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Monday, February 25, 2013

What Is Hypertension?

Hypertension is defined as an elevated arterial blood pressure higher than 140/90 mmHg. Blood pressure is a parameter that varies continuosly from individual to individual, similar to parameters like age, weight etc.
There are several factors that predisposes to having a high blood pressure, this includes; Age, weight, ethnic background, diet, lifestyleand a lot more that would still be mentioned in details within the body of this write up.

What different blood pressure values Indicates

  The following are the classification of blood pressure levels according to the British Hypertension Society/WHO and European society of Hypertension:

Less than  120/80 .........................>> Optimal blood pressure
Less than 130/85.......................>> Normal
Between 130-139/85-89.............>> High Normal

140-159/90-99.....................>Mild Hypertension
160-179/100-109...................>>Moderate Hypertension
180/110 and above...................>>Severe hypertension

There can however be an isolated systolic hypertension wherein the systolic blood pressure is high and the diastolic remains normal.If the systolic and diastolic pressures falls into different categories in the classification, then the higher value is taken.
However if you are measuring your blood pressure with a home kit, a BP greater than  135/85 mmHg is diagnostic of hypertension.

Causes of Hypertension
 Majority of hypertension in about 80-90 % of people is due to an unknown cause hence it is called Essential/ primary or idiopathic hypertension

Several facctors however predisposes to development of hypertension, this includes;

1. Genetic Factors : Hypertension tends to run in families

2. Obesity: Fat people tend to have higher blood pressure than thin people

3.Alcohol Intake: Consumption of alcohol predisposes to hypertension

4.Smoking

5.High Salt Intake: Taking diets with high level of salt predisposes to hypertension because salts contains sodium

6. Stress: Excessive stress has been found to trigger hypertension


The other form of hypertension is known as secondary hypertension, this is where blood pressure elevation is the result of a specific and potentially treatable cause.
Some common causes includes:

1. Renal diseases such as chronic glomerulonephritis, renovascular diseases and adult polycystic disease

2. Endocrine causes such as Conn's syndrome, adrenal hyperplasia, cushing syndrome and phaechromocytoma

3.Congenital cardiovascular causes like coarctation of the aorta

4.Pregnancy

5.Drugs such as NSAIDs, oral contraceptives

Management of Hypertension
Once hypertension is diagnosed from consecutive blood pressure measurement, important measures has to be taken to reduce the pressure to a range that is as close to normal as possible, failure of which could lead to several complications such as stroke, damage to the kidney, coronary artery disease and lots more.

It is important to present at the hospital as early as possible, where several investigations will be carried out such as;
ECG 

Urine Stix test for protein and blood

Fasting blood sugar

Serum Electrolyte, Urea and Creatinine

Definitive treatment depends on the severity of the BP measurement, once it is not severe, a period of assessment should be provided during which non-drug measures can be used along with repeated BP measurement.

Some useful ways of managing hypertention without drugs are :
  • Weight Reduction : BMI should be < 25kg/m sq.
  •  Low fat and saturated fat diet
  • Low sodium diet < 6g sodium chloride per day
  • Limited alcohol consumption
  • Increased fruit and vegetable
  • Increase oily fish consumption
  • Dynamic exercise, at least 30 minutes brisk work per day
  • Quit smoking                                                                                                                                     
   
Drug therapy should usually be initiated after a period  of careful assessment and in severe or malignant hypertension.There are various classes of drugs that can be used, and this i plan to elaborate in future.


Article was written by DR. Adeyinka Adegbosin,  the curator of this blogs, readers feedback are well appreciated, do not hesitate to leave a comment if you find this article useful.
You can invite me to write topics on various health issues for you, i will most likely oblige; send email to chainblogs@gmail.com

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