High blood pressure (hypertension)
High blood pressure (hypertension)
Dr. Faozat Aragbaye
Hypertension is defined as blood pressure above 140/90, and is considered severe if the pressure is above 180/120mmHg
There are two types of hypertension. Each type has a different cause.
1) Primary hypertension is also called essential hypertension. This kind of hypertension develops over time with no identifiable cause. Most people have this type of hypertension.
Risk factors include:
- Genes- Some people are genetically predisposed to hypertension.
- Physical changes- Aging of some internal organs may upset natural balance and this may lead to hypertension
- Environment –Unhealthy lifestyle choices can deal to hypertension.
2) Secondary hypertension often occurs suddenly and can become more severe than primary hypertension. Several conditions that may cause secondary hypertension include:
- kidney disease, obstructive sleep apnea, congenital adrenal hyperplasia, a disorder of cortisol-secreting adrenal glands, hyperthyroidism, or an overactive and thyroid gland.
Others include hyperparathyroidism, which affects calcium and phosphorous levels alcohol abuse or chronic use, pheochromocytoma, a rare cancer of adrenal gland, Cushing syndrome that corticosteroid drugs can cause, pregnancy, obesity, diabetes, due to kidney problems and nerve damage.
Hypertension is a silent condition. Many people won’t experience any symptoms. It may take some time before any symptom is noticed and even then, the symptoms may be attributed to other issues. Symptoms of hypertension can include:
- shortness of breath
- chest pain
- visual changes
- blood in the urine
Diagnosing hypertension is as simple as taking a blood pressure reading. Most doctors’ offices check blood pressure as part of routine visit. A hypertension diagnosis is rarely given after just one reading. If blood pressure remains high , other tests would be conducted to rule out the underlying conditions. These tests can include:
- urine test
- cholesterol screening
- blood for urea and creatinine test
- ultrasound of the kidney and heart
MANAGEMENT AND TREATMENT
1) Lifestyle adjustments are the standard, first line treatment for hypertension. Here are some recommendations on lifestyle adjustments:
- Regular physical exercise- current guidelines recommend that all people, including those with hypertension engage in at least 150 minutes of moderate intensity, aerobic exercise every week, or 75 minutes a week of high intensity exercise. People should exercise on at least 5 days of the week. Examples of suitable activities are walking, jogging, cycling, or swimming
- Stress reduction- Avoiding or learning to manage stress can help control blood pressure. Meditation, warm baths, yoga and simply going on long walks are relaxation techniques that can help relieve stress.
- Avoid consumption of alcohol, recreational drugs, tobacco, and junk food to cope with stress as these can contribute to elevated blood pressure
- Avoid or quit smoking because smoking increases blood pressure.
Specific medications are used to treat hypertension. Antihypertensive medications are recommended by the doctors.
- Reducing salt intake- WHO recommend reducing salt intake to under 5gm a day to decrease risk of hypertension and other related health problems.
- Eating more fruits and vegetables and less fat
- Moderating alcohol consumption.
- Managing body weight. A balanced diet with a calorie intake that matches with individual’s size, sex, and activity level will help.
Uncontrolled high blood pressure can lead to complications including:
- Heart attack or stroke
- Heart failure
- Weakened and narrowed blood vessels of the kidneys
- Thickened, narrowed or torn blood vessels in the eyes
- Metabolic syndrome
- Trouble with memory or understanding