HYPERTENSION

Definition:

Hypertension is a disorder characterized by consistently high blood pressure. Generally, high blood pressure consists of systolic blood pressure (the "top" number, which represents the pressure generated when the heart beats) higher than 140 or diastolic blood pressure (the "bottom" number, which represents the pressure in the vessels when the heart is at rest) over 90.

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Hypertensive heart disease refers to heart problems that occur because of high blood pressure. These problems include:

Coronary artery disease and angina

Heart failure

Thickening of the heart muscle (called hypertrophy)

High blood pressure means the pressure inside the blood vessels (called arteries) is too high. As the heart pumps against this pressure, it must work harder. Over time, this causes the heart muscle to thicken.

Without treatment, symptoms of heart failure may develop. Sometimes, the muscle can be so thick that it does not get enough oxygen. This can cause angina (chest pain).

High blood pressure also leads to thickening of the blood vessel walls. When combined with cholesterol deposits in the blood vessels, the risk of heart attack and stroke increases.

Hypertensive heart disease is the leading cause of illness and death from high blood pressure

A few people with early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal, these signs and symptoms usually don't occur until high blood pressure has reached a severe or life-threatening stage.

When to Contact a Medical Professional:

Call your health care provider if you have high blood pressure and develop any symptoms

There are two types of high blood pressure.

Primary (essential) hypertension

For most adults, there's no identifiable cause of high blood pressure. This type of high blood pressure, called essential hypertension or primary hypertension, tends to develop gradually over many years.

Secondary hypertension

Some people have high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including:

· Kidney problems

· Adrenal gland tumors

· Thyroid problems

· Certain defects in blood vessels you're born with (congenital)

· Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs

· Illegal drugs, such as cocaine and amphetamines

· Alcohol abuse or chronic alcohol use

· Obstructive sleep apnea

Resistant hypertension: When your blood pressure is difficult to control

· If your blood pressure remains stubbornly high despite taking at least three different types of high blood pressure drugs, one of which should be a diuretic, you may have resistant hypertension.

· Resistant hypertension is blood pressure that's resistant to treatment. People who have controlled high blood pressure but are taking four different types of medications at the same time to achieve that control also are considered to have resistant hypertension.

· Having resistant hypertension doesn't mean your blood pressure will never get lower. In fact, if you and your doctor can identify what's behind your persistently high blood pressure, there's a good chance you can meet your goal with the help of treatment that's more effective.

· Your doctor or hypertension specialist can evaluate whether the medications and doses you're taking for your high blood pressure are appropriate. You may have to fine-tune your medications to come up with the most effective combination and doses.

Risk factors:

High blood pressure has many risk factors as follows:

· Age: The risk of high blood pressure increases as you age. Through early middle age, or about age 45, high blood pressure is more common in men. Women are more likely to develop high blood pressure after age 65.

· Family history: High blood pressure tends to run in families

Being overweight or obese: The more you weigh the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls.
Using tobacco: Not only does smoking or chewing tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls. This can cause your arteries to narrow, increasing your blood pressure. Secondhand smoke also can increase your blood pressure.
Too much salt (sodium) in your diet: Too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.
Too little potassium in your diet: Potassium helps balance the amount of sodium in your cells. If you don't get enough potassium in your diet or retain enough potassium, you may accumulate too much sodium in your blood.

· Drinking too much alcohol: Over time, heavy drinking can damage your heart. Having more than two drinks a day for men and more than one drink a day for women may affect your blood pressure.

If you drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for women of all ages and men older than age 65, and up to two drinks a day for men age 65 and younger.

· Stress. High levels of stress can lead to a temporary increase in blood pressure. If you try to relax by eating more, using tobacco or drinking alcohol, you may only increase problems with high blood pressure.

· Certain chronic conditions. Certain chronic conditions also may increase your risk of high blood pressure, such as kidney disease and sleep apnea.

Blood pressure measurements fall into four general categories:

· Normal blood pressure: Your blood pressure is normal if it's below 120/80 mm Hg. However, some doctors recommend 115/75 mm Hg as a better goal. Once blood pressure rises above 115/75 mm Hg, the risk of cardiovascular disease begins to increase.

· Pre-hypertension: Pre-hypertension is a systolic pressure ranging from 120 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg. Pre-hypertension tends to get worse over time.

· Stage 1 hypertension: Stage 1 hypertension is a systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg.

· Stage 2 hypertension: More severe hypertension, stage 2 hypertension is a systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher.

Treatment:

Eat healthy foods
Decrease the salt in your diet.
Maintain a healthy weight
Increase physical activity
Limit alcohol
Don't smoke
Manage stress
Monitor your blood pressure at home
Practice relaxation or slow, deep breathing


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Milan Tomic

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