HYPERTENSION or HIGH BLOOD PRESSURE- A Major health issue

INTRODUCTION 

HYPERTENSION is one of the leading cause of severe health complications and increases the risk of various heart diseases. It sometimes become the major cause of death. Hypertension is the another name for High Blood Pressure. We all heard this term   High blood pressure , as it is common among elderly people . But nowadays, almost half of the adult population have hypertension but they are not aware of this fact.

WHAT IS HYPERTENSION ?

HYPERTENSION or HIGH BLOOD PRESSURE  is a condition in which the blood pressure in the arteries is chronically elevated . Hypertension is defined as an average systolic blood pressure above 140mmHg and a diastolic blood pressure is above 90mmHg.

In order to understand high blood pressure, first of all we have to understand the term BLOOD PRESSURE. 

BLOOD PRESSURE is defined as the pressure or force exerted by the blood against the walls of blood vessels. Normal BLOOD PRESSURE is 120/80mm Hg.

CAUSES OF HYPERTENSION 

There are various causes present which are responsible for hypertension.These are:

• Genetic factors 
• Ethnicity such as African Americans have high risk as compared to another groups
• Age: risk increases with age as the arteries become stiffer and narrow due to plaque build up.
• Gender: males are more prone as compared to females.
• Sedentary lifestyle
• Obesity
• Stress
• Alcohol, tobacco and smoking.
• salt and fat rich diet.
• low potassium intake.
• certain medications such as birth control pills etc.
• certain diseases such as Cushing 's syndrome.

CLINICAL MANIFESTATIONS

High blood pressure sometimes causes no symptoms and this is often labelled as SILENT KILLER. Sometimes people may experience:

• severe headache, dizziness and blurred vision
• nausea and vomiting
• fatigue and confusion 
• chest pain
• shortness of breath
• irregular heart beat
• papilledoma(swelling of optic disk)
• ear noise or buzzing
• temporary paralysis of one side called hemiplegia
• bleeding from nose etc.

DIAGNOSTIC EVALUATIONS

High blood pressure is diagnosed as:

• Collect family history of high blood pressure, diabetes or cardiovascular diseases
• Focused history to collect important data including symptoms like chest pain , headache etc.
• Medical history of co existing conditions such as diabetes
• Complete blood count and urinalysis
• chest X-ray 
• Doppler ultrasound
• Blood pressure monitoring is very important : to mark the condition as hypertension, it is important to check blood pressure for 3 days consecutively and blood pressure should be monitored from both arms, if now the B.P. is elevated then the person is hypertensive.

 COMPLICATIONS

Uncontrolled high blood pressure can lead to:

• Heart attack or stroke
• Aneurysm, or abnormal bulge in the wall of artery that can burst
• Heart failure
• Kidney failure because the blood vessels in the kidneys become narrowed and weak.
• Hypertensive retinopathies in eyes leads to blindness.

HOW TO MANAGE HYPERTENSION?

MEDICAL MANAGEMENT

The purpose of the medical management is to maintain blood pressure within the normal ranges by the simplest and safest means . But the doctor's consultation is also important. The following class of drugs are involved :

• DIURETICS: Diuretics helps the kidneys to get rid of sodium and water from the body. This decreases the volume of blood in the body and lowers blood pressure. Ex.furosemide(40-240 mg/ day).
• BETA BLOCKERS: These medications reduces the workload on heart. Ex.propanolol(40-480 mg/ day)
• ALPHA BLOCKERS: These medications reduces nerve impulses to blood vessels, reducing the effects of natural chemicals that narrow blood vessels. Ex. prazocin (2-30 mg / day)
• VASODILATORS: These medications work directly on the muscles in the walls of  arteries and prevents the tightening of muscles and narrowing of arteries. Ex. nitroglycerin
• ACE INHIBITORS: These medications helps by relaxing blood vessels by blocking  the formation of  a natural chemical that narrows blood vessels. Ex. remipril(1.25-20 mg / day )
• CALCIUM CHANNEL BLOCKERS:These medications helps by relaxing muscles of blood vessels. Ex. nifedipine.

The dose of each medicine is recommended according to severity of disease and according to patient's conditions. 

OTHER THERAPY

Alternative therapies may be helpful for people in order to control their  blood pressure. The techniques that induces relaxation and reduce stress  are recommended. These include:

• Meditation 
• Acupuncture
• yoga
• Relaxation training 

Image By- kike Vega

These techniques are well accepted that may help to reduce high blood pressure.

NUTRITION AND DIETARY SUPPLEMENTS 

Image By- Jez Timme

Eating a healthy diet that is low in saturated fats and sodium can help to lower blood pressure. These nutritional tips may help :

• DASH Diet : It is Dietary Approaches to Stop Hypertension. DASH is a flexible and balanced eating plan. You can start this by consulting your family doctor.
• DASH diet lowers hypertension and also improves the levels of fats in the blood stream and hence, reduces the risk of various cardiovascular diseases.
• DASH diet emphasizes on eating fresh fruits and vegetables, whole grains, high fibres , beans , pulses and nuts , fish rich in omega 3 twice a week , non tropical oils such as olive oil, low fat dairy products and low intake of sweets.
• AVOID refined foods, frozen and canned food , trans fats and hydrogenated vegetable oil. 
• Drink 8-9 glasses of water daily 
• coconut water is very beneficial.
• Try to eliminate potential food allergens, preservatives and food additives.
• Instead of fruit juices , try to consume whole fruit because it has more fibre content, whereas in juice the whole fibre of fruit is removed. So, try to avoid juices .
• Avoid caffeinated drinks like tea,coffee etc.

LIFESTYLE AND HOME REMEDIES

Lifestyle modification is very important in order to control and prevent hypertension . Here's some tips that patient can follow:

• Eat healthy and fresh food 
• Decrease the salt intake in diet 
• Maintain healthy weight
• Increase physical activity
• Limit alcohol and avoid smoking
• Proper management of stress 
• Monitor blood pressure regularly
• Practice relaxation or slow , deep breathing exercise.

CONCLUSION 

Regular blood pressure monitoring can help people avoid many more severe complications. So, it is very important to take your medications on time and regularly . It is the responsibility of patient and their care taker to keep check on the diet and medication. Encourage patient to make required lifestyle changes in order to control hypertension and to live healthy life .

In this whole article, I provide a detailed information regarding Hypertension. I mentioned its various causes, signs and symptoms, diagnostic evaluations, its complications and its treatment including dietary management. 

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