Hypertension

HYPERTENSION:

Hypertension is a chronic medical condition in which the blood pressure is elevated. It is also referred to as high blood pressure or shortened to HT, HTN, or HPN. The word “hypertension”, by itself, normally refers to systemic, arterial hypertension.

Hypertension can be classified as either essential (primary) or secondary. Essential or primary hypertension means that no medical cause can be found to explain the raised blood pressure. It is common. About 90-95% of hypertension is essential hypertension.[2][3][4][5] Secondary hypertension indicates that the high blood pressure is a result of (i.e., secondary to) another condition, such as kidney disease or tumours(adrenal adenoma or pheochromocytoma).

Persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial aneurysm, and is a leading cause of chronic renal failure.[6] Even moderate elevation of arterial blood pressure leads to shortened life expectancy. At severely high pressures, defined as mean arterial pressures 50% or more above average, a person can expect to live no more than a few years unless appropriately treated.[7] Beginning at a systolic pressure (which is peak pressure in the arteries, which occurs near the end of the cardiac cycle when the ventricles are contracting) of 115 mmHgand diastolic pressure (which is minimum pressure in the arteries, which occurs near the beginning of the cardiac cycle when the ventricles are filled with blood) of 75 mmHg (commonly written as 115/75 mmHg), cardiovascular disease (CVD) risk doubles for each increment of 20/10 mmHg.[8]

A recent classification recommends blood pressure criteria for defining normal blood pressure, prehypertension, hypertension (stages I and II), and isolated systolic hypertension, which is a common occurrence among the elderly. These readings are based on the average of seated blood pressure readings that were properly measured during 2 or more office visits. In individuals older than 50 years, hypertension is considered to be present when a person’s blood pressure is consistently at least 140 mmHg systolic or 90 mmHg diastolic. Patients with blood pressures over 130/80 mmHg along with Type 1 or Type 2diabetes, or kidney disease require further treatment.[8]

Classification	Systolic pressure		Diastolic pressure
	mmHg	kPa (kN/m2)	mmHg	kPa (kN/m2)
Normal	90–119	12–15.9	60–79	8.0–10.5
Prehypertension	120–139	16.0–18.5	80–89	10.7–11.9
Stage 1	140–159	18.7–21.2	90–99	12.0–13.2
Stage 2	≥160	≥21.3	≥100	≥13.3
Isolated systolic hypertension	≥140	≥18.7	<90	<12.0
Source: American Heart Association (2003).[8]

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Signs and symptoms

Mild to moderate essential hypertension is greatly asymptomatic.[15][16][17][18][19] Accelerated hypertension is associated with headache, somnolence, confusion, visual disturbances, and nausea and vomiting(hypertensive encephalopathy).

Retinas are affected with narrowing of arterial diameter to less than 50% of venous diameter, copper or silver wire appearance, exudates, hemorrhages, or papilledema.[20] Some signs and symptoms are especially important in infants and neonates such as failure to thrive, seizure, irritability or lethargy, and respiratory distress.[21] While in children hypertension may cause headache, fatigue, blurred vision, epistaxis, and bell palsy.[21]

Health – Lowering Blood Pressure

Ten ways to go beyond low-sodium.

You can’t see it, you can’t feel it, and unless you get checked, you won’t even know you have it. That makes high blood pressure, or hypertension, a quiet killer, one that slowly damages your blood vessels, heart, and eyes while simultaneously increasing your risk of heart disease, stroke, dementia, and kidney disease. High blood pressure results in stiff, inflexible arteries that are virtual magnets for cholesterol and other blood components that form the gunk known as plaque. If you already have this gunk, blood rushing past at high force is just what it takes to nick the “cap” off mounds of plaque, setting the dominoes in motion for a heart attack.

One in five Americans have high blood pressure, and nearly a third don’t know they have it. Many of the rest of us are at risk, as blood pressure slowly creeps up with age. Regardless of where your blood pressure lies along the spectrum, the following tips will help lower it if it’s high, and keep it from rising if it’s where it should be–guaranteed.

1. Every morning, take a brisk 15-minute walk.
Amazingly, you don’t need a lot of exercise to make a difference in your blood pressure. When Japanese researchers asked 168 inactive volunteers with high blood pressure to exercise at a health club for different amounts of time each week for eight weeks, blood pressure dropped almost as much in those who exercised 30-90 minutes a week as in those who exercised more than 90 minutes a week.

2. Write “take medication” on your calendar every day.
Twenty-five percent of the time, when your blood pressure hasn’t dropped after you’ve started medication, the reason is that you forgot to take your pills.

3. Buy a home blood pressure kit.
A study in the Journal of the American Medical Association found that home blood pressure testing provides a better overall picture of blood pressure than measurement in a doctor’s office. In the study, office measurement failed to identify 13 percent of patients who had high blood pressure only in the office but not at home (called “white-coat hypertension”). It also failed to identify 9 percent of people who had high blood pressure at home but not in the doctor’s office. Another study, this one presented at the 2004 European Society of Hypertension meeting, found that people who monitored their blood pressure at home had lower overall blood pressure than those who only had their pressure taken at the doctor’s office. A good home blood pressure kit costs under $100, a small price to pay for peace of mind.

4. Sprinkle 2 tablespoons flaxseed over your yogurt in the morning
and mix 2 tablespoons into your ice cream, spaghetti sauce, or other food later in the day. One small study found that adding 4 tablespoons of the crunchy stuff significantly lowered systolic blood pressure (a strong predictor of heart disease) in postmenopausal women with a history of heart disease. Flaxseed is rich in many nutrients and in fiber. Its effects on blood pressure are likely due to its high content of omega-3 fatty acids.

5. Substitute tea for your morning (and afternoon and evening) coffee.
An Australian study found that every one-cup increase in daily tea consumption decreased systolic blood pressure (the top number) two points and diastolic pressure one point. The benefits ended after four cups, however.

6. Dip your chips into guacamole.
Why? Avocados have more bloodpressure-lowering potassium than any other fruit or vegetable, including bananas. We should get about 4.7 grams a day of potassium, but most Americans get just half this amount.

7. Turn to dark chocolate when your sweet tooth asserts itself.
Unlike milk chocolate, dark chocolate is rich in flavonoids that keep your arteries flexible, preventing the increases in pressure that come with stiffer blood vessels. That’s thought to be one reason for the normal blood pressure of a tribe of Panamanian Indians who eat a high-salt diet but also consume massive amounts of cocoa. In addition, a study published in the Journal of the American Medical Association found that three ounces of dark chocolate a day helped to lower blood pressure in older people with isolated systolic hypertension (a type of high blood pressure in which only the upper number of a pressure reading is high). Other good sources of flavonoids include tea and wine, as well as many fruits and vegetables.

8. Snack on roasted soybeans.
These make a crunchy, nutrient-packed munch that’s as yummy as any bag of chips. Studies show that people with high blood pressure can lower their systolic readings by an average of 10 points by eating one ounce of roasted soybeans (also called soy nuts) a day for two weeks. The beans are available at some supermarkets, as well as specialty and health food stores. Just look for unsalted beans.

9. Flavor your food with lots of ground pepper.
Why? Pepper is a strong, dominant flavor that can help you reduce your interest in salt. In fact, your tongue is easily trained away from its salt addiction. When you switch to low-salt foods, your meals may taste bland for a couple of days. Bring in the pepper. And if that doesn’t appeal to you, try garlic, lemon, ginger, basil, or other big-punch flavors you like. After a week, your old favorite foods will taste dreadfully oversalted and your blood pressure will be singing your praises.

10. Eat a banana or a quarter of a cantaloupe at each breakfast.
That’s because both are rich in potassium. Potassium is sometimes called the “un-salt” because if you don’t get enough of it, your blood pressure is likely to rise. It’s easy to slide potassium into your diet. Other high-potassium foods include spinach, lima beans, sweet potatoes, and the aforementioned avocados.

Source: Reader’s Digest