High blood pressure is a common condition in which the force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.
Blood pressure is determined by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.
Causes :-
There are two types of high blood pressure :-
01. Primary (essential) hypertension For most adults, there's no identifiable cause of high blood pressure. This type of high blood pressure, called essential hypertension or primary hypertension, tends to develop gradually over many years.
02. Secondary hypertension Some people have high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including:
03. Kidney problems
04. Adrenal gland tumors
05. Certain defects in blood vessels you're born with (congenital)
06. Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs
07. Illegal drugs, such as cocaine and amphetamines.
Symptoms :-
A. Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels.
B. Although a few people with early-stage high blood pressure may have dull headaches, dizzy spells or a few more nosebleeds than normal, these signs and symptoms typically don't occur until high blood pressure has reached a severe — even life-threatening — stage.
Risk factors :- (High blood pressure has many risk factors, including: )
01. Age. The risk of high blood pressure increases as you age. Through early middle age, high blood pressure is more common in men. Women are more likely to develop high blood pressure after menopause.
02. Race. High blood pressure is particularly common among blacks, often developing at an earlier age than it does in whites. Serious complications, such as stroke and heart attack, also are more common in blacks.
03. Family history. High blood pressure tends to run in families.
04. Being overweight or obese. The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so does the pressure on your artery walls.
05. Not being physically active. People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction — and the stronger the force on your arteries. Lack of physical activity also increases the risk of being overweight.
6. Using tobacco. Not only does smoking or chewing tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls. This can cause your arteries to narrow, increasing your blood pressure. Secondhand smoke also can increase your blood pressure.
7. Too much salt (sodium) in your diet. Too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.
8. Too little potassium in your diet. Potassium helps balance the amount of sodium in your cells. If you don't get enough potassium in your diet or retain enough potassium, you may accumulate too much sodium in your blood.
Too little vitamin D in your diet. It's uncertain if having too little vitamin D in your diet can lead to high blood pressure. Vitamin D may affect an enzyme produced by your kidneys that affects your blood pressure.
10. Drinking too much alcohol. Over time, heavy drinking can damage your heart. Having more than two drinks a day can raise your blood pressure.
11. Stress. High levels of stress can lead to a temporary, but dramatic, increase in blood pressure. If you try to relax by eating more, using tobacco or drinking alcohol, you may only increase problems with high blood pressure.
12. Certain chronic conditions. Certain chronic conditions also may increase your risk of high blood pressure, including high cholesterol, diabetes, kidney disease and sleep apnea.
Sometimes pregnancy contributes to high blood pressure, as well.
Although high blood pressure is most common in adults, children may be at risk, too. For some children, high blood pressure is caused by problems with the kidneys or heart. But for a growing number of kids, poor lifestyle habits — such as an unhealthy diet and lack of exercise — contribute to high blood pressure.
Complications :-
The excessive pressure on your artery walls caused by high blood pressure can damage your blood vessels, as well as organs in your body. The higher your blood pressure and the longer it goes uncontrolled, the greater the damage.
Uncontrolled high blood pressure can lead to:
A. Heart attack or stroke. High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications.
B. Aneurysm. Increased blood pressure can cause your blood vessels to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening.
C. Heart failure. To pump blood against the higher pressure in your vessels, your heart muscle thickens. Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body's needs, which can lead to heart failure.
D. Weakened and narrowed blood vessels in your kidneys. This can prevent these organs from functioning normally.
E.. Thickened, narrowed or torn blood vessels in the eyes. This can result in vision loss.
F. Metabolic syndrome. This syndrome is a cluster of disorders of your body's metabolism — including increased waist circumference, high triglycerides, low high-density lipoprotein (HDL), or "good," cholesterol, high blood pressure, and high insulin levels. If you have high blood pressure, you're more likely to have other components of metabolic syndrome. The more components you have, the greater your risk of developing diabetes, heart disease or stroke.
G. Trouble with memory or understanding. Uncontrolled high blood pressure may also affect your ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people who have high blood pressure.
Tests and diagnosis :-
Blood pressure is measured with an inflatable arm cuff and a pressure-measuring gauge. A blood pressure reading, given in millimeters of mercury (mm Hg), has two numbers. The first, or upper, number measures the pressure in your arteries when your heart beats (systolic pressure). The second, or lower, number measures the pressure in your arteries between beats (diastolic pressure).
Blood pressure measurements fall into four general categories
01. Normal blood pressure. Your blood pressure is normal if it's below 120/80 mm Hg. However, some doctors recommend 115/75 mm Hg as a better goal. Once blood pressure rises above 115/75 mm Hg, the risk of cardiovascular disease begins to increase.
02. Prehypertension. Prehypertension is a systolic pressure ranging from 120 to 139 mm Hg or a diastolic pressure ranging from 80 to 89 mm Hg. Prehypertension tends to get worse over time.
Stage 1 hypertension. Stage 1 hypertension is a systolic pressure ranging from 140 to 159 mm Hg or a diastolic pressure ranging from 90 to 99 mm Hg.
Stage 2 hypertension. More severe hypertension, stage 2 hypertension is a systolic pressure of 160 mm Hg or higher or a diastolic pressure of 100 mm Hg or higher.
Both numbers in a blood pressure reading are important. But after age 50, the systolic reading is even more significant. Isolated systolic hypertension — when diastolic pressure is normal but systolic pressure is high — is the most common type of high blood pressure among people older than 50.
Medications to treat high blood pressure ;-
01. Thiazide diuretics. Diuretics, sometimes called water pills, are medications that act on your kidneys to help your body eliminate sodium and water, reducing blood volume. Thiazide diuretics are often the first — but not the only — choice in high blood pressure medications. If you're not taking a diuretic and your blood pressure remains high, talk to your doctor about adding one or replacing a drug you currently take with a diuretic.
02. Beta blockers. These medications reduce the workload on your heart and open your blood vessels, causing your heart to beat slower and with less force. When prescribed alone, beta blockers don't work as well in blacks or in older adults — but they're effective when combined with a thiazide diuretic.
03. Angiotensin-converting enzyme (ACE) inhibitors. These medications help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels.
04. Angiotensin II receptor blockers (ARBs). These medications help relax blood vessels by blocking the action — not the formation — of a natural chemical that narrows blood vessels.
05. Calcium channel blockers. These medications help relax the muscles of your blood vessels. Some slow your heart rate. Calcium channel blockers may work better for blacks and older adults than do ACE inhibitors or beta blockers alone. A word of caution for grapefruit lovers, though. Grapefruit juice interacts with some calcium channel blockers, increasing blood levels of the medication and putting you at higher risk of side effects. Talk to your doctor or pharmacist if you're concerned about interactions.
06. Renin inhibitors. Aliskiren (Tekturna) slows down the production of renin, an enzyme produced by your kidneys that starts a chain of chemical steps that increases blood pressure. Tekturna works by reducing the ability of renin to begin this process. Due to a risk of serious complications, including stroke, you shouldn't take aliskiren with ACE inhibitors or ARBs.
If you're having trouble reaching your blood pressure goal with combinations of the above medications, your doctor may prescribe: -
A. Alpha blockers. These medications reduce nerve impulses to blood vessels, reducing the effects of natural chemicals that narrow blood vessels.
B. Alpha-beta blockers. In addition to reducing nerve impulses to blood vessels, alpha-beta blockers slow the heartbeat to reduce the amount of blood that must be pumped through the vessels.
C. Central-acting agents. These medications prevent your brain from signaling your nervous system to increase your heart rate and narrow your blood vessels.
D. Vasodilators. These medications work directly on the muscles in the walls of your arteries, preventing the muscles from tightening and your arteries from narrowing.
Lifestyle changes to treat high blood pressure. No matter what medications your doctor prescribes to treat your high blood pressure, you'll need to make lifestyle changes to lower your blood pressure. These changes usually include eating a healthier diet with less salt (the Dietary Approaches to Stop Hypertension, or DASH, diet), exercising more, quitting smoking and losing weight.
Lifestyle and home remedies:-
1. Eat healthy foods.
2. Decrease the salt in your diet
3. Maintain a healthy weight
4. Increase physical activity.
5. Limit alcohol
6. Don't smoke
7. Manage stress
8. Monitor your blood pressure at home.
9. Practice relaxation or slow, deep breathing.
Alternative medicine :-
Although diet and exercise are the best tactics to lower your blood pressure, some supplements also may help decrease it. These include
01. Alpha-linolenic acid
02. Blond psyllium
03. Calcium
04. Cocoa
05. Cod-liver oil
06. Coenzyme Q10
07. Omega-3 fatty acids
08. Garlic.
Tips to help you remember to take your blood pressure medicine :-
01. Take your medicine after you brush your teeth. Keep it with your toothpaste as a reminder.
02. Put self-stick notes in visible places to remind yourself.
03. Use a weekly pillbox to store your medicines so you can see at a glance whether you’ve taken the current day’s dose.
04. Keep your medicine on the nightstand next to your bed to remind yourself to take your evening medications.
05. Ask a friend or relative to call your telephone answering machine to remind you to take your medicine; then don’t erase the message.
06. Establish a buddy system with a friend who also takes a medication each day.
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