High Blood Pressure (Hypertension)

heart impulsEvery fourth adult on the planet has a moderately elevated blood pressure, and every thirteenth is suffering from more severe forms of hypertension. Many consider that moderately increased pressure is not harmful, but if left untreated may lead to serious consequences.

Research shows that if high blood pressure is not controlled, it can be a major factor in the occurrence of stroke. During hypertension, there is also a risk of angina pectoris and myocardial infarction, various diseases of the heart and kidney damage.

In people with diabetes, high blood pressure can cause visual impairment or even lead to blindness.

The medical term for high blood pressure is hypertension. This word means increased pressure of the fluid in the blood vessels.

It is known that the blood pressure is the power of the blood directed towards the walls of arteries, and at the same time, the heart pumps blood through the vast network of blood vessels consisting of arteries, veins and millions of capillaries.

In a healthy body, the walls of blood vessels are elastic, and nothing obstructs the blood moving all over the body, thus bringing fresh oxygen to the cells and carrying the products of metabolism. If the walls of the arteries are damaged by atherosclerosis, they lose flexibility, supply the organs with insufficient blood and heart has to work harder for blood to reach every part of the body.

How the heart works – Facts

–          In the resting state your heart can pulse 4320 times per hour and during this period, it can pump 260 liters of blood.

–          During physical activity, your heart can work five times more intensely.

–          A blood cell can walk the whole body in 45 seconds

What is high blood pressure?

Blood pressureThe heart pumps blood throughout the body through major blood vessels called arteries supplying the brain and body with oxygen and essential nutrients. The pressure of the blood flowing in arteries is determined by how the vigorous heart works and what the condition of the vessels themselves is.

High blood pressure or hypertension occurs when the pressure on the walls of large blood vessels becomes too intense.

In a healthy adult, normal blood pressure is 120/80mm of the mercury column. Ideally, blood pressure should remain lower than 140/85 mm. But if the pressure is consistently higher than that level, and even more if it is greater than 160/90 it requires immediate treatment.

The increased blood pressure in itself does not mean disease. Many people with hypertension feel completely healthy and have no symptoms.

However, consistently high blood pressure over time can cause damage to blood vessels and lead to serious problems: visual impairment, hardening of the arteries (atherosclerosis), heart attack, stroke, heart disease and kidney disease.

Blood Pressure Parameters

–          The average blood pressure is between 120/80 to 140/85 mm of the mercury column.

–          The larger figure (systolic pressure) shows how your heart works. If you are 40 years old, the value of your pressure may predict future heart disease because this pressure characterizes the heart rate and can vary significantly depending on the kind of activity carried out at some point. In healthy people, the amount of systolic pressure is usually 120-140 mm of the mercury column.

–          The lower figure (diastolic pressure) corresponds to the pressure in your arteries when the heart works relaxed. If it is higher than 80-85 mm of mercury column that shows that your blood vessels are damaged or that medium and small blood vessels are narrowed and have lost their elasticity. In healthy people, diastolic pressure is about 80 mm of the mercury column. Usually, doctors consider that diastolic pressure should not exceed 80 mm, and in some cases the figure of 90 can be considered normal.

How is blood pressure regulated?

Blood pressure is controlled by a humoral mechanism of the brain and kidneys. The word “humoral” means that the regulatory impact occurs by substances dissolved in pure blood. The area of the brain that regulates blood pressure gets signals about the strength of the blood pressure of the nerves found in the arteries. Relatively small vessels, arterioles, if necessary can hang or spread, thereby changing blood pressure in the arteries.

This process controls the hormone renin, which is produced by the kidneys. Production of renin causes secretion the other chemical in the blood, angiotensin, which can narrow arterioles and thus increase blood pressure. Angiotensin enhances the secretion of the hormone of the adrenal gland, which in turn allows the salt retention in the body.

Salt increases blood volume, which leads to increased blood pressure.

Hypertension Stages

If systolic pressure ranges between 140 and 159 mm of the mercury column, it means that the first stage of hypertension disease is started. If the systolic and diastolic pressure is in different categories (one increased and the other normal), it tells us in what type (sick or healthy) person belongs.

For example, the pressure 140/80 is seen as the first stage of the illness, although diastolic pressure is normal.

The second stage includes blood pressure with systolic pressure of 160 to 179 mm of mercury column or a diastolic pressure of 100 to 109 mm of the mercury column.

Earlier, the first stage was called mild and second moderate hypertension, but the practice shows that both stages are severe conditions -not only for the course of the disease but also for possible body impairment as a result of high blood pressure.

In the third stage of hypertension parameter for systolic pressure is 180 mm of mercury column and more, or 110 mm of mercury column and more for diastolic pressure.

This case is so serious that the patient must be under the control of the doctor, and the tightening period of the disease is essential and demands hospitalization.

Another situation should be noted here, another type of blood pressure, and that’s when systolic pressure is high and diastolic pressure within the normal range. It is the so-called isolated systolic hypertension disease.

In typical cases, it develops in people after the 65 years of life. This type of illness can cause neck artery stenosis – narrowing of neck artery which leads to a powerful stream of blood to the head and brain. Stenosis occurs due to the creation of clots and their sticking on the walls of arteries, which prevents the normal flow of blood through the blood vessels.

As in the third phase of the disease, after the establishment of the immediate diagnosis treatment is needed.

While for the people whose systolic pressure ranges from 140-160 mm of mercury column (with normal diastolic pressure) it is enough to improve their lifestyle, in the event of a pressure greater than 160 mm of the mercury column, treating it strictly necessary.

Most severe of all forms of this disease is malignant hypertension disease. It’s characterized by high diastolic pressure, usually greater than 130 mm of the mercury column. The disease has an easier outcome if the treatment is started on time.

Without treatment, the patient can die within a year. The disease is accompanied by complications: impairment of the central nervous system, weakening of vision – almost to blindness, severe headaches, sleepiness and loss of consciousness.

All these symptoms are called Hypertensive encephalopathy.

Who is prone to hypertension?

It is not known exactly why some people have hypertension, and some don’t, but certain factors increase the risk.

Age

From 20 to 40 years old, blood pressure gradually increases. After 40 years old this growth is accelerating.

Gender

Annually twenty to forty women have lower blood pressure than men of the same age, but that could change because of hormonal changes, for example during pregnancy. The same applies to older women who use therapy to supplement hormones during menopause.

Inherited factor

If one of your parents had high blood pressure, the probability for it to occur to you is doubled.

Obesity

Obesity is an essential factor in the risk of hypertension, due to the additional strain on the heart.

Diet

It has been proven that the high content of salt and fat intake, and low content of potassium, magnesium, and phosphorus, enable the development of hypertension. Avoid using processed food and eat as many fresh vegetables and fruits.

Stress

The role of the stress in the development of hypertension has not been explained. However, people whose blood pressure increases in stressful situations, are often prone to arterial hypertension.

Smoking

Smokers risk to “earn” high blood pressure more than non-smokers: nicotine constricts blood vessels.

General health

Some diseases are associated with arterial hypertension, and many of them are related to hormonal disorders. A person with diabetes is at risk of stroke, heart and kidney diseases. This risk is growing rapidly if arterial pressure is increased.

High Blood Pressure Examination Process

blood pressure measuringSome doctors call hypertension “the silent killer” since it slightly damages the heart, blood vessels, kidneys, and almost without any noticeable symptoms.

You come to doctor with complains of a headache, the heaviness of the head, dizziness, feeling the flow of blood to the head, insomnia, strong heartbeat – all these symptoms appear because of restlessness, tiredness, or because of change of weather.

After measuring blood, pressure doctor begins to ask questions that seemingly have nothing to do with patient complaints.

Has your body weight changed in recent years? What is your mode of work and rest? Do you get nervous easily? What foods prevalent in your menu? Do you use a lot of salts?

Then little clearer questions follow.

Do you smoke? Do you consume alcoholic beverages, in which quantities and how often? Do you have diabetes? Do you have someone in the family who suffers from hypertension?

Surely you will be asked the following question:

Are you taking some medicines and if you are taking, which are they?

All these questions are directly related to high blood pressure.

By default the doctor will refer you to a more detailed examination, including examination of a stethoscope, blood pressure measurements, growth, weight, and eye check – to determine whether retina is injured.

If the doctor hears the noise of the heart, he may refer you to the X-examination of the chest, to determine if the size of the heart is normal.

The examination continues by checking the pulse of the different parts of the body. It checks the presence of noise in neck artery or other auguries of its tightness and abdominal examination can discover the appearance of noise or aneurysm of the aorta.

Then it will be checked if there is swelling in the legs, which determines the presence of heart insufficiency at a standstill.

Sometimes blood pressure in the thighs is measured, and if parameters are significantly lower than ones from the hand, those are clear symptoms of constriction of the aorta.

Sometimes the doctor measures the blood pressure of the patient in the standing position and compares the results with those from the seating position. This is done to find out whether the body is prone to high oscillation of pressure when changing position. It is also a disease called orthostatic hypertension. Just when standing (especially sharp), one might feel dizzy or even lose balance.

By listening to the lungs, the doctor will want to check if there might be a wet and heavy cough, which would also indicate a heart insufficiency, in which the heart is unable to pump blood efficiently. The neurological examination must show whether the patient previously experienced the micro stroke.

Of course, no research aimed at determining the diagnosis cannot pass without analysis of blood and urine.

Laboratory analysis can show the deviation in the average content of sodium, potassium, protein, glucose, creatinine and urea levels in the blood.

Any disruption can be a symptom of another disease, not excluding here hypertension, its course, and treatment.

Thus, low potassium content can be a symptom of illness of the adrenal gland, high ratios of glucose content – a sign of diabetes, elevated creatinine and urea indicates the kidney disease.  The analysis of the urine can indicate the presence of blood, protein, sugar.

And of course, we need an electrocardiogram (ECG) – a method of recording the electrical potentials from the surface of bodies associated with the cyclical heartbeat.

All checks will help not to make a mistake when concluding the diagnosis of the existence of hypertension and, what is of particular importance, to determine whether it is a primary or secondary disease.

If it is the primary you need to determine at what point the disease is, and if it is secondary you need to determine which disease is its cause.

You need to know all this to get proper treatment. The diagnosis established by incomplete data leads to treatment that can be insufficient, or even to show as contradictory in cases of other diseases.

What do we need to remember?

The problem is that you may not know that you have high blood pressure because it does not produce symptoms.

During hypertension, it does not always come to headaches and nose bleeds. Therefore, it’s vital for everyone to know what his blood pressure is. Regular measuring is necessary and if blood pressure is increased you need to return to the normal state with the help of particular drugs and to change lifestyle.

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