INTRODUCTION

Whether it is called hypertension or its other name, high blood pressure, here is another one of those conditions that can be deadly if not given prompt attention. It can be the precursor of other dreaded conditions like stroke and heart attack, both of which have the potential to terminate life very abruptly.

Statistics in the developing world are not always available or reliable, but looking at what obtains in the western world, we can have an idea just how prevalent high blood pressure is. In the United States, for example, hypertension is the third most chronic condition. In the developing world, poor living standards and ignorance can spell danger for many people. Diet in particular could be a major factor contributing to hypertension.

In order to understand hypertension, we should begin by looking at the way blood is circulated throughout the body and, in particular, the pressure exerted on the small blood vessels arteries.

BLOOD PRESSURE

Blood Pressure refers to the pressure of circulating blood against the walls of the arteries. The heart can pump into the large arteries a greater volume of blood than can be absorbed by the tiny arterioles and capillaries. The resulting back pressure is exerted against the arteries. Any condition that makes the blood vessels contract or expand or affect their elasticity, or any disease of the heart that interferes with its pumping power affects the blood pressure.

Blood pressure is an important diagnostic index, especially of circulatory function. In a healthy human being, the blood pressure is maintained within a certain average range with a great constancy. The complex process is controlled by the brain.

Reading Blood Pressure

Blood Pressure is read at two points: the high point at which the heart contracts to empty its blood into circulation, called systole; and the low point at which the heart relaxes to fill with blood returned by the circulation, called diastole. Pressure is measured in millimetres (mm) of mercury by an instrument called a sphygmomanometer (usually called sphyg for short). The doctor or nurse making the examination listens to a stethoscope applied to an artery in the lower arm. During a single cardiac cycle or heartbeat, the blood pressure varies from maximum during systole to minimum during diastole. Usually both measurements are given as a ratio expression of the highest over the lowest, for example, 140/80

Reasons for variation in blood pressure.

In healthy people, blood pressure varies from about 80/45 in infants, to about 120/80 at age 30, to about 140/85  at age 40 and over. Why does it increase with age? In younger people, arteries are elastic and can absorb the shock of heart contracts. This elasticity is lost with age, which forces the pressure to rise.

Blood pressure varies between individuals and in the same individual at different times. It is generally higher in men than in women and children. It is lowest during sleep, and is influenced by a wide range of factors. Many healthy people have habitual systolic pressures of from about 95 to 115 not associated with symptoms or disease.

Abnormally high blood pressure, or hypertension, is considered a contributory cause of arteriosclerosis. Poisons generated within the body generate cause extreme hypertension in various disorders. Abnormally low pressure, or hypotension, is observed in infectious and wasting diseases, haemorrhage, and collapse. A systolic pressure of much lower than 80 is usually associated with shock.

CLASSIFICATION OF BLOOD PRESSURE LEVELS FOR 18 YEARS AND ABOVE

CATEGORY	SYSTOLIC	DIASTOLIC
Normal	Less than 130	Less than 85
High Normal	130-139	85-89
HYPERTENSION
Stage 1 (Mild)	140-159	90-99
Stage 2 (Moderate)	160-179	100-109
Stage 3 (Severe)	180-200	110-119
Stage 4 (Very Severe)	Over 200	Over 119

 

·         Measurement is done in millimetres of mercury.

·         Optimal blood pressure is less than 120/80.

·         Unusually low readings should be evaluated by a physician.

 

HYPERTENSION

Hypertension (high blood pressure) may be classified as secondary hypertension if some other disorder is the cause. More commonly, it is known as essential or primary hypertension if no specific cause is found. Individuals with high blood pressure are at a greater risk of suffering a stroke or a heart attack, but treatment of hypertension reduces this risk.

On the positive side, about 70% of patients have mild hypertension, which is relatively easily managed. The emphasis now is on non-drug therapy for this category.

Causes of Primary Hypertension.

Both environmental and genetic factors are thought to contribute to primary hypertension. As was mentioned earlier, blood pressure tends to increase with age. It is also more likely to occur if a person is overweight, has a diet which includes a lot of salt, has a low potassium intake, drinks a high level of alcohol, is physically inactive, and is under psychological stress. Although it is clear that a tendency to hypertension can be inherited, the genetic factors responsible for this are largely unknown.

Diagnosis

Diagnosis of hypertension is not always straightforward. Within the general population, there are some people with low blood pressure, some with normal, and some who are diagnosed as being hypertensive, but the point at which a person is said to be hypertensive is not easy to define.

Most guidelines suggest that if a person’s diastolic pressure is 90-95mm, and their systolic pressure is greater than 140-160mm, then that person should receive treatment in order to lower the blood pressure. Normally, blood pressure is measured on several separate occasions before a diagnosis is made. Blood and urine samples are tested at the same time.

TREATMENT

The aim of treatment is to reduce blood pressure so that the risk of stroke or heart attack is reduced. Treatment is normally administered by a physician. Losing weight decreases blood pressure, so it is beneficial for an individual to have a diet that is lower in salt, alcohol and total fats, and higher in potassium,, calcium, polyunsaturated fats, magnesium, dietary fibre. Increased physical activities can also reduce blood pressure. Although smoking does not directly cause high blood pressure, it does increase the risk of suffering a stroke or heart attack.

Drug can only be prescribed by a doctor.

 

SECONDARY HYPERTENSION

About 90 per cent of hypertension cases are essential or primary hypertension; the remain 10 per cent are secondary hypertension. This section suffers from hypertension caused by kidney disease, the contraceptive pill or endocrine (hormonal) disorders. If a secondary cause is diagnosed, its treatment should reduce the hypertension.

 

HYPERTENSION DURING PREGNANCY

Severe hypertension in pregnancy is known as pre-eclampsia; this can lead to eclampsia, which may be fatal. Treatment is to lower the blood pressure with drugs, and in serious cases premature delivery of the baby will alleviate the symptoms.

 

KEEP YOUR BLOOD PRESSURE UNDER CONTROL

Practical, inexpensive method based on years of research work on blood pressure.

Watch your weight. While there are lots of hypertensives who are not fat, obese people tend to have three times as much hypertension as people of normal weight.

Twenty per cent above the ideal weight for your height and bone structure is where obesity starts. But obese people need not lose anywhere near that much to reduce high blood pressure. A study show that stout with high blood pressure can achieve normal pressures by losing only half of their excess weight even though they remain “considerably obese”.

Shake the Salt Habit

The link between sodium and high blood pressure has never been proven beyond a doubt. But what is known is that a salt-sensitive subset of hypertensives probably exists, and you may be one of them.

There’s no way to know if you’re salt sensitive other than putting yourself on a low-sodium diet and seeing what effect that has on your blood pressure. So we just ask all our hypertensives to cut down on salt to about 5 grams a day a hope it has a good effect. Most people, once they cut down, really don’t find they need as much salt as they thought they did. So keep the salt low, but don’t count on it to do everything.

Cut down on alcohol. Because the connection between alcohol consumption and high blood pressure has been well documented, people with hypertension should limit their alcohol consumption.

Pass the potassium, please. Increased levels of this mineral may be valuable in helping control high blood pressure. How do you know if you’re getting enough? Well, it’s hard to avoid potassium if you eat plenty of natural foods. Potatoes, fresh fruit and fish are loaded with it.

Make the calcium connection. Calcium seems to have a favourable effect on some people, but the search to discover exactly who will respond favourably to calcium continues.

It seems that salt-sensitive hypertensives, who may be about half the people with high blood pressure, are the same ones who respond well to calcium. So if salt is bad for you, calcium is good.

The kind of exercise to avoid. Exercise, as part of a programme to reduse hypertension, appears to add to the treatment. But isometric exercises (in which muscles are caused to act against each other or against a fixed object) such as weight lifting must be avoided. The reason is that weight-lifting exercises may cause pressure to temporarily skyrocket.

The kind you can try. Numerous studies have shown the beneficial effects of aerobic exercises (designed to increase the body’s oxygen intake) on high blood pressure. But the primary advice for hypertensives is to proceed with caution.

The reason exercise works is that it forces the blood vessels to open up (vasolidate), and that makes the blood pressure come down. Even though it tends to go back up during exercise, it drops when exercise ends. Then when it goes back up, it doesn’t go up as much..

Swimming, walking, and bike riding are all good exercises for hypertension. You don’t have to run. You do about the same amount of work when you walk, it just takes longer to do it. The key thing is that it should be a brisk walk – a quarter mile in 4 minutes when you start, then later a full mile in about 15 minutes or less.

Think vegetarian. Studies have shown that vegetarians have lower blood pressure than the general population – 10 to 15 mm Hg., lower for both systolic and diastolic pressures. Maybe it’s because people who follow vegetarian diets tend not to smoke, drink, or overeat.

Measure it yourself. For anybody who has high blood pressure, it is by far the most sensible way to go about monitoring your condition.

But home monitoring can do more than just track condition – it can help make you more aware of how diet, exercise, and medication are affecting your blood pressure. It may also help you overcome the ‘white coat’ reaction many people experience.. The minute they walk into a doctor’s office, they tense up and their pressures rise dramatically.

Blood pressure kits come in three basic categories: mechanical, electronic with manual cuff inflation, and electronic with automatic cuff inflation. The most practical is the electronic types with manual inflation. They are inexpensive, but you can get a good reading without any training at all.

Check your pressure regularly. Whether you do it yourself or at a doctor’s clinic, periodic check of your blood pressure is advisable, especially for adults forty and above.

By:Countdown