HIGH BLOOD PRESSURE

WHAT IS HIGH BLOOD PRESSURE OR HYPERTENSION?

It refers to the force or pressure of the blood against the walls of the blood vessels, also known as arteries.

Normal Blood Pressure: 120(systolic) / 80(diastolic) mmHg

The first (or top) number is your systolic blood pressure. It is the highest level your blood pressure reaches when your heart beats.

The second (or bottom) number is your diastolic blood pressure. It is the lowest level your blood pressure reaches as your heart relaxes between beats.

Blood pressure is measured in millimetre Mercury.

When do I have High Blood pressure also known as Hypertension?

When systolic is > 140-160mmHg.

When diastolic is > than 85mmHg patient must change his/her lifestyle;

> 90 mmHg patient must get medicine;

> 95mmHg patient is not controlled on current medicine

>above 100mmHg patient will be referred to hospital (Hypertensive crisis).

RISK FACTORS [3;4]

The risk of getting high blood pressure increases with age.

Men are said to be more susceptible until the age of 64 years and women become more likely after the age of 65 years.
People of an African descents are said to have a higher risk of developing high blood pressure at an earlier age than other races.

Family history: having a first-degree family member who has high blood pressure and developed it at a young age puts you at higher risk.

Being overweight or obese results in you needing more blood to supply oxygen and nutrients to your tissues, resulting in an increase of pressure on the walls of your arteries.

Smoking or chewing tobacco raises your blood pressure and it has a direct toxicity to the wall of your arteries.

Too much salt or sodium in your diet increase your blood pressure.

Too little potassium in your diet causes an increase in your sodium as it helps to balance the sodium in the body cells, thus causing an increase to you blood pressure.

Excessive alcohol in the long run will cause damage to your heart, thus affecting the blood pressure.

High stress levels can cause an increase in your blood pressure.

Chronic conditions such as kidney disease, diabetes and sleep apnoea can cause an increase to the blood pressure.

CAUSES [5]

Primary hypertension: developed over time with no identifiable cause.
- Genetics: inherited from parents.
- Physical changes of the body.
- Environment such as unhealthy lifestyle such unhealthy eating habits and lack of physical activity.
Secondary hypertension: caused by something else and often happens quickly.
- Kidney disease
- Congenital heart defects
- Thyroid problems
- Side effects of certain medications
- Illegal drug use and alcohol or chronic use
- Adrenal gland problems
- Endocrine tumors

SIGNS AND SYMPTOMS

Severe headache

Nosebleeds

Fatigue or confusion

Vision problems

Chest pain

Difficulty breathing

Irregular heartbeat

Buzzing in ears

Pounding in your chest, neck, or ears

COMPLICATIONS

Eye sight problems: vision loss may be experienced due to weakened narrowed or torn blood vessels that are a result of high blood pressure. [2]

Stroke: persistent high blood pressure may lead to damage to the arteries and may result in haemorrhages and thus poor blood flow to the brain. [1]

Heart failure: due to high blood pressure the heart thus has to pump against high pressure which leads to the heart walls working harder causing them to thicken. A thickened wall will make it harder for the heart to pump to meet the needs of the body. [2]

Heart attack: high blood pressure may lead to thickening or hardening of the arteries which can result in a heart attack. [2]

Kidney failure: blood is filtered through the kidneys and when the small blood vessels of the kidney experience damage due to high pressure waste will be unable to be filtered by the body. [1]

Dementia: if blood vessels that supply the brain with blood are narrowed, it will limit the amount of blood flowing to the brain causing a type of dementia known as vascular dementia.[1] A mental deterioration will be experienced, and it will affect daily living.

Aneurysm: blood vessels can become weakened and bulge due to increase in blood pressure. [2]

LIFESTYLE CHANGES

Educate yourself on blood pressure number. Know what ranges are healthy and unhealthy. If you can, monitor your number at home and chart them down and present them to the doctor when you go for your appointment. [7]

High blood pressure is a lifelong disease and it is said to be a ‘silent killer’. Make sure you listen to your doctor, take medications as prescribed and go for regular check-ups. [7]

Being overweight can raise blood pressure and may cause interference with breathing during sleep (sleep apnoea). Weight loss is essential to help with the control of blood pressure. [6]

Regular exercise of about 30 minutes a day, on five or more days of the week. This can includes exercises such as aerobics, brisk walking, jogging, cycling, swimming, dancing, etc. Exercise can help in reducing blood pressure. [6]

Having a healthy diet which consists mostly of whole grains, fruits, vegetables, low-fat dairy products and less saturated fats and cholesterol such as fast food can help in reducing your blood pressure. [6]

Reduce the amount of sodium in your diet. Read labels, eat fewer processed foods, don’t add salt to your food, etc [6]

Limit the amount of alcohol you consume. Too much alcohol can increase your blood pressure. [6]

Stop smoking as it can increase your blood pressure many minutes after you have finished smoking. [6]

Find methods to help you manage stress such as, yoga, deep breathing exercises, meditations, etc. Try to avoid stress triggers, make time for activities you enjoy and focus on issues you can control and make plans to solve those. [6]

Cut down on the amount of caffeine you take. It has been seen to raise blood pressure of those who rarely drink it. [6]

High Blood Pressure - Hypertension

High blood pressure is known as the ‘silent killer’ because there are usually no warning signs and no obvious symptoms. As a result, many people are unaware they have it and many people who are diagnosed often find it difficult to accept.

WHAT IS HIGH BLOOD PRESSURE?

When your heart beats it pumps blood around your body. This is vitally important because it supplies your body’s tissues and organs with the oxygen and nutrients it needs to function.

As the blood moves, it pushes against the inner walls of your arteries.1 The force or strength of this pushing is your blood pressure.

High blood pressure occurs when your blood applies too much force against the walls of your blood vessels.2a Elevated blood pressure is not necessarily cause for concern. For example, it increases when you exercise or when you are stressed.3a This is normal. However, if your blood pressure is persistently high, over a longer period of time it can lead to serious complications such as increasing your risk of:

Heart disease

Stroke

Kidney failure

Blindness

Blood vessel damage

Sudden cardiac death4

Hypertension is the medical term for High Blood Pressure

WHO GETS IT?

High blood pressure occurs more frequently in older people but it affects most people in adulthood to some extent.3b While certain risk factors such as age and genetics cannot be modified, there are numerous factors such as lifestyle choices that can be controlled.

Regardless, hypertension does not go away on its own so it’s important to know what causes it, who is at risk and to get your blood pressure checked at least once a year.2b

According to the World Health Organisation, of the estimated 1.13 billion people who have high blood pressure, fewer than 1 in 5 have it under control

CAUSES AND RISK FACTORS

Hypertension is often described as either primary or secondary.

PRIMARY HYPERTENSION (UNKNOWN CAUSES)

Also known as essential hypertension, primary hypertension is the most common type. It usually takes years to develop, and while it has no single identifiable cause, a combination of risk factors may play a role including:

Genetics – gene mutations or abnormalities inherited from your parents

Age - physical changes in the body as you get older

Lifestyle – being overweight, lack of exercise, too much alcohol, smoking, and a high salt diet, sleep deprivation6a, 7a

SECONDARY HYPERTENSION (CAUSED BY OTHER CONDITIONS AND MEDICATIONS)

Secondary hypertension often occurs faster than primary hypertension. Causes may include:

Tumours in the adrenal gland

Thyroid problems – if the thyroid produces too much or too little thyroid hormone

Obstructive sleep apnea – a condition where a person’s breathing regularly stops and starts while sleeping

Congenital vascular malformation – hereditary problems with blood vessels

Certain prescription medications such as oral contraceptives

Alcoholism or drinking too much alcohol7b, 8

SIGNS AND SYMPTOMS

Unlike a cold or flu, asthma, or a migraine, you cannot ‘feel’ high blood pressure. If you experience symptoms such as headaches, shortness of breath, dizziness, chest pain or nosebleeds, your blood pressure levels are likely at a dangerous or life-threatening stage.2c, 6b

You can have high blood pressure for years and not have any symptoms. Even when blood pressure elevates to dangerous levels, many people experience no signs or symptoms2c

HOW IS HIGH BLOOD PRESSURE DIAGNOSED?

High blood pressure is easily detected. Diagnosis is simple and pain free. All you need is a blood pressure measurement taken by a healthcare professional (doctor, clinic sister or nurse) using an inflatable arm cuff and pressure measuring gauge or stethoscope.

Your blood pressure measurement recording shows two numbers, expressed as systolic blood pressure (SBP) over diastolic blood pressure (DB).

DIASTOLIC BLOOD PRESSURE3D, 5C, 9B

The bottom number measures the pressure inside your artery when your heart rests between beats and refills with blood. The cycle in which your blood pressure falls is called diastole.

SYSTOLIC BLOOD PRESSURE3C, 5B, 9A

The top number measures the pressure inside your artery when your heart contracts, or beats and pumps blood through your body. Blood pressure is at its highest or in its peak cycle, which is called systole.

Understanding your blood pressure numbers:

Definitions and classification of office BP (mmHg)

IF YOUR BLOOD PRESSURE READING IS HIGH6C

If your blood pressure measurement is high, you may need to have more readings taken in the following days or weeks. A hypertension diagnosis is seldom given after just one measurement. There could be various reasons for your elevated blood levels such as stress about an upcoming business pitch. Also, keep in mind that your blood pressure naturally goes up and down throughout the day.

HOW TO TREAT HYPERTENSION

Various factors, such as identified causes help to inform treatment options, which will likely start with lifestyle changes to lower your blood pressure particularly when it comes to primary hypertension. Lifestyle changes may be sufficient if your blood pressure levels are elevated but, if your blood pressure is really high, your doctor may prescribe medication straight away.6d

In the case of secondary hypertension, if your doctor identifies an underlying health condition, he or she will:

Recommend treatment to address the underlying condition or 6e

If certain medications you are taking to treat a pre-existing condition are raising your blood pressure levels, he or she will:

Change your medication6f

EDUCATE YOURSELF AND OTHERS

Most doctors and clinic sisters take a blood pressure reading as part of a routine visit. If you don’t receive one at your next appointment, request it.

If your blood pressure sits in the healthy (normal) range, maintain or adopt a healthy lifestyle to prevent or delay the onset of high blood pressure. Eat a heart-healthy diet and limit your salt intake, exercise regularly, and limit your alcohol intake.2c

If you discover your blood pressure does not sit in the healthy range, a healthy lifestyle together with medication often helps to bring it under control to reduce your risk of life-threatening complications.2d

REFERENCES

Shackelford, K. [Internet]. Health Complications of Hypertension. New York: Verywell health; [updated 2019 Apr 21; cited 2019 Aug 19]. Available from: https://www.verywellhealth.com/complications-of-hypertension-1763820.
Mayo Clinic Staff [Internet]. High blood pressure (hypertension). America: Mayo Clinic; [update 2018 May 12; cited 2019 Aug 19]. Available from: https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410.
Mayo Clinic Staff [Internet]. High blood pressure (hypertension). America: Mayo Clinic; [updated 2018 May 12; cited 2019 Aug 23]. Available from: https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410.
WebMD [Internet]. Causes of High Blood Pressure. America: WebMD LLC; [updated 2017 Jul 11; cited 2019 Aug 23]. Available from: https://www.webmd.com/hypertension-high-blood-pressure/guide/blood-pressure-causes#1.
Holland, K. [Internet]. Everything you need to know about High Blood Pressure (Hypertension). America: Healthline Media; [updated 2018 Feb 01; cited 2019 Aug 23]. Available from: https://www.healthline.com/health/high-blood-pressure-hypertension#overview.
Mayo Clinic Staff [Internet]. 10 ways to control high blood pressure without medication. America: Mayo Clinic; [updated 2019 Jan 09; cited 2019 Sep 04]. Available from: https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974.
America heart Association [Internet]. Changes you Can Make to Manage High Blood Pressure. America: America Heart Association; [updated 2017 Nov 30; cited 2019 Sep 04]. Available from: https://www.heart.org/en/health-topics/high-blood-pressure/changes-you-can-make-to-manage-high-blood-pressure.
American Heart Association [Internet]. High Blood Pressure. America: American Heart Association; [cited 2019 Sep 11]. Available from: https://www.heart.org/en/health-topics/high-blood-pressure.
American Heart Association [Internet]. Health Threats from High Blood Pressure. America: American Heart Association; [updated 2019 Oct 31; cited 2019]. Available from: https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure.