Hypertension or high blood pressure is a very common condition among adults. It is defined as systolic blood pressure (SBP) that is equal or greater than 140 mmHg or diastolic blood pressure (DBP) that is equal or greater than 90 mmHg. The systolic blood pressure is the highest pressure inside the arteries after the heart has just contracted, whereas the diastolic blood pressure is the lowest pressure inside the arteries when the heart is relaxed. In a blood pressure (BP) reading, the first number corresponds to the SBP, and the second number corresponds to the DBP. Hypertension is defined as a BP of 140/90 or higher.
Hypertension usually presents without any symptoms. Many people go about their daily business without any knowledge that they are hypertensive. Most often, people will only find out about their hypertension when it is already causing complications in other organs of the body. Because of this, hypertension was branded as the “silent killer,” a disease that affects millions of individuals without any warning.
There are two types of hypertension: essential and secondary hypertension.
Essential Hypertension has no identifiable cause. It just develops spontaneously over time. This is the most common type of hypertension that affects millions of adults today. This is largely related to age and heredity. This type of hypertension is generally asymptomatic or silent until it creates an identifiable complication.
Secondary hypertension is the type of hypertension that is caused by other diseases in the body. This type of hypertension develops “secondary” to an underlying condition. Causes of secondary hypertension include:
- Heart problems
- Kidney problems
- Adrenal gland tumor
- Brain tumor
- Sleep apnea
- Drug abuse
Hypertension is a life-threatening disease that has many long-term complications. The elevated pressure in the arteries damages the organs that are supplied by these vessels. Since the arteries supply almost all the organs in the body, hypertension can virtually damage all of the organs in the body. Some of the most common complications of hypertension are:
- Heart disease: Hypertension makes it difficult for the heart to pump against a strong pressure. This can lead to heart attack, heart enlargement and eventual heart failure.
- Stroke: Hypertension can cause the vessels in the brain to rupture, causing a bleed inside the brain.
- Kidney failure: High blood pressure can damage the kidneys permanently, leading to a life-long need for hemodialysis.
- Eyes: High blood pressure can damage the eyes, leading to blurring of vision and even blindness.
Diagnosis of hypertension is very simple. It just involves taking the blood pressure using an apparatus that is placed on the arm or on the wrist. Elevated blood pressure reading at rest on two separate occasions is sufficient to make the diagnosis of hypertension.
Treatment of hypertension is two-pronged. It involves lifestyle changes and medications.
Lifestyle changes can have a big impact in the management of hypertension. In fact, some cases of mild hypertension require only lifestyle changes to be controlled. These lifestyle modifications include:
- Moderating salt and fats/cholesterol in the diet
- Regular exercise (at least 30 minutes per day for 3-4 days a week)
- Weight loss in obese individuals
- Quitting smoking and avoiding too much alcohol
- Avoiding stress
In addition to lifestyle changes, the doctor can also prescribe antihypertensive medications. Examples of these medications are;
- Calcium channel blockers
- ACE inhibitors
These medications are maintenance medications, which mean that they should be taken on a daily basis, often for life. These medications are adjusted by the doctor on a regular basis according to the control of the patient’s hypertension.
A common misconception that most hypertensive patients have is that they can stop taking their medications when they have consumed a full prescription or when their blood pressure becomes normal. What they fail to realize is that hypertension is a life-long condition, and the medications for it have to be taken as maintenance.
It's also a good idea to purchase a blood pressure meter for home monitoring. People monitor their own blood pressure regularly maintain better control and are able to pre-empt complications more effectively.
Hypertension in pregnancy
Most women with high blood pressure will have a normal pregnancy. But women with high blood pressure have a higher chance of having certain problems during pregnancy, such as:
- Preeclampsia – Women with preeclampsia have high blood pressure and too much protein in their urine or problems with organs such as the liver, kidneys, or eyes. Preeclampsia usually happens during the second half of pregnancy, and can be a dangerous condition. It can cause problems with a baby's growth in the mother's uterus. It can also affect the mother's liver, kidneys, blood, heart, and nervous system.
- Placental abruption – The placenta is the organ inside the uterus that brings the baby nutrients and oxygen, and carries away waste. It is attached to the inside wall of the uterus. A placental abruption is when part or all of the placenta separates from the uterus before the baby is born. If this happens, the baby might not get enough nutrients and oxygen.
- Slowed growth of the baby – The baby can be small and not grow normally.
Whether you require medications depends on how high your blood pressure is. If it is very high, you will need to take medicine during pregnancy to keep it under control.
Call your doctor or nurse right away if:
- You don't feel your baby move as much as usual.
- You start having contractions. A contraction is when the uterus muscle squeezes. This can cause pain and make your belly hard.
- You have belly pain.
- You have bleeding from the vagina.
- You have any symptoms of preeclampsia. These can include:
- A bad headache
- Changes in vision, such as blurry vision or flashes of lights
- Pain in the upper belly
If you have high blood pressure during pregnancy, you are more likely to give birth earlier than normal. That's because if you have preeclampsia, a placental abruption, or a baby that is small for its age, the doctor might need to deliver your baby early. But if your blood pressure is under control during pregnancy, chances are good that your baby will be healthy.