypertensives medications work through various methods and may have peculiar side effects. Therefore, when taking them, discuss any adverse effects you notice with your doctor so necessary adjustments can be made to suit your unique needs.

Conclusion

Hypertension is a common medical condition that is mostly asymptomatic but can result in severe complications or death. Therefore, proactive measures must be taken to prevent, detect, or control it.