THE SILENT KILLER: HYPERTENSION. Dr. Ikongshul G. Ashima

Your body is a conglomerate of cells. The cells unite to form tissues, tissues unite to form an organ and organs unite to form a system and the systems unite to form you. So it all begins with the cells. So when the cells begin to die without being replaced, the tissues formed from those cells begin to die and the organs from those tissues begin to die and the system from those organs will begin to die leading to the death of the individual if there is no quick and proper medical intervention.

To maintain its function, every tissue in the body receives oxygen-full blood supply through a network of an aorta, arteries, arterioles and capillaries in that order and when the cells have used up the oxygen, the blood travels back to the lungs to get more oxygen through a network of venules, veins and the vena cava in that order. This system is known as the circulatory system and this is made possible by the heart and the calf muscles. So before your heart falls in love, it primary purpose is to pump blood.

The blood requires a certain pressure measured in Millimeter mercury (mmHg) to enable it travel to and fro the lungs to go to and fro the tissues, to and fro your cells just like water passing through the water pipes in your house. This pressure is determined both by the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The resistance in the arteries is determined by how narrow your arteries are. Therefore, the narrower your arteries are and the more blood your heart pumps, the higher your blood pressure.

Your systolic and diastolic blood pressure determines your total blood pressure readings. The systolic is the top number and the diastolic is the down number. It is expressed as:

BP= SP (mmHg)/DP (mmHg)

Where,

BP= Blood Pressure, SP=Systolic Pressure, DP= Diastolic Pressure.

Systolic pressure is the highest pressure exert on the wall of your arteries each time your heart beats and pushes the blood round your body.

Diastolic pressure is the lowest pressure exert on the wall of your arteries when your heart relaxes between beats.

For adults aged 18 years and above, normal systolic is lower than 120 mm Hg, and diastolic is lower than 80 mm Hg. That is, normal blood pressure is less than 120/80. When these figures are exceeded, it means your blood pressure is high. This implies that the pressure exerted by the blood on the walls of your arteries is abnormally high and when it goes from 140/90, it is called hypertension. According to WHO, over 1billion people worldwide have hypertension.

Classification and causes of Hypertension

Primary /Essential Hypertension: It is hypertension of unknown cause or as a result of genetic/epigenetic or environmental factors. About 90% of hypertension in adults is primary hypertension.

Secondary Hypertension: It is hypertension caused by multiple factors which include:

Drugs and toxins:

Alcohol

Birth control pills

Cold remedies

Decongestants

Cocaine and amphetamines

NSAIDs

Herbal remedies containing licorice

Cyclosporine

Nicotine

vasopressors (Ephedrine, Epinephrine, dopamine, phenylephrine)

Renal and renal vascular:

Kidney disease

Urinary tract obstruction

Renin-producing tumor

Hormonal:

Cushing syndrome

Primary aldosteronism (excess production of aldosterone hormone from the adrenal gland)

Congenital adrenal hyperplasia (genetic problems that affect the adrenal glands)

Vascular:

Aortic coarctation (narrowing of the aorta)

Inflammation of the blood vessels known as vasculitis

Neurogenic:

Brain tumor

Intracranial hypertension

Autonomic dysfunction

Sleeping disorder known as sleep apnea

Diet

Too much salt: Salt contains sodium and too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.

Too little potassium: Potassium helps balance the amount of sodium in your cells. If you take in less potassium in your diet, you may accumulate too much sodium in your blood.

Too much fatty foods

Eating less fruit and vegetables

Others

Too much stress

Too little physical

Thyroid problems

Congenital defects in blood vessels

Pregnancy induced hypertension

Risk Factors

Age: The risk increases with age from 45 years of age

Sex: Till age 64, it is more common in men than women and women who are above 65 are more likely to have hypertension than men.

Obesity: More body weight means more demand of oxygen by cells of your tissues and as your blood volume increases, the pressure exerted on the walls of your arteries increases as well.

Race:  more common among the African race

Family history

Lack of exercise: this leads to overweight which increases your blood pressure. Using Tobacco: smoking or chewing tobacco immediately raises your blood pressure temporarily.  Nicotin in tobacco can cause your arteries to narrow and increase your risk hypertension.

Diabetes mellitus

Symptoms of Hypertension

The reason why hypertension is called a silent killer is because most of the time, it is asymptomatic. That means you can have hypertension for years without any symptoms to indicate that something is wrong even if your blood pressure readings reach dangerously high levels. Even without symptoms, continuous damages to your blood vessels and heart can be detected.

A few people with hypertension may have:

Headaches

Shortness of breath

Nose-bleeding

Blurry vision

These signs and symptoms most times are not specific and usually don’t occur until the situation has reached a severe or life-threatening stage.

Effect of Hypertension

Over time, hypertension can cause a wide range of problems which includes but not limited to the following:

Aneurysm:  Too much pressure on your blood vessels causes them to become weak and form bulges, called aneurysms. A raptured aneurysm is life-threatening medical emergency.

Heart failure: Extra hard work is required by the heart to pump blood against the higher pressure in your vessels. This leadss to left ventricular hypertrophy; a condition caused by the thickening of the walls of the heart pumping chamber. The thickened muscle will develop difficulties in pumping enough blood to tissues, which can lead to heart failure.

Heart attack or stroke.

Blindness: Hypertension can thicken, narrow or tear blood vessels in the eyes leading to vision problems or blindness.

Kidney failure

Memory or understanding problems: Hypertension may also affect your ability to think, comprehend, remember and learn.

Dementia. Narrowed or blocked arteries can limit blood flow to the brain, leading to a certain type of dementia (vascular dementia). A stroke that interrupts blood flow to the brain also can cause vascular dementia.

 Management of Hypertension

High blood pressure cannot be cured. But it can be managed effectively through:

Lifestyle changes and, when needed, medication

Lifestyle changes

Eat less salt

Eat more fruit and vegetables

Keep to a healthy weight

Make small changes to your eating habits and activity levels that you can keep to for life.

Drink less alcohol

Exercise your body

Stop smoking

When to see your doctor to check your blood pressure

For those who seem healthy, it is recommended as follows:

Age 18: at least every two years

Age 40 and above: every year.

If you fall in the range of 18 to 39 with a high risk of high blood pressure see the doctor every year.

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