Hypertension
a.k.a.
High blood pressure
Hypertension is when there is
excessive pressure against the blood vessel walls.
The heart has to work harder in order
to pump the blood through the body when it is working against this elevated
pressure, and this can eventually lead to an enlarged heart and heart damage.
It can also lead to injury to blood
vessels in the kidneys which can lead to chronic renal failure.
Hypertension is the second leading
cause of chronic renal failure.
Blood pressure is measured by two
numbers, the systolic pressure and the diastolic pressure.
The systolic pressure, or the first
number, measures the pressure in the blood vessels when the heart contracts to
pump blood to the body.
The diastolic pressure, or the second
number, measures the pressure in the blood vessels when the heart is relaxed and
refilling with blood.
Normal blood pressure is less than
130/85.
High normal is 130-139/85-89.
Anything above these numbers is
considered hypertension, and puts the patient at risk for complications.
If a patient is determined to have
hypertension, regardless of whether it is mild or severe, it needs the attention
of a physician to determine the best method of management.
Who gets it and what are its
causes?
There are several risk factors for
hypertension, some which are out of the patients control, and others that can be
altered to reduce a patient’s risk.
Family history, genetic factors, and
age over 40 are examples of risk factors that cannot be altered.
Patients that are overweight, have
high levels of stress, have high intake of caffeine or alcohol, who smoke, or do
not exercise regularly can make lifestyle changes to decrease their risk for
hypertension.
Certain medications can also increase
the risk of developing high blood pressure—steroids, oral contraceptives, and
estrogen have all been found to be culprits.
Long term use of over-the-counter
non-steroidal anti-inflammatory agents (NSAIDS), such as aspirin, ibuprofen,
indomethacin and naprosyn, can cause kidney damage which can lead to further
problems with high blood pressure.
Some medical conditions such as
cirrhosis, kidney disease, Cushing’s disease and pregnancy can cause
hypertension, sometimes only temporarily.
What are the symptoms?
Unfortunately, hypertension usually
has no symptoms. This is why it is often called the "silent killer." The best
way to monitor for the disease is to have regular blood pressure checks by the
patient’s physician, especially if the patient has any of the risk factors for
developing the disease.
Just about every physical examination
includes checking the patient’s blood pressure.
It is done with an inflatable cuff
around the arm, and the person checking the blood pressure listens over the
patient’s artery.
This test may, however, not always be
accurate. Recent exercise, stress, or incorrect cuff size can temporarily
increase the measurement. If the first reading is found to be high, it is
suggested that the reading be repeated a few minutes later.
People with normal blood pressure
should be rechecked at least every two years. If someone if found to have high
normal blood pressure or above, they should be monitored more closely.
Evaluating the blood pressure at home
can eliminate those patients with a syndrome known as "white-coat syndrome."
This is when the patient’s blood pressure is slightly elevated when in the
doctor’s office, most likely due to anxiety, and once the patient is at home,
the blood pressure returns to normal.
If this syndrome is ruled out, and
the hypertension is found to be real, the patient will need further follow up.
Mild hypertension should be rechecked
at least twice over several weeks, and the patient should be evaluated for other
organ damage. This is most often done through laboratory studies.
If the patient is found to have
severe hypertension or any evidence of organ damage, they should be considered
for initiation of drug therapy immediately.
Treatment
For high normal blood pressure or for
mild hypertension, physicians usually have patients try to get it under control
with lifestyle
changes.
These can include increasing
exercise, stopping smoking, and
dietary modification.
Lowering salt intake
is one of the most frequent changes suggested to patients. Unfortunately, these
are not always successful, either because the hypertension is resistant, or the
patient is not compliant with making the changes.
At this point, anti-hypertensive
medications are needed to help control the blood pressure.
There are several different
classifications of drugs that are used to treat hypertension. The physician most
often will prescribe a combination of medications to try to lower the blood
pressure, and make adjustments as necessary to get it under control.
Any treatment should always include
lifestyle modification, regardless of whether or not medications are needed.
At this time, there is no surgical
treatment for hypertension.
The above
opinionated views and information serves to educated and informed consumer . The
information provided herein should not be used during any medical emergency or
for the diagnosis or treatment of any medical condition. It should not replaced
professional advise and consultation. A licensed physician should be consulted
for diagnosis and treatment of any and all medical conditions
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