Hypertension, also called high blood pressure is a condition that arises when the blood pressure is consistently too high, i.e the force of blood against a blood vessel is high.
Then what is blood pressure?
Blood pressure is the force exerted by blood against the blood vessel wall, as it passes through the body. Hypertension is said to occur when this blood pressure is too high. Blood pressure is expressed as a fraction of systolic and diastolic pressure.
Systolic pressure is the pressure in the blood vessel when the heart contracts, while diastolic blood pressure is the pressure when the heart is in the resting phase. For adults, normal blood pressure should be between 100/60mmHg and 130/80mmHg. A blood pressure reading above 140/90mmHg is termed high.
Hypertension occurs when the body’s smaller blood vessels (the arterioles) narrow, causing the blood to exert excessive pressure against the vessel walls and forcing the heart to work harder to maintain the pressure.
Cause.
The cause is idiopathic(unknown), however, there are predisposing factors which is categorized as modifiable and non-modifiable.
Unmodifiable include:
- Genetic or familial
- Age
- Gender
- Race.
Modifiable which we have control over includes the following: Overweight/obesity
- Lack of exercise/sedentary lifestyle,
- Smoking
- Consumption of alcohol
- Diabetes mellitus
- High cholesterol
Types of hypertension
- Systemic hypertension
- Pulmonic hypertension
- Portal hypertension
- Renal hypertension
- Intracranial hypertension
- Intra ocular hypertension
Image 1 showing a Nurse examining blood pressure of a child during one of our outreach
Diagnostic investigation
- Chest X-ray
- ECG
- Hormonal Studies
- Lipid profile
- Urinalysis, 24 hours urine study
- Echocardiography
Signs and symptoms
Uncomplicated hypertension may have no symptoms hence the name “ SILENT KILLER” They may have headache, dizziness, vertigo, tinnitus (ringing in the ears, blurring of vision etc. Symptoms are usually those of the complicated.
Complications
- Hypertension can cause serious damage to the heart, blood vessel and other body organs e.g the kidney, lungs, brain, eyes.
- Chest pain and angina
- Heart Attack is a long term complication which occurs when the blood supply to the heart is cut off, and the myocardial cells die due to lack of oxygen.
- Hypertrophy
- Cardiomegaly
- Heart Failure
- Renal hypertension and renal failure
- Stroke
- Aneurysm etc
Management
- Lifestyle modification
- Weight control
Pharmacological management
A Cardiologist based on individual patients uniqueness and diagnostic result places the patient on antihypertensive and advise to be compliant with medications. A single class of drug to a combination of different classes of drugs may be prescribed. It is important that the patient stays compliant to drugs and continues to monitor their blood pressure.
Picture showing a woman whose blood pressure is being taken during one of our health outreach in Abeokuta