High blood pressure (Hypertension)

2021-07-30 03:48 PM

Hypertension usually develops over many years, and eventually affects nearly all organs. Fortunately, hypertension can be easily detected.

Define

High blood pressure is a common condition in which the pressure of the blood against the artery walls is high enough, and can eventually cause health problems, such as heart disease.

Blood pressure is determined by the amount of blood the heart pumps and the amount of resistance to blood flow in the arteries. The more blood the heart pumps and the narrower the arteries, the higher the blood pressure.
 
It is possible to have high blood pressure for many years without any symptoms. Uncontrolled high blood pressure increases the risk of serious health problems, including heart attack and stroke.

Hypertension usually develops over many years, and eventually affects nearly every organ. Fortunately, hypertension can be easily detected. And when you know you have high blood pressure, you can work with your doctor to control it.

Symptoms

Most people with high blood pressure have no signs or symptoms, even when blood pressure is dangerously high.

Although some people with early stages of hypertension may have a dull headache, dizziness, or a few more nosebleeds than usual, signs and symptoms usually do not appear until the high blood pressure has passed. cause serious or even life-threatening conditions.
 
Blood pressure can be measured as part of a regular doctor's appointment.
 
Get your blood pressure checked at least every two years starting at age 20. It may be advisable to have it measured more often if you've been diagnosed with high blood pressure or other risk factors for cardiovascular disease. Children 3 years of age and older usually have their blood pressure measured as part of their annual checkup.

If you don't see your doctor regularly, you can get a free blood pressure screening from another health resource in the community. Machines can also be found in some stores to measure blood pressure, but these may give inaccurate results.

Causes

There are two types of high blood pressure.

Primary (idiopathic) hypertension

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

Secondary hypertension

Some people have high blood pressure caused by an underlying problem. This type of high blood pressure, called secondary hypertension, tends to come on suddenly and cause higher blood pressure than normal hypertension. Other conditions and medications can lead to secondary hypertension, including:

Kidney problems.

Adrenal gland tumors.

Certain defects in the blood vessels (congenital).

Certain medications such as birth control pills, cold medicines, decongestants, prescription pain relievers, and some prescription medications.

Illegal drugs, such as cocaine and amphetamines

Risk factors

High blood pressure has many risk factors, including:

Age. The risk of blood pressure increases with age. Through middle age, hypertension is more common in men. Women are more likely to develop high blood pressure after menopause.

Race. Hypertension is particularly common in blacks, often developing at an earlier age in whites. Serious complications, such as stroke and heart attack, are also more common in blacks.

Family history. Hypertension tends to run in families.

Overweight or obese. The heavier the excess, the more oxygen and nutrients need to be delivered to the tissues. As the volume of blood circulating through the blood vessels increases, the pressure on the artery walls increases.

No movement. People who are inactive often have a higher heart rate. The higher the heart rate, the harder the heart has to work with each contraction and the stronger the force to pump blood into the arteries. Lack of physical activity also increases the risk of being overweight.

Tobacco use. Not only does smoking or chewing tobacco immediately raise blood pressure temporarily, but the chemicals in tobacco can damage the lining of the artery walls. This can cause narrowing of the arteries, increasing blood pressure. Cigarette smoke can also raise blood pressure.

Too much salt (sodium) in the diet. Too much sodium in the diet can cause the body to retain fluid, increasing blood pressure.

Too little potassium in the diet. Potassium helps balance the amount of sodium in the cells. If you don't get enough potassium in your diet or keep enough potassium, too much sodium can build up in your blood.

Too little vitamin D in the diet. It is uncertain if too little vitamin D in the diet can lead to high blood pressure. Vitamin D may affect enzymes produced by the kidneys that affect blood pressure.

Drink too much alcohol. Over time, heavy drinking can damage the heart. More than two or three drinks in a day can also temporarily raise blood pressure, as it can cause the body to release hormones that increase blood flow and heart rate.

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

Certain chronic diseases. Certain chronic problems can also increase the risk of high blood pressure, including high cholesterol, diabetes, kidney disease, and sleep apnea.

Sometimes pregnancy contributes to high blood pressure.

Although hypertension is most common in adults, children are also at risk. For some children, high blood pressure is caused by problems with the kidneys or heart. But for a large number of children, poor lifestyle habits, such as an unhealthy diet and lack of exercise - contribute to high blood pressure.

Complications

Too much pressure on the artery walls causes high blood pressure, which can damage blood vessels as well as organs in the body. The higher the blood pressure and its uncontrolled, the more damage there is.

Uncontrolled high blood pressure can lead to:

Heart attack or stroke. High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke, or complications.

Aneurysm. High blood pressure can cause blood vessels to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening.

Heart failure. To pump blood against the higher pressures in the vessels, the heart muscle thickens. Finally, thick muscles can have a hard time pumping enough blood to meet the body's needs, which can lead to heart failure.

Kidney failure and narrowing of blood vessels in the kidneys. This can cause this organ to not work properly.

Blood vessels in the eye thicken, narrow, or tear. This can lead to vision loss.

Metabolic syndrome. This syndrome is a group of disorders of the body's metabolism including increased waist circumference, high triglycerides, low high-density lipoprotein (HDL), cholesterol, blood pressure, and high insulin levels. If you have hypertension, you are more likely to have other components of metabolic syndrome. The other components if present, the risk of developing diabetes, heart disease, or stroke is greater.

The trouble with memory or comprehension. Uncontrolled hypertension can also affect your ability to think, remember, and learn. The trouble with memory or understanding concepts is more common in people with high blood pressure.

Tests and diagnostics

Blood pressure is measured with an arm pump and pressure gauge. Blood pressure readings in millimeters of mercury (mm Hg) come in two numbers. The pressure in the arteries when the heart beats (systolic pressure). Pressure in the arteries between beats (diastolic pressure).

Blood pressure falls into four main categories

Normal blood pressure. Blood pressure is normal if it is below 120/80 mm Hg. However, some doctors recommend 115/75 mm Hg as a better target. When blood pressure rises above 115/75 mm Hg, the risk of cardiovascular disease begins to increase.

Prehypertension. Prehypertension is a systolic pressure ranging from 120 to 139 mm Hg or diastolic pressure between 80 and 89 mm Hg. Prehypertension tends to get worse over time.

Stage 1 hypertension. Systolic blood pressure is 140 - 159 mm Hg or diastolic pressure is between 90 - 99 mm Hg.

Stage 2 hypertension. More severely, stage 2 hypertension has a systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher.

Both numbers in blood pressure are important. But after age 50, systolic blood pressure increases significantly more. Systolic hypertension - when the diastolic pressure is normal but the systolic pressure is high - is the most common type of hypertension in people older than 50.

It may take 2 - 3 blood pressure readings at a time, two or more separate appointments for your doctor to make a diagnosis of high blood pressure. This is because blood pressure often changes throughout the day and sometimes specifically during a visit to the doctor, a condition called white coat hypertension. Your doctor may ask you to record your blood pressure at home and at work to provide more information.

If you have any type of high blood pressure, your doctor may recommend regular checkups, such as urinalysis, blood tests, and an electrocardiogram (ECG) - a test of heart activity measures. . Your doctor may also recommend additional testing, such as a cholesterol test, to check for other signs of heart disease.

Measure blood pressure at home

An important way to check if blood pressure treatment is working, or worsening hypertension, is to monitor blood pressure at home. Blood pressure monitoring is widely available, and a prescription is not required for the purchase of a gauge. Talk to your doctor about how to get started.

Treatments and drugs

The goals of blood pressure treatment depend on the individual case.

Blood pressure treatment goals   Cases

140/90 mm Hg or less

 

If you are a healthy adult

130/80 mm Hg or less

 

If you have chronic kidney disease, diabetes, or coronary artery disease, or are at high risk for coronary artery disease

120/80 mm Hg or less

 

If you have left ventricular dysfunction or heart failure, or have severe chronic kidney disease

 

Although 120/80 mmHg or less is the ideal blood pressure target.

If you're a 60-year-old (formerly 80) or older and your blood pressure is very high, your doctor may set a blood pressure target that's slightly above 140/90 mm Hg.

Lifestyle changes can be geared towards controlling hypertension. But sometimes lifestyle changes are not enough. In addition to diet and exercise, your doctor may recommend medication to lower your blood pressure. What medications your doctor prescribes depends on the stage of your hypertension and other medical problems.

Medications to treat high blood pressure

Thiazide diuretics. Diuretics, which are drugs that cause the kidneys to help the body get rid of salt and water, reducing blood volume. Thiazide diuretics are often the first, but not the only, choice of antihypertensive drugs. If you take a diuretic and your blood pressure is still high, talk to your doctor about adding or replacing the medication you're taking.

Beta-blockers. These drugs reduce the workload on the heart and open up the blood vessels, causing the heart to beat more slowly and with less force. When used alone, beta-blockers are not as effective in blacks or in the elderly as they are in the elderly, but they are effective when combined with thiazide diuretics.

Angiotensin-converting enzyme (ACE) inhibitors. These drugs help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels.

Blocks Angiotensin II receptors. These drugs help relax blood vessels by blocking the action - not the formation of a natural chemical that narrows blood vessels.

Calcium channel blockers. These drugs help relax the muscles of the blood vessels. Some slow the heart rate. Calcium channel blockers may work better for blacks and older adults, than ACE inhibitors or beta-blockers alone. A warning for grapefruit lovers. Grapefruit juice interacts with some calcium channel blockers, increasing blood levels of the drug and having a higher risk of side effects. Talk to your doctor or pharmacist if concerned about interactions.

Renin-inhibitors. Aliskiren (Tekturna) slows the production of renin, an enzyme produced by the kidneys that initiate a cascade of chemicals that raise blood pressure. Tekturna works by reducing renin's ability to initiate this process.

If you're having trouble reaching your blood pressure goals with a combination of the above medications, your doctor may prescribe:

Alpha-blockers. These drugs reduce nerve impulses to blood vessels, reducing the effects of natural chemicals that cause narrowing of blood vessels.

Alpha - beta-blockers. In addition to reducing nerve impulses to blood vessels, alpha-beta blockers slow the heart rate to reduce the amount of blood that needs to be pumped through the vessels. These drugs block the nerve signaling system to the brain. To increase heart rate and narrow blood vessels.

Vasodilators. These drugs work directly on the muscle in the artery walls, preventing the muscles from tightening and the arteries from narrowing.

When your blood pressure is under control, your doctor may give you daily aspirin to reduce your risk of heart problems.

To reduce the number of daily doses of medication, your doctor may prescribe a drug combination at a lower dose than the single drug dose. In fact, two or more blood pressure medications often work better than one. Sometimes finding the most effective drug or combination of drugs is a problem.

Lifestyle changes to treat high blood pressure

In addition to having your doctor prescribe medication to treat high blood pressure, you will need to make lifestyle changes to lower your blood pressure. These changes usually include a healthy diet with less salt, more exercise, quitting smoking, and losing weight.

Anti-hypertensive when blood pressure is difficult to control

If blood pressure remains "stubbornly" high despite taking at least three different blood pressure medications, one of which must be a diuretic, there may be a possibility of resistant hypertension. Antihypertensive is blood pressure that is resistant to treatment. People who already have high blood pressure under control but are taking four drugs at once to achieve control are also considered likely to have resistant hypertension.

Having resistant hypertension doesn't mean your blood pressure will never go lower. In fact, if it is possible to recognize what is behind the persistent increase in blood pressure, there is a good chance that the goal can be met with the help of more effective treatment.

Your doctor or blood pressure specialist can assess whether the medications and dosage you are taking for high blood pressure are appropriate. It is possible to adjust medications to come up with the most effective combination and dosage.

In addition, your doctor may consider medications you are taking for other problems. Certain medications, foods, or supplements can make high blood pressure worse, or medications that prevent high blood pressure work as well. Be open and honest with your doctor about all medications or supplements available.

If you don't take your blood pressure medicine exactly as directed, there may be a cost. If you skip a dose because it's unlikely, because of side effects, or simply because you forgot to take it, talk to your doctor about solutions. Do not change treatment without your doctor's instructions.

Lifestyle and Remedies

Lifestyle changes can help control and prevent high blood pressure, even while taking blood pressure medication. Here's what can be done:

Eat healthy food. Try these dietary approaches for hypertension. Hypertension, which emphasizes fruits, vegetables, whole grains, and low-fat dairy foods. Get plenty of potassium, which can help prevent and control high blood pressure. Eat less saturated fat.

Reduce salt in the diet. Although 2,400 milligrams (mg) of sodium a day is the limit for healthy adults, limiting sodium intake to 1,500 mg/day will have a more dramatic effect on blood pressure. While it is possible to reduce salt intake by reducing the amount of salt added, it is also important to pay attention to the amount of salt in processed foods, such as canned or frozen soups.

Maintain a healthy weight. If you are overweight, even losing 2.3 kg can lower your blood pressure.

Increase physical activity. Regular physical activity can help lower blood pressure and keep weight under control. Aim for at least 30 minutes of physical activity every day.

Limit alcohol intake. Even when you're healthy, alcohol can raise blood pressure. If drinking, moderate - up to one drink a day for women and everyone over 65, and two drinks a day for men.

No smoking. Smoking damages the walls of blood vessels and speeds up the hardening of the arteries. If you smoke, ask your doctor to help you quit.

Stress management. Reduce stress as much as possible. Practice healthy techniques for coping, such as muscle relaxation and deep breathing. Getting lots of sleep can help.

Monitor blood pressure at home. If the drug is suitable and even warning and to know the potential. If your blood pressure is under control with home blood pressure monitoring, you may be less likely to see your doctor.

Practice relaxation or slow deep breathing. Practice deep, slow breathing to help you relax. There are a number of devices available that can help guide the breath for relaxation.

Alternative medicine

While diet and exercise are the best tactics for lowering blood pressure, certain supplements can also help lower blood pressure. These include:

Alpha-linolenic acid (ALA).

Calcium.

Cocoa.

Cod liver oil.

Coenzyme Q10.

Omega-3 fatty acids.

Garlic.

While it is best to include these supplements in the diet as foods, it is also possible to take pills or supplements. Talk to your doctor before adding any of these supplements to treat blood pressure. Some supplements can interact with medications, causing harmful side effects, such as an increased risk of bleeding that can be fatal.

It is also possible to practice relaxation techniques, such as yoga or deep breathing, to help relax and reduce stress levels. These practices may temporarily lower blood pressure.

Coping and supporting

High blood pressure is not a problem that can be treated and then ignored. It is a necessary condition to manage for the rest of your life. To keep blood pressure under control:

Take medicine properly. If side effects or costs cause problems, do not stop taking the medication. Ask your doctor about other options.

Schedule to see a doctor. Efforts must be made to successfully treat high blood pressure. Doctors can't do it alone. Work with your doctor to bring your blood pressure to a safe level and keep it there.

Through healthy habits. Eat healthy foods, lose excess weight, and be physically active. Limit alcohol intake. If you smoke, quit.

Stress management. Say no to additional tasks, negative thoughts, maintain good relationships, be patient and optimistic.

Sticking with lifestyle changes can be difficult, especially if you don't see or feel any symptoms of high blood pressure. If motivation is needed, remember the risks of uncontrolled hypertension. You can get help by enlisting the support of family and friends.