High Blood Pressure

High blood pressure is a medical condition sometimes also known as hypertension, or HTN. It is characterized by abnormally elevated blood pressure. Hypertension is technically arterial hypertension, whether the arterial modifier is employed or not, and can be either primary or secondary

Primary hypertension is when diagnostic testing can find no underlying cause for the patient’s condition, whereas secondary hypertension is when the hypertension can be demonstrated to be caused by some other condition or illness, such as a tumor, or kidney disease.

When hypertension is persistent, it is a major risk factor for developing heart failure, heart disease or stroke, or an aneurism, and can also lead to the patient suffering chronic renal failure. A person’s life expectancy scales quite uniformly downwards as their blood pressure rises, and very high blood pressure will almost certainly result in death if not properly treated.

Increased levels of salt, and therefore sodium, in modern diets is thought to be the number one cause of high blood pressure worldwide. The excess salt in the bloodstream causes the influx of more water, and thereby increases the pressure on the blood vessels. Over 50% of patients with high blood pressure find that their condition reacts positively to a reduction of salt in their diets.

The hormone renin, produced in the kidneys, may cause hypertension in some patients when its action exceeds normal limits. But the mechanism of this is not yet fully understood. However, some patients who have what is described as ‘low renin’ hypertension to react more positively to treatments that would be expected to address this hormonal issue, such as diuretics drug therapy.

Metabolic syndrome, sometimes referred to as ‘syndrome X’, is when the vasodilatory properties of insulin are overridden by sympathetic neural activity, causing high blood pressure. Individuals suffering from insulin resistance, or hyperinsulinemia, are more prone to this condition.

Another common cause of high blood pressure is sleep apnea, when a person stops breathing many times during the night, causing them to lurch into a phase of wakefulness or semi-wakefulness as their body gasps for oxygen. This condition needs to be treated either with lifestyle changes such as dieting (for the overweight), or possibly surgery to prevent whatever obstruction may be causing the sleep apnea.

High blood pressure is thought to be a genetic condition to some extent, with a consensus view that a number of genetic expressions probably contribute to high blood pressure and that a combination of these will manifest as hypertension. Studies indicate that in around 30% of cases, a parent will pass on a predisposition to high blood pressure to their children.

Because there are no classic or giveaway signs of high blood pressure, it is usually discovered incidentally by a medical professional either doing a routine checkup or testing for some other illness. Some patients do however report symptoms of dizziness, blurred vision, tinnitus and headaches, which may or may not be caused by elevated blood pressure.

Malignant or accelerated hypertension is an advanced stage of high blood pressure in which patients may experience blurred vision and bad headaches, and which may cause organ damage. Accelerated hypertension may also cause nausea, vomiting, confusion and visual abnormalities and should be treated as a serious medical emergency.

Because high blood pressure presents with general symptoms of unwellness, or no symptoms at all, it is often mistaken for a mental illness such as stress or anxiety. And while anxiety is thought to exacerbate the condition in patients with hypertension, it is not in itself a cause of the disease.

For patients with relatively mild high blood pressure, simple lifestyle changes such as a healthier diet, weight loss and increased levels of exercise may lead to a complete turnaround. If a person’s blood pressure is particularly high or persistent, they are likely to be given a lengthy course of drug treatment in order to reduce it to a consistent safe level.

Giving up smoking does not have a direct effect on a person’s blood pressure, but will help to avoid potentially disastrous complications such as stroke or myocardial infarction. Daily calcium supplementation is also evidenced to be effective in treating hypertension.

A nutritional program designed specifically to combat high blood pressure has been designed, known as DASH, which stands for ‘Dietary Approaches to Stop Hypertension’. It is a low-sodium, low-fat diet rich in fruit and vegetables (which tend to contain potassium, a natural neutralizer of sodium). Since salt intake is a major cause of high blood pressure, reducing the amount of salt in your diet is highly recommended if you suffer from, or are prone to suffer from, hypertension. Taking regular exercise is also helpful.

Reducing stress levels can also help to ease the severity and symptoms of high blood pressure. Stress is not a cause of hypertension, but can make it worse.
Antihypertensive drugs may also be used, which act to lower the blood pressure and therefore reduce the potential for complications in patients with dangerously high blood pressure.

Regular doses of antihypertensive medications can reduce a patient’s risk of suffering a stroke by around forty percent, as well as making heart attacks, heart failure and vascular disease more unlikely. In most cases, the goal of hypertension treatment should be to maintain a blood pressure below 140/90 mmHg, and individual drugs can only lower blood pressure a certain amount, so combinations of drugs may be needed.

Some examples of drugs being used to treat high blood pressure today include ACE inhibitors (captopril, enalapril, lisinopril), alpha blockers (doxazosin, terazosin), beta blockers (labetalol, propranolol), calcium channel blockers (verapamil, amlodipine), renin inhibitors (aliskiren), diuretics (bendroflumathiazide, hydrochlorothiazide) and various combinations of these drugs.