Hypertension: Most Commonly Asked Questions

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High blood pressure or hypertension is a medical condition when the force of the blood pushing against the walls of the blood vessels is very high in a consistent manner. Here are a few frequently asked questions about hypertension which will clear all your doubts about this condition.

Hypertension

1. How to Identify High Blood Pressure?

One can diagnose high BP using repeated routine check-ups. Common symptoms of high blood pressure include:

  1. Severe headache
  2. Fatigue
  3. Vision blurring
  4. Chest pain
  5. Breathing insufficiency
  6. High heartbeat
  7. Pounding in chest or ears
  8. Blood in urine etc.

2. How is Blood Pressure Measured?

The device used to measure blood pressure is known as a sphygmomanometer. The cuff is secured around the arm and the measurement is obtained in mm/Hg (units of pressure). There are two numbers as readings: 

  1. The one written on the top is the systolic blood pressure is the force with which blood flows through the arterial walls. 
  2. The bottom measure is the diastolic blood pressure, which is the force of the blood when the heart does not pump but rests.

3. What are the Criteria to Identify High Blood Pressure?

 As per 2007 guidelines:

  1. Optimal blood pressure is recorded when the patient’s systolic BP is less than 120 mm/Hg and diastolic BP is less than 80 mm/Hg.
  2. Normal blood pressure is recorded when the patient’s systolic BP is between 120-129 mm/Hg and diastolic BP is between 80-84 mm/Hg.
  3. A high normal blood pressure is recorded when the patient’s systolic BP is between 130-139 mm/Hg and diastolic BP is between 85-89 mm/Hg.
  4. Grade 1 hypertension is recorded when the patient’s systolic BP is between 140-159 mm/Hg and diastolic BP is between 90-99 mm/Hg.
  5. Grade 2 hypertension is recorded when the patient’s systolic BP is between 160-179 mm/Hg and diastolic BP is between 100-109 mm/Hg.
  6. Grade 3 hypertension is recorded when the patient’s systolic BP is above 180 mm/Hg and diastolic BP is above 110 mm/Hg. It is also referred to as hypertensive crisis situation.
  7. Isolated systolic hypertension is recorded when the patient’s systolic BP is above 140 mm/Hg and diastolic BP is less than 90 mm/Hg.

4. What are the Causes of Hypertension?

The most common causes of hypertension are:

  1. Old age
  2. Overweight
  3. Low physical activity
  4. High salt intake
  5. Poor dietary regulation
  6. Stress
  7. Excessive alcohol intake
  8. Smoking
  9. Genetic cellular structuring
  10. Family history of high blood pressure

Hypertension can also be induced due to the following disease conditions affecting one’s body namely:

  1. Diabetes
  2. Sleep apnea
  3. Thyroid disorders
  4. Chronic kidney disease
  5. Dyslipidemia 

5. What are the Types of Hypertension?

There are two basic types of hypertension:

  1. When the cause of hypertension is unknown it is called primary hypertension. Obesity, smoking, alcohol consumption, and diet are the reasons behind primary hypertension.
  2. When the causes of hypertension can be identified, it is referred to as secondary hypertension. Generally, hormone abnormalities, thyroid disorder, excessive salt intake, drug-induced hypertension, airway obstruction, and abnormalities in arteries carrying blood to the kidney are the common causes of secondary hypertension.

Other types of hypertension are:

  1. Isolated systolic hypertension
  2. Malignant hypertension
  3. Radiant hypertension
  4. Whitecoat hypertension (BP is high in doctor’s presence, the rest of the time, it is normal)
  5. Labile hypertension (always fluctuating)

6. What is Malignant Hypertension and What are Its Specific Causes?

Malignant hypertension is recorded when one’s BP rises extremely rapid. If one’s systolic pressure shoots up above 180 and diastolic pressure shoots up above 120 it is a case of malignant hypertension. This is a rare occurrence and requires medical assistance immediately. It can also cause organ failure. The specific reasons of malignant hypertension are:

  1. Missing hypertension medications
  2. Kidney disease
  3. Spinal cord injury
  4. Tumor of the adrenal gland
  5. Birth control pills
  6. Collagen vascular disease
  7. Drugs such as cocaine

7. Does High BP Cause a Heart Attack?

Persistent high blood pressure can cause heart failure when the heart is not able to pump blood adequately at a higher force. Ischemic heart diseases and hypertensive hypertrophic cardiomyopathy can also be observed in BP patients.

8. Does High BP Affect Kidneys?

Hypertension affects blood vessels and the nephrons in the kidneys. This leads to improper functioning of the kidneys. Sometimes, if one has kidney failure and the blood is not filtered properly in the kidneys, it can cause high blood pressure as well.

9. Is Hypertension Curable?

Hypertension can be controlled, if it is diagnosed at an early stage. Eating a healthy diet, exercising, limiting alcohol usage, reducing stress, maintaining a healthy sleep routine, reducing smoking habits, managing diabetes, regular health checkups, etc. can help in keeping one’s blood pressure within permissible limits.

10. Why is Hypertension Referred to as a Silent Killer?

One cannot identify hypertension at its early stages as it initially affects internal organs only. When diagnosed at later stages, it can result in heart failure or stroke in the future and hence it is referred to as a silent killer.

11. What Causes Hypertension in a Child?

Overweight is the prime cause of hypertension in children. Other medical conditions like kidney failure, narrowed arteries, etc. can also be a reason for hypertension in children. 

12. What are the Drug Therapies for Hypertension?

Blood thinners, beta-blockers, calcium channel blockers, ACE inhibitors are common drugs used to lower blood pressure. The choice of drugs is decided based on the patient’s age.

13. What is the Best Diet for a Healthy Hypertension Patient?

According to Dr. Insha Khan (Consultant Dietician), high blood pressure can be lowered by following the DASH diet. DASH is the abbreviation for Dietary Approaches to Stop Hypertension. The diet plan includes the following:

  1. More fruits and vegetables (4 to 5 servings per day)
  2. Low-fat dairy products (2 to 3 servings per day) like 1% fat milk or skimmed milk
  3. Reducing food rich in saturated fat, cholesterol, and trans fat
  4. Cut down on sweets (less than 3 per week)
  5. Consumption of poultry, meat fish can be maintained to 6 servings per week
  6. Whole grain foods and nuts (6 to 8 servings per day)
  7. Restrict high sodium, sugary beverages, and red meat (sodium can be cut down to 1500mg per day)
  8. Fluid intake to be minimum 2 liters per day

Apart from diet, it is important to follow some lifestyle modifications to cure hypertension. Physical exercise is very crucial in regulating blood pressure. In addition to regular exercise, stress-free life also plays a major role in reducing hypertension.

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