Definition and Overview

High blood pressure, also known as hypertension, is a condition that occurs when the amount of blood pumped by the heart is more than what the artery walls can accommodate. When the amount of blood is high, complications may occur depending on the relationship between the amount of blood and the capacity of the artery. The more blood that flows and the narrower the artery walls, the higher the blood pressure becomes.

There are two kinds of high blood pressure depending on its cause: these are primary or essential hypertension, which can develop over years and show no symptoms, and secondary hypertension, which occurs as an effect of another underlying condition. Although it is more common among elderly people, high blood pressure can happen to people of any age, including children and teenagers. People who experience hypertension face a higher risk for more serious conditions such as heart attack and stroke.

Causes

There is no definite cause for primary or essential hypertension. It gradually develops throughout the span of many years and is usually aggravated by the aging process. For secondary hypertension, however, there is another underlying medical condition that eventually leads to it. The following are the conditions that are most commonly associated with high blood pressure:

  • Kidney problems
  • Adrenal gland tumors
  • Thyroid problems
  • Congenital defects in blood vessel
  • Sleep apnea

Secondary hypertension may also be caused by taking certain medications and substances such as:

  • Birth control pills
  • Cold remedies
  • Decongestants
  • Pain relievers
  • Alcohol
  • Cocaine
  • Amphetamines

Key symptoms

In some cases of high blood pressure, symptoms do not show even if the blood pressure reading has already reached a high level. This can be dangerous because symptoms may occur only when the condition has become life-threatening. However, the symptoms that are commonly associated with the condition are the following:

  • Dull headaches
  • Dizziness
  • Nosebleeds
  • Problems with balance

Types of treatments available

Making lifestyle changes is usually the first course of treatment recommended for hypertension sufferers. By reducing the activities that heighten their risk for hypertension, patients can maintain a healthy level of blood pressure. Doctors recommend maintaining a healthy diet with a lower level of salt intake, exercising regularly, quitting smoking, and maintaining a healthy weight. People who are overweight can benefit greatly from losing just 5 pounds of weight, which can already significantly lower their blood pressure.

Dietary changes are also usually focused on reducing sodium levels or salt intake. The advisable level of sodium that can be taken in a day by a patient over the age of 51 and has hypertension, diabetes, or chronic kidney disease is 1500 mg. Healthier patients with no other medical conditions can have a salt intake of as much as 2300 mg a day.

These lifestyle and dietary changes also need to be combined with proper medication to keep blood pressure under control. Some common medications prescribed for high blood pressure include:

  • Thiazide diuretics – These medications eliminate sodium and water from the kidneys to reduce blood volume.
  • Beta-blockers – These slow down the beating of the heart, reducing the amount of blood it pumps throughout the body. These, however, need to be combined with other types of medications, as they do not work well alone.
  • Angiotensin-converting enzyme (ACE) inhibitors
  • Angiotensin II receptor blockers (ARBs)
  • Calcium channel blockers
  • Renin inhibitors
  • Alpha blockers
  • Alpha-beta blockers
  • Central acting agents
  • Vasodilators
  • Aldosterone antagonists

Blood pressure that remains high even after the medication has been taken is referred to as resistant hypertension. Doctors may have to work closely with their patients to find the right combination of drugs to take and to monitor the progress of treatment. It is also very important for people with hypertension to take their medications exactly as they are advised to do so by their attending physician. Taking the right doses at the proper time is important especially when different drugs are being combined. Missing doses can have serious negative effects on the condition and may affect the efficacy of treatment.

Patients with hypertension must also approach treatment with a specific goal to achieve. This goal, which is represented by the safe range of high blood pressure they need to maintain, depends on the state of the patient’s overall health as well as their age. The ideal level of blood pressure is 120 mm Hg, but adults aged over 60 or older who are healthy are advised simply to keep their blood pressure lower than 150/90 mm Hg. Adults aged below 60, on the other hand, should keep it lower than 140/90 mm Hg. Lastly, hypertension patients who also have other medical conditions such as chronic kidney disease, diabetes, or coronary artery disease should have a treatment goal of less than 140/90 mm Hg.

During the treatment process, constant monitoring of blood pressure is vital to a patient’s recovery and is very helpful in telling whether or not the prescribed medication is working. Thus, it also helps if family members know how to monitor blood pressure levels so this can be done at any time at the patient’s home.

When to see a doctor

The symptoms of high blood pressure do not usually show until the condition has come to a dangerous level. Because of this, it is important for one’s blood pressure to be checked regularly, especially if the patient already has a history of hypertension or is being treated for chronic hypertension. Blood pressure reading is also usually part of routine check-ups, so it is advisable to see a doctor regularly for well checkups. It is still advisable, however, to get blood pressure monitored at least once every two years since age 18, even if the patient has no history of the condition.

References:

  • Whelton P., Appel L. (2014). “Sodium and Cardiovascular Disease: What the Data Show.” American Journal of Hypertension.
  • Gore, J. (2015). “Accuracy of Cardiovascular Risk Prediction Scores.” Journal Watch.
  • Moloo, J. (2014). “Should Patients with Mild Hypertension be Treated?” Journal Watch.
  • The New England Journal of Medicine. “Thiazide Diuretics.”
  • Sacks, F., Campos, H., (2010). “Dietary Therapy in Hypertension.” The New England Journal of Medicine.
  • Foody, J. (2014). “How do Recent Blood Pressure Recommendations Affect Goal Attainment?” Journal Watch.
  • Soloway, B., (2014). “Hypertension Treatment Shouldn’t Be Tailored to Patient Adiposity.” Journal Watch.
  • Ernst, M., Moser, M. (2009). “Use of Diuretics in Patients with Hypertension.” The New England Journal of Medicine.
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