High blood pressure is a very common condition with serious consequences if left untreated. This article is aimed at providing basic knowledge about the causes, treatment, complications and prognosis of hypertension.
Things You Need To Know!!
High Blood Pressure or Hypertension is a very common and serious condition which if untreated may lead to permanent and often fatal damage to various organs of the body including the heart, kidneys, brain and eyes. Hypertension means the pressure of the blood inside the blood vessels is higher than what it should be. A blood pressure (BP) of more than 139/89 mmHg is regarded to be higher than normal range.
How to Diagnose?
A high BP reading checked randomly on at least two occasions while the person is at rest is needed to make a diagnosis of hypertension. In almost 90-95% of the cases the cause of high blood pressure is not known, this is called essential/idiopathic hypertension. Remaining 5-10% of the cases are of secondary hypertension in which an underlying cause is identifiable.
Signs and Symptoms:
Hypertension is called a silent killer as there are no distinct signs or symptoms of this disease. It is a leading cause of death and disability worldwide. End organ damage may manifest as heart attack, stroke, CKD (Chronic Kidney Disease), or hypertensive retinopathy. A vast majority of people are diagnosed incidentally on routine physical checkup.
The symptoms manifest only later in life when there has been irreversible organ damage. It is important to start controlling blood pressure as soon as the diagnosis is made so as to prevent or at least slow the progression of organ damage. Co-morbid conditions such as diabetes mellitus accelerate the organ damage.
High pressure inside the blood vessels causes damage to the inner lining of vessels leading to erosion, deposition of calcium, cholesterol and inflammatory cells collectively. This process is called atherosclerosis. This narrows the lumen of blood vessels especially the coronary arteries predisposing the individual to angina and heart attack. Similar process in carotid arteries and cerebral arteries may predispose an individual to stroke.
Management of Hypertension:
Goal of therapy is to bring blood pressure within normal range. A stepwise approach is applied. First step is lifestyle modifications which include:
These measures should be followed in all individuals with hypertension regardless of whether the decision has been made to implement drug therapy. Second step is giving medications to control blood pressure. Your doctor may prescribe medications according to the response to therapy. These medications are also given in a stepwise manner. Patient is started on one type of medicine usually a calcium channel blocker or an ACE inhibitor. Other medications like diuretics and beta blockers may be added depending upon the response to treatment until optimum BP control is achieved. Usually these medications are taken throughout life to maintain blood pressure in normal limits.
For secondary hypertension when a cause is identified the treatment is aimed at addressing the cause. Some of the causes of secondary hypertension are renal artery stenosis, coarctation of aorta, pheochromocytoma, hyperthyroidism and tumor of the adrenal cortex.
If uncontrolled, high blood pressure has a poor prognosis with high risk of stroke and heart disease, the two leading causes of death worldwide. However, if blood pressure is well controlled and lifestyle modifications are implemented, the prognosis can be excellent with the risks decreased significantly.