High blood pressure is also known as hypertension. Blood pressure is the amount of force exerted against the walls of the arteries as blood flows through them. When this force exerted by blood against the walls of the arteries is abnormally high during blood circulation, that condition is referred to as high blood pressure. This condition would arise when these blood carrying arteries are weak and the heart would then apply more force in pumping blood and this same force would also be exerted against the walls of the arteries as blood flows through them.
If left untreated or uncontrolled, high blood pressure can cause many health problems. These conditions include heart failure, vision loss, erectile dysfunction, stroke, and kidney disease.
Causes of High Blood Pressure:
The risk of developing hypertension increases as people age.
The heart is a muscle that pumps blood around the body.
Blood that has low oxygen levels is pumped towards the lungs, where oxygen supplies are replenished. The oxygen rich blood is then pumped by the heart around the body to supply our muscles and cells. The pumping of blood creates pressure.
If a person has high blood pressure, it means that the walls of the arteries are receiving too much pressure on a constant basis.
The causes of high blood pressure are divided into two categories:
Essential high blood pressure: This has no established cause.
Secondary high blood pressure: There is an underlying cause.
Even though there is no identifiable cause for essential high blood pressure, there is strong evidence linking some risk factors to the likelihood of developing the condition.
Most of the causes below are risk factors for essential high blood pressure. There are also examples of secondary high blood pressure:
1) Age
The older you are the higher your risk of having high blood pressure.
2) Family history
If you have close family members with hypertension, your chances of developing it are significantly higher. An international scientific study identified eight common genetic differences that may increase the risk of high blood pressure.
3) Temperature
A study that monitored 8,801 participants over the age of 65 found that systolic and diastolic blood pressure values differed significantly across the year and according to the distribution of outdoor temperature. Blood pressure was lower when it got warmer, and rose when it got colder.
4) Ethnic background
Evidence indicates that people with African or South Asian ancestry have a higher risk of developing hypertension, compared to people with predominantly Caucasian or Amerindian (indigenous of the Americas) ancestries.
5) Obesity and overweight
Both overweight and obese people are more likely to develop high blood pressure, compared to people of normal weight.
6) Some aspects of gender
In general, high blood pressure is more common among adult men than adult women. However, after the age of 60 years both men and women are equally susceptible.
7) Physical inactivity
Lack of exercise, as well as having a sedentary lifestyle, raises the risk of hypertension.
8) Smoking
Smoking causes the blood vessels to narrow, resulting in higher blood pressure. Smoking also reduces the blood’s oxygen content so the heart has to pump faster in order to compensate, causing a rise in blood pressure.
9) Alcohol intake
People who drink regularly have higher systolic blood pressure than people who do not, according to researchers. They found that systolic blood pressure levels are about 7 millimeters of mercury (mmHg) higher in people who drink frequently than in people who do not drink.
10) High salt intake
Researchers reported that societies where people do not eat much salt have lower blood pressures than places where people eat a lot of salt.
11) High fat diet
Many health professionals say that a diet high in fat leads to a raised high blood pressure risk. However, most dietitians stress that the problem is not how much fat is consumed, but rather what type of fats.
Fats sourced from plants such as avocados, nuts, olive oil, and omega oils are good for you. Saturated fats, which are common in animal-sourced foods, as well as trans fats, are bad for you.
12) Mental stress
Various studies have offered compelling evidence that mental stress, especially over the long term, can have a serious impact on blood pressure. One study suggested that the way that air traffic controllers handle stress can affect whether they are at risk of developing high blood pressure later in life.
13) Diabetes
People with diabetes are at a higher risk of developing hypertension. Among people with type 1 diabetes, high blood sugar is a risk factor for incident hypertension – effective and consistent blood sugar control, with insulin, reduces the long-term risk of developing hypertension.
People with type 2 diabetes are at risk of hypertension due to high blood sugar, as well as other factors, such as overweight and obesity, certain medications, and some cardiovascular diseases.
14) Psoriasis
A study that followed 78,000 women for 14 years found that having psoriasis was linked to a higher risk of developing high blood pressure and diabetes. Psoriasis is an immune system condition that appears on the skin in the form of thick, red scaly patches.
15) Pregnancy
Pregnant women have a higher risk of developing hypertension than women of the same age who are not pregnant. It is the most common medical problem encountered during pregnancy, complicating 2 to 3 percent of all pregnancies.
16) Ulcer
People with stomach ulcer are also easily prone to develop hypertension.
Signs and symptoms of hypertension
Most people with high blood pressure will not experience any symptoms. It is often known as the “silent killer” for this reason.
However, once blood pressure reaches about 180/110 mmHg, it is considered a medical emergency known as a hypertensive crisis. At this stage, symptoms will show, including:
Headache, nausea, vomiting, dizziness, blurred or double vision
Nosebleeds, palpitations, or irregular or forceful beating of the heart, breathlessness.
Children with high blood pressure may have the following signs and symptoms: headache, fatigue, blurred vision, nosebleeds, Bell’s palsy, or an inability to control facial muscles on one side of the face.
Newborns and very young babies with high blood pressure may experience the following signs and symptoms:
failure to thrive, seizure, irritability,
lethargy, respiratory distress
People who are diagnosed with high blood pressure should have their blood pressure checked frequently. Even if yours is normal, you should have it checked at least once every six months, and more often if you have any contributory factors.
Complications:
If the hypertension is not treated or controlled the excessive pressure on the artery walls can lead to damage of the blood vessels (cardiovascular disease), as well as vital organs. The extent of damage depends on two factors; the severity of the hypertension and how long it goes on for untreated.
Below is a list of some of the possible complications of high blood pressure:
Stroke, heart attack and heart failure,
blood clots, aneurysm, kidney disease, thickened or narrow or torn blood vessels in the eyes, metabolic syndrome, brain malfunction, erectile dysfunction and memory problems.
Treatment:
Treatment for high blood pressure depends on several factors, such as its severity, associated risks of developing stroke or cardiovascular disease, etc.
In addition to medication, you are also to advise your patients on lifestyle changes. Changes in lifestyle can help lower high blood pressure.
The following are recommended lifestyle changes that can help lower blood pressure.
Regular exercise:
A regular program of exercise can prove beneficial in lowering blood pressure.
Exercising for 30 to 60 minutes five days a week will usually lower a person’s blood pressure by 4 to 9 mmHg. If you embark on an exercise program you should see the benefits fairly soon – within a matter of two to three weeks, especially if you have been leading a sedentary lifestyle for a long time.
Exercise needs to be tailored to the needs and health of the person with hypertension and the secret of getting success out of exercise is to do it regularly. Exercising at weekends and doing nothing from Monday to Friday will be much less effective.
Losing weight:
Studies have revealed that even moderate weight loss – just ten pounds – can have a significant impact in lowering elevated blood pressure.
If you are overweight, the nearer you get to your ideal weight the more your blood pressure is likely to fall. Any high blood pressure medications you are taking will become more effective when you lose weight.
Reducing your waistline will have the greatest effect. Achieving a healthy body weight involves a combination of exercise, good diet, and at least 7 hours good quality sleep each night.
Relaxation techniques:
Adding the relaxation response, a stress-management approach, to other lifestyle modifications may significantly improve treatment of the type of hypertension most common in the elderly.
Sleep:
Not getting enough sleep can increase a person’s risk of developing high blood pressure. Some studies have suggested that adults sleep no less than 7 hours and no more than 8 hours per day. In 2008 the American Academy of Sleep Medicine published a study suggesting that people with sleep duration above or below the recommended 7-to-8 hours per night face an increased risk of hypertension .
Some people may have to be on medication to control hypertension for the rest of their lives or take care of it. You may advise discontinuing treatment if the individual has managed to maintain good blood pressure levels for a given period, and is not considered to be at significant risk of stroke or cardiovascular disease.
Diet:
Managing the diet can be effective way of both preventing and treating high blood pressure. This means eating plenty of fruits and vegetables, good quality unrefined carbohydrates, vegetable oils, and omega oils. If you eat animal products make sure all the fat is trimmed and avoid processed meats.
Lowering salt intake:
Studies have shown that even a moderate reduction in salt, or sodium, intake can lower blood pressure levels by 2 to 8 mmHg.
Alcohol:
Some studies indicate that consuming alcohol helps lower blood pressure, while others report the opposite.
In very small amounts, alcohol may lower blood pressure. But if you drink too much, even moderate amounts in some cases, blood pressure levels may increase.
People who drink more than moderate amounts of alcohol regularly will almost always experience elevated blood pressure levels.
Caffeine:
There is a wide range of studies that report on whether caffeine has an impact on blood pressure. Many have conflicting conclusions but agree that moderating caffeine intake is advisable for people with high blood pressure.
Ranges:
High blood pressure is considered to be 140/90 mmHg or higher.
Anyone whose blood pressure is 140/90 mmHg or more for a sustained period is said to have high blood pressure, or hypertension.
Blood pressure is usually divided into five categories:
Hypotension, or low blood pressure
Systolic(top) mmHg 90 or less, or
Diastolic(down) mmHg 60 or less
Normal
Systolic mmHg 90-119, and
Diastolic mmHg 60-79
Prehypertension
Systolic mmHg 120-139, or
Diastolic mmHg 80-89
Stage 1 Hypertension
Systolic mmHg 140-159, or
Diastolic mmHg 90-99
Stage 2 Hypertension
Systolic mmHg over 160, or
Diastolic mmHg over 100
Diagnosis:
People measure two types of blood pressure:
Systolic pressure: This is the blood pressure when the heart contracts.
Diastolic pressure: This is the blood pressure between heartbeats.
If you are told that your blood pressure is 120/80 mmHg, it means you have a systolic pressure of 120 mmHg and a diastolic pressure of 80 mmHg.
Sphygmomanometer:
Most lay people have seen this device. It consists of an inflatable cuff that is wrapped around the upper arm. When the cuff is inflated it restricts the blood flow. A mercury or mechanical manometer measures the pressure.
A manual sphygmomanometer is often used together with a stethoscope.
With a digital sphygmomanometer all measurements are carried out with electrical sensors.
With advances in new wearable technology, people can now keep track of their blood pressure at home.
One blood pressure reading is not enough to diagnose hypertension in a patient. People’s blood pressure can vary during the day, a visit to the clinic may spike the reading because the patient is anxious or stressed, having just eaten may also temporarily affect blood pressure readings.
As the definition of hypertension is defined as “repeatedly elevated blood pressure” you have to take several readings over a set period. This may require three separate measurements one week apart – often the monitoring goes on for much longer before a diagnosis is confirmed.
On some rare occasions, if the blood pressure is extremely high, or end-organ damage is present, diagnosis may be made immediately so that treatment can start promptly. End-organ damage generally refers to damage to major organs fed by the circulatory system, such as the heart, kidneys, brain or eyes. Also, if the individual is a confirmed hypertensive patient, treatment can commence immediately.
Kidney disorder: If the patient has a urinary tract infection, urinates frequently, or reports pain down the side of the abdomen, they could be signs and symptoms of a kidney disorder.
If you place the stethoscope on the side of the abdomen and hears the sound of a rush of blood, it could be a sign of stenosis. This is a narrowing of an artery supplying the kidney.
Additional tests for high blood pressure:
You may also order the following tests to aid in diagnosis of high blood pressure:
Urine and blood tests: Underlying causes might be due to cholesterol, high potassium levels, blood sugar, infection, kidney malfunction, etc. Protein or blood in urine may indicate kidney damage. High glucose in the blood may indicate diabetes.
Exercise stress test: More commonly used for patients with borderline hypertension. This usually involves pedaling a stationary bicycle or walking on a treadmill. The stress test assesses how the body’s cardiovascular system responds to increased physical activity. If the patient has hypertension this data is important to know before the exercise test starts. The test monitors the electrical activity of the heart, as well as the patient’s blood pressure during exercise. An exercise stress test sometimes reveals problems that are not apparent when the body is resting. Imaging scans of the heart’s blood supply might be done at the same time.
Electrocardiogram (ECG): This tests the heart’s electrical activity. This test is more commonly used for patients at high risk of heart problems, such as hypertension and elevated cholesterol levels. The initial ECG is called a baseline. Subsequent ECGs may be compared with the baseline to reveal changes which may point to coronary artery disease or thickening of the heart wall.
Holter monitoring: The patient carries an ECG portable device that is attached to electrodes on their chest for about 24 hours.
Echocardiogram: This device uses ultrasound waves which show the heart in motion. Then you will be able to detect problems, such as thickening of the heart wall, defective heart valves, blood clots, and excessive fluid around the heart.
Because hypertension is often a silent condition, it can cause damages to your body for years before symptoms become obvious. If hypertension isn’t treated, you may face serious, even fatal, complications.
Complications of hypertension include the following.
Damaged arteries
Healthy arteries are flexible and strong. Blood flows freely and unobstructed through healthy arteries and vessels.
Hypertension makes arteries tougher, tighter, and less elastic. This damage makes it easier for dietary fats to deposit in the arteries and restrict blood flow. This damage can lead to increased blood pressure, blockages, and, eventually, heart attack and stroke.
Damaged heart
Hypertension makes the heart work too hard. The increased pressure in the blood vessels forces the heart’s muscles to pump more frequently and with more force than a healthy heart should have to.
This may cause an enlarged heart. An enlarged heart increases your risk for the following:
heart failure, arrhythmias, sudden cardiac death, heart attack.
Damaged brain:
The brain relies on a healthy supply of oxygen-rich blood to work properly. High blood pressure can reduce the brain’s supply of blood:
Temporary blockages of blood flow to the brain are called transient ischemic attacks (TIAs) .
Significant blockages of blood flow cause brain cells to die. This is known as a stroke.
Uncontrolled/treated hypertension may also affect the memory and ability to learn, recall, speak, and reason. Treating hypertension often doesn’t erase or reverse the effects of uncontrolled hypertension. It does, however, lower the risks for future problems.
If you have risk factors for hypertension, you can take steps now to lower your risk for the condition and its complications. Add healthy foods to your diet, slowly work your way up to eating more servings of heart-healthy plants. Aim to eat more than seven servings of fruits and vegetables each day. Then aim to add one more serving per day for two weeks. After those two weeks, aim to add one more serving. The goal is to have ten servings of fruits and vegetables per day.
Cut sugar:
Try to incorporate fewer sugar-sweetened foods, including flavored yogurts, cereals, and sodas. Packaged foods hide unnecessary sugar.
