Hypertension or High Blood Pressure

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Hypertension or high blood pressure is very common serious health condition around the world. It occurs when one's blood pressure is higher than normal (Systolic: 120mmHg/Diastolic: 80mmHg). Depending on the cause, there are two types of hypertension: essential or primary hypertension (90%) and secondary hypertension (10%). There are few causes of hypertension that are modifiable and some are not. Long term complications of hypertension can be deadly. Over 1 billion people around the world are suffering from hypertension and it causes 7.5 million death world wide.

Risk factors:
1.         Essential or primary hypertension (90%): Age, sex, race, obesity, diabetes, less physical activities, excessive salt intake, excessive fatty food intake, excessive alcohol intake, smoking and family history.
2.         Secondary hypertension (10%): Preexisting medical condition such as chronic kidney disease. 

Cause:
Above risk factors can cause hypertension.


Symptoms:
In general, pain in the head and neck, blurred vision, dizziness, and breathlessness.
1.         Primary hypertension: No symptoms, blood pressure rises gradually/silently.
2.         Secondary hypertension: Symptoms associated with other medical conditions.
3.         Emergency or urgency: Confusion, dizziness, chest pain and shortness of breath.

Diagnosis:
Blood pressure often/most commonly measured or taken in brachial artery of upper arm. Other areas to take blood pressure are: mid aspect of posterior calf in popliteal artery and at the ankle, just posterior to the medial malleolus in posterior tibial artery.
Normal blood pressure: 120mmHg/80mmHg
Elevated blood pressure: 120-129mmHg/80-85mmHg
Stage 1 high blood pressure: 130-139mmHg/80-89mmHg
Stage 2 high blood pressure: >140mmHg/>90mmHg

Complications:
1.         Consistent high blood pressure in the artery can cause wear and tear of endothelial cells resulting weakness and damage of the vessel wall leading myocardial infraction, aneurysm and stroke.
2.         Hypertensive crisis: Systolic >180mmHg and diastolic >120mmHg.
3.         Hypertensive urgency with no end organ damage.
4.         Hypertensive emergency with end organ damage such as encephalopathy, stroke, retinal hemorrhages and exudates, papilledema, MI, HF, aortic dissection, kidney injury, microangiopathic hemolytic anemia, eclampsia.
5.         High blood pressure can lead to CAD, LVH, HF, atrial fibrillation, aortic dissection, aortic aneurysm, stroke, chronic kidney disease (hypertensive nephropathy), retinopathy.

Preventions:
1.         Life style change – eat healthy balanced diet with less salt and fatty foods and engage in daily 30-minute mild to moderate physical activities or exercise.
2.         Weight control
3.         Stress reduction

Treatment:
Treat with antihypertensive drugs. Click here to see the list of antihypertensive drugs. 


By-
Maruful Bhuiyan
MD Candidate, Chicago. IL, USA. 

Editor-
Fariha Ahmed
Student of City University of New York (CUNY) 
New York, USA. 

(Any suggestion, comment or correction will be highly appreciated) 

Reference: 

CDC- High Blood Pressure

WHO- Hypertension

Health.gov - Preventing and Controlling Hypertension 

PubMed - Antihypertensives (Blood Pressure Medications)






















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