Hypertension, also referred to as high blood pressure, is a condition in which the arteries have persistently elevated blood pressure that it may eventually cause health problems, such as heart disease. Blood pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure. High blood pressure, is dangerous because it makes the heart work harder to pump blood out to the body and contributes to hardening of the arteries, or atherosclerosis, to stroke, kidney disease, and to heart failure.
A blood pressure reading is written like this: 120/80. It’s read as “120 over 80.” The top number is called the systolic, and bottom number is called the diastolic. Systolic—The top or larger number measures the pressure in the arteries while the heart muscle is contracting. Diastolic—The bottom or smaller number measures the pressure while the heart relaxes between beats. Blood pressure usually is measured in millimeters of mercury (mm Hg).
|BLOOD PRESSURE CATEGORY||SYSTOLIC mm Hg
|DIASTOLIC mm Hg
|NORMAL||LES THAN 120||and||LESS THAN 80|
|ELEVATED||120-129||and||LESS THAN 80|
|HIGH BLOOD PRESSURE
(HYPERTENSION) STAGE 1
|HIGH BLOOD PRESSURE
(HYPERTENSION) STAGE 2
|140 OR HIGHER||or||90 OR HIGHER|
(consult your doctor immediately)
|HIGHER THAN 180||and/or||HIGHER THAN 120|
The five blood pressure ranges as recognized by the American Heart Association are:
Blood pressure numbers of less than 120/80 mm Hg are considered within the normal range. If your results fall into this category, stick with heart-healthy habits like following a balanced diet and getting regular exercise.
Elevated blood pressure is when readings consistently range from 120-129 systolic and less than 80 mm Hg diastolic. People with elevated blood pressure are likely to develop high blood pressure unless steps are taken to control the condition.
Hypertension Stage 1
Hypertension Stage 1 is when blood pressure consistently ranges from 130-139 systolic or 80-89 mm Hg diastolic. At this stage of high blood pressure, doctors are likely to prescribe lifestyle changes and may consider adding blood pressure medication based on your risk of atherosclerotic cardiovascular disease (ASCVD), such as heart attack or stroke.
Hypertension Stage 2 is when blood pressure consistently ranges at 140/90 mm Hg or higher. At this stage of high blood pressure, doctors are likely to prescribe a combination of blood pressure medications and lifestyle changes.
This stage of high blood pressure requires medical attention. If your blood pressure readings suddenly exceed 180/120 mm Hg, wait five minutes and then test your blood pressure again. If your readings are still unusually high, contact your doctor immediately. You could be experiencing a hypertensive crisis.
If your blood pressure is higher than 180/120 mm Hg and you are experiencing signs of possible organ damage such as chest pain, shortness of breath, back pain, numbness/weakness, change in vision or difficulty speaking, do not wait to see if your pressure comes down on its own. Call or visit a health facility immediately.
CAUSES OF HYPERTENSION
Based on the cause hypertension can be grouped into two types.
Primary (essential) hypertension
For most adult’s cases, there’s no identifiable cause of high blood pressure. This type of high blood pressure, called primary (essential) hypertension, tends to develop gradually over many years.
This is high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including thyroid problems, Obstructive sleep apnoea, Kidney problems
Adrenal gland tumours, Certain defects you’re born with (congenital) in blood vessels and Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs and some Illegal drugs.
RISK FACTORS FOR HYPERTENSION
High blood pressure has many risk factors, including:
- People with family members who have high blood pressure
- Pregnant women
- Women who take birth control pills
- People over the age of 35
- People who are overweight or obese
- People who are not active
- People who drink alcohol excessively
- People who eat too many fatty foods or foods with too much salt
- People who have sleep apnea
Symptoms and Signs
A person with hypertension may not notice any symptoms, and it is often called the “silent killer.” While undetected, it can cause damage to the cardiovascular system and internal organs, such as the kidneys.
Regularly checking your blood pressure is vital, as there will usually be no symptoms to make you aware of the condition. It is maintained that high blood pressure causes sweating, anxiety, sleeping problems, and blushing. However, in most cases, there will be no symptoms at all. If blood pressure reaches the level of a hypertensive crisis, a person may experience headaches and nosebleeds. Severe hypertension (hypertensive crisis) can cause severe cardiovascular, neurologic, renal, and retinal symptoms (e.g. symptomatic coronary atherosclerosis, HF, hypertensive encephalopathy, renal failure). A 4th heart sound is one of the earliest signs of hypertensive heart disease. Retinal changes may include arteriolar narrowing, hemorrhages, exudates, and, in patients with encephalopathy, papilledema.
Blood pressure can be measured by a sphygmomanometer, or blood pressure monitor. Having high blood pressure for a short time can be a normal response to many situations. Acute stress and intense exercise, for example, can briefly elevate blood pressure in a healthy person. For this reason, a diagnosis of hypertension normally requires several readings that show high blood pressure over time.
The systolic reading of 140 mmHg refers to the pressure as the heart pumps blood around the body. The diastolic reading of 90 mmHg refers to the pressure as the heart relaxes and refills with blood.
Long-term hypertension can cause complications through atherosclerosis, where the formation of plaque results in the narrowing of blood vessels. This makes hypertension worse, as the heart must pump harder to deliver blood to the body.
High blood pressure raises the risk of a number of health problems, including a heart attack.
Hypertension-related atherosclerosis can lead to:
- heart failure and heart attacks
- an aneurysm, or an abnormal bulge in the wall of an artery that can burst, causing severe bleeding and, in some cases, death
- kidney failure
- hypertensive retinopathies in the eye, which can lead to blindness
- Regular blood pressure testing can help people avoid the more severe complications.
Hypertension is diagnosed and classified by sphygmomanometry. History, physical examination, and other tests help identify cause and determine whether target organs are damaged.
Regular health checks are the best way to monitor your blood pressure. While blood pressure is best regulated through the diet before it reaches the stage of hypertension, there is a range of treatment options.
Lifestyle adjustments are the standard first-line treatment for hypertension.
Regular physical exercise
Doctors recommend that patients with hypertension engage in 30 minutes of moderate-intensity, dynamic, aerobic exercise. This can include walking, jogging, cycling, or swimming on 5 to 7 days of the week.
Avoiding stress, or developing strategies for managing unavoidable stress, can help with blood pressure control.
Using alcohol, drugs, smoking, and unhealthy eating to cope with stress will add to hypertensive problems. These should be avoided.
Smoking can raise blood pressure. Giving up smoking reduces the risk of hypertension, heart conditions, and other health issues.
People with blood pressure higher than 140 over 90 may use medication to treat hypertension.
Drugs are usually started one at a time at a low dose. Side effects associated with antihypertensive drugs are usually considered minor.
Eventually, a combination of at least two antihypertensive drugs is usually required.
A range of drug types are available to help lower blood pressure, including:
- diuretics, including thiazides, chlorthalidone, and indapamide.
- beta-blockers and alpha-blockers
- calcium-channel blockers
- central agonists
- peripheral adrenergic inhibitor
- angiotensin-converting enzyme (ACE) inhibitors
- angiotensin receptor blockers
The choice of drug depends on the individual and any other conditions they may have.
Anyone taking antihypertensive medications should be sure to carefully read labels, especially before taking any over-the-counter (OTC) medications, such as decongestants.
These may interact with medications used to lower blood pressure.
Ensuring the following is very helpful
- Cessation of smoking
- No alcohol intake
- Weight reduction and exercise
- Do not stress
Ensuring the following is very helpful
- Reduce salt intake
- No fat intake
- More fruits and vegetables
DRUGS- FOR LIFE!!
HERBAL MANAGEMENT OF Hypertension
Common herbal medicines commonly used in Ghana for the management of hypertension are:
- Allium sativum- Garlic: Contains allicin which relaxes the muscles and as well thins the blood.
- Tetrapleura tetraptera (Prek3se-Twi name): Contains tannic acid which causes vasodilation, reducing the peripheral resistance.
- Diodia scandens: Acts as a diuretic by decreasing fluid volume in the system and helps to reduce the peripheral resistance.
- Lippia multiflora ( Sareso nunum- Twi name): Causes vasodilation and reduce sympathetic hypertension
Causes of High Blood Pressure. WebMD. https://www.webmd.com/hypertension-high-blood-pressure/guide/blood-pressure-causes#1. Accessed May 9, 2019
High blood pressure (hypertension). Mayoclinic. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410. Accessed May 9, 2019
What is high blood pressure? American Heart Association. http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/GettheFactsAboutHighBloodPressure/What-is-High-Blood-Pressure_UCM_301759_Article.jsp#.WrqtReR1rcs. Accessed May 9, 2019.
Hypertensive crisis: When you should call 9-1-1 for high blood pressure. American Heart Association. https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/hypertensive-crisis-when-you-should-call-911-for-high-blood-pressure#.WrqtoOR1rcs. Accessed May 9, 2019.