Dr Om Prakash

High blood pressure, known as hypertension in medical terms, is a common problem.  There is evidence that the number of people suffering is on an increase.  It affects a large number of people, and as there are no symptoms in the initial years.  It can cause organ damage even before it is diagnosed.  Let us look at some of the essential facts about high blood pressure.

What is high blood pressure?

Blood pressure is the force of blood against the walls of the arteries.  When this pressure is elevated over a period of time it is called hypertension.  Normal blood pressure is 120/80mm of mercury; A blood pressure above 140/90mm of mercury is classified as hypertension.  A blood pressured over 120/80 to 139/89 is called pre-hypertension; this means that you don’t have high blood pressure but that you are more likely to develop it.

How is blood pressure measured?

Blood pressure is measured by an instrument, the sphygmomanometer, which is of two types; those which use a mercury column and those which are aneroid manometers.  Your doctor will measure your blood pressure and record it.  The systolic (higher) reading refers to the pressure at the moment the left ventricle is contracting and the diastolic pressure is the lower reading when the left ventricle is relaxing. Both these readings are important.

What are the consequences of untreated hypertension?

Persistent high blood pressure can lead to cerebral stokes, heart attacks,  heart failure, kidney damage and damage to the retina, It is now well established that optimal control of blood pressure can save lives, reduce the burden of illness and improve the quality of life.

Can hypertension be prevented?

If you have a family history of hypertension, some steps can help prevent and control your blood pressure.  Some of these are regular physical activity such as brisk walking for about 45 minutes daily, reducing salt intake, consuming fruits and vegetables, maintaining the optimal body weight and cessation of tobacco smoking.  If you consume alcohol, it should be in moderation.

Can stress cause hypertension?

Stress can certainly raise your blood pressure temporarily; there is no evidence that it is a major cause of hypertension.  Yet, reduction of stress may improve the quality of life.

What causes hypertension?

Unfortunately, in most adults with high blood pressure, the exact cause is not known. In younger adults, elevated blood pressure can be traced to some specific cause like a hormonal disturbance, narrowing of blood vessels of the kidney or other rare causes.  But theses form a small percentage and most people with hypertension have to be treated for an indefinite period of time.

How is hypertension treated?

Apart from the lifestyle changes noted above, medication have a major role to play in adequate control of blood pressure.  Your physician will assess your condition and suggest the eight combinations of medications. The commonest categories of blood pressure medication are as follows.

Diuretics: These help to flush out water and sodium from the body.

Beta blockers: These reduce the sympathetic nerve impulses to the heart and blood vessels, thereby reducing the vascular resistance and the force of contraction of the heart.

A C E inhibitors: Angiotensin converting enzyme inhibitors reduce a hormone, angiotensin II, which causes blood vessels to narrow.  These drugs relax the blood vessels, bringing down the blood pressure.

Angiotensin antagonists: These drugs protect the blood vessels from the action of angiotensin II, causing dilatation of vessels.

Calcium channel blockers: These reduce the entry of calcium ion into the muscle cells of blood vessels and the heart, reducing the blood pressure.

What about associated conditions?

Your physician will also assess other factors that may require attention.  The major ones are obesity, high lipid levels and diabetes mellitus.  If anyone or more are present, obviously, he will prescribe medication and diet regulation accordingly.  He may alter the dose and combination of medications form time to time.

The MOST important thing is to realize that hypertension has to be treated for a long time, mostly life long and compliance with medical advice is essential.  Your physician will order tests such as blood lipid levels, kidney tests, electrocardiograms, echocardiograms and tread mill tests to ensure that none of your bodily organs are affected.  The need for your cooperation and compliance cannot be over-emphasized.