Hypertension: A Silent Killer

Hypertension: A Silent Killer

By Wazira Firdous Ansari
Hypertension is also known as high blood pressure. It develops when there are difficulties in getting the blood through your body. It may occur due to the narrowing of your arteries or some kind of blockage. If the problem stays, the heart has to work twice as hard to pump your blood. The heart moves blood through narrower vessels, which makes blood pressure rise.
Blood pressure is the force of blood pushing against the walls of the arteries as the heart pumps out blood. Normal blood pressure is required to push the blood through the body and supply oxygen and nutrients to the tissues. But if blood pressure rises and remains elevated over time, a various serious health problems may occur which includes stroke, coronary heart disease and heart failure, chronic kidney disease, and even early death.
Hypertension has been called a “silent killer” because it often has no warning signs or symptoms, and many people do not even know that they have hypertension.
Most of the time, the reason of high blood pressure is not exactly known. This is called essential hypertension.If High blood pressure is caused by other medical condition or medicines you are taking it is called secondary hypertension which may be due to:

  • Chronic kidney disease
  • Disorders of the adrenal gland (such as pheochromocytoma or Cushing syndrome)
  • Hyperparathyroidism
  • Pregnancy or preeclampsia
  • Medications such as birth control pills, diet pills and some other medicines
  • Symptoms of Hypertension

Hypertension does not commonly cause symptoms. But, in some cases, the following symptoms can occur:
Chest pain
Vision problems
Tiredness
Headache
Nausea or vomiting
Pale skin colour
Risk factors for hypertension
In over 90% of cases, no specific cause can be identified. These cases are called primary hypertension. A number of risk factors predispose a person to develop hypertension. These factors include: high salt intake, obesity, having a sedentary lifestyle, smoking, heavy drinking, inadequate sleep, stress, family history of hypertension and increasing age. In a small minority of patients, specific causes may be identified. These include renal diseases, endocrine diseases and some drugs.
How to lower your blood pressure
The simplest way to diagnose yourself hypertension is to get your blood pressure checked by a medical professional with a device called sphygmomanometer. If the blood pressure is:

  • Between 120/80 (120 over 80) and 140/90 (140 over 90) is called pre- hypertension stage – which often leads to hypertension
  • Between 140/90 and 160/100, is stage 1 hypertension
  • Between 160/100 and 180/110, is stage 2 hypertension
  • Above 180/110,is stage 3 hypertension (and you need immediate medical care)

People in stage 3 hypertension tend to suffer from secondary hypertension, which is a form of high blood pressure with known causes such as kidney disease, hormonal disease (e.g. gland tumor, hyperthyroidism), lead poisoning, head injuries and pregnancy.
In primary hypertension (the most common) or secondary hypertension, it’s very important that you consult a doctor for high blood pressure. This is the only way to understand what type of hypertension you are suffering from and which treatment is best for you.
Treatment of hypertension
Treatment typically involves lifestyle changes and medications when necessary. If you are prehypertensive, but otherwise healthy, your doctor is most likely going to encourage lifestyle changes, such as eating a healthy diet, quitting smoking, getting more exercise, and managing stress, as a first step to lowering your blood pressure. However, if this doesn’t work, or you are already hypertensive, you may need medications.
If you are healthy, blood pressure medications are recommended when your blood pressure is 160 / 100 mm Hg or higher, but if you have other cardiovascular risk factors such as atherosclerosis, diabetes, or obesity, your doctor is likely to recommend medication earlier so as to protect your kidneys, heart, brain, eyes and other organs from potential damage. Generally, the treatment goal is to lower blood pressure to less than 140 / 90 mm Hg in people younger than 60, and less than 150 / 90 in people older than 60.
The following different classes of drugs are used to treat high blood pressure are:
Diuretics – these promote the production of urine, which removes excess fluid from the bloodstream. This reduces the volume of blood in your circulatory system, and your blood pressure.
Beta-blockers – these make your heart beat slower and with less force, and your blood vessels open up. This reduces blood pressure, and improves blood flow.
Angiotensin-converting enzyme inhibitors, (ACE inhibitors) – these block the action of a hormone that causes your blood vessels to constrict and that thickens and stiffens the walls of your blood vessels and heart, as well as triggering the release of another hormone that increases the amount of sodium and water in your body. Together, this has the effect of lowering blood pressure.

  • Angiotensin II receptor blockers – these affect similar biochemical pathways as ACE inhibitors, for similar effects.
  • Alpha blockers – these block the action of hormones that trigger vasoconstriction of the smaller arteries and veins, improving blood flow and lowering blood pressure.
  • Calcium channel blockers – these relax and widen blood vessels by preventing calcium from entering heart cells and the muscle cells within the blood vessel walls. This slows your heart rate and vasodilates your arteries, resulting in lower blood pressure.

Diuretics are often recommended as the first line of therapy for most people who have high blood pressure, and no other medical conditions. If you do have a medical condition, then your doctor may choose a medication from one of the other drug classes to suit your individual needs. For example, if you have diabetes, your doctor may prescribe an ACE inhibitor rather than a diuretic, as diuretics sometimes interfere with blood sugar levels. The good thing is that if one drug doesn’t work, then there are plenty more to choose from. And, if your blood pressure is extremely high, your doctor may prescribe combinations of two or more medications to bring it under control.
After you start antihypertensive medication, your doctor will want to follow your blood pressure regularly for a few months to make sure you reach your treatment goal. You may also need blood tests to check the health of your kidneys, which are sometimes affected as a side effect of blood pressure medicine.
Prevention and Control of hypertension
Regular visits to your doctor and getting the right tests done is important. They can detect irregularities in your blood pressure.
It’s vital to pay attention. This is especially true when it starts to show up with problems in other parts of your body.Pay attention to your body and take care of yourself by taking a balanced diet that is low in salt, keeping physically active, avoiding obesity, quitting smoking, a voiding alcohol consumption and managing stress are useful in preventing hypertension. Periodic checks for blood pressure can detect hypertension early. So, we should take good care and proper management is essential for this silent killer disease from leading to various hypertension related complications

—The author is working at SKIMS Soura Srinagar as a staff nurse. She can be reached at: Firdousansari4133@redifmail.com

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