High blood pressure is a very common condition when left untreated for a long period leads to many serious diseases like heart disease, kidney disease, peripheral vascular disease and stroke. Hence high blood pressure is also called a “silent killer”.
Blood pressure is the force of blood pushing against the wall of the arteries. Blood pressure is measured in two numbers: an upper number, which is known as the Systolic Blood Pressure and a lower number, which is known as the Diastolic Blood Pressure. The upper number measures the pressure in the arteries when the heart beats and the lower number measures the pressure in the arteries in-between heartbeats. Both upper and lower numbers must be in the right range for blood pressure to be considered normal.
Blood pressure is divided into several categories based on its severity:
Causes of High Blood Pressure
Hypertension is classified into two types based on its cause(s)- Primary (Essential ) and Secondary hypertension
Primary (Essential) hypertension: No apparent cause is identified for high blood pressure not known. High blood pressure is the effect of genetic and environmental factors. Risk factors are for essential hypertension are:
Secondary hypertension: When high blood pressure results secondary to other disease condition or circumstances. Common cause of secondary hypertension are kidney disease, disease of endocrine glands (hormone dysregulation) and obstructive sleep apnea. Chronic use of certain medication may also lead to hypertension: nonsteroidal anti inflammatory drugs (NSAIDs) like ibuprofen, decongestants like pseudoephedrine, steroids, cyclosporine, birth control pills. Other causes include: drug abuse like cocaine and amphetamine abuse, chronic alcohol abuse and certain congenital abnormalities of blood vessels (coarctation of aorta).
Most of the time high blood pressure does not cause symptoms until it cause serious health problems such as stroke, heart attack, heart failure and kidney failure.
When your blood pressure is extremely high, you might feel certain symptoms like:
You should consult a physician if you have any of the above symptoms.
Hypertension is diagnosed by blood pressure measurement on more than one occasion. Regular blood pressure check up is important especially if you have diabetes or are older. History, physical exam and laboratory tests are conducted to determine severity, cause or complication of hypertension.
Aim of hypertension treatment is to prevent complications like stroke, heart attack, heart failure and kidney failure. As most hypertension are primary, treatment is aimed at controlling risk factors. So treatment is usually lifelong and regular follow up is needed.
Lifestyle modification is very important. One should also continue taking high blood pressure medication as prescribed, and not to stop by yourself as this can suddenly raise blood pressure to dangerously high level (Rebound hypertension). The goal is to keep blood pressure less than 140/90 in most cases.
When underlying cause is known, its treatment may help cure hypertension. It is also important to treat other cardiovascular risk factors like diabetes and high cholesterol.
Medications for High Blood Pressure
Several groups of medications are used to control high blood pressure. Examples – diuretics, calcium channel blockers, angiotensin converting enzyme inhibitor (ACEI), Angiotensin receptor blocker (ARB), beta blocker and vasodilators. More than one group of medicine may be needed to control blood pressure.
Treatment of secondary hypertension- depends upon underlying cause, for example, treatment of thyroid disease, surgical removal of tumor of adrenal gland etc
Adapting a healthy lifestyle and regular health check up can help prevent or diagnose hypertension at earlier stage so that timely intervention can be done to prevent serious complication(s).