Heart & Blood Pressure

Heart and Blood Pressure

If you are above 40 years and have attended any kind of Medical OPD for whatever problem it may have been, You would’ve been subjected to the question “Are you hypertensive?” or “Do you have High BP?” Or else, if you are a person of very much a Type A personality or if you get angry for a lot of things or get stressed often or get too emotional, you would’ve heard someone tell you “Come on, take it easy or you are gonna get High Blood Pressure” So, Hypertension or High Blood Pressure is not an uncommon word for most of us, but does it have as much understanding as its popularity? That’s where this article will help you.

High Blood Pressure is directly related to heart problems. Increased blood pressure increases the strain on the heart and results in cardiac problems.

Definition of High Blood Pressure:

High Blood Pressure is a very common disease with more than 30% prevalence rate. Technically it is defined as a Systolic Blood pressure more than 140mmHg and a Diastolic Blood Pressure of more than 90mm Hg. But it can be better described as a progressive cardiovascular syndrome characterized by the presence of BP elevation to a level that places an individual at an increased risk of target organ damage in multiple vascular beds.

Causes of High Blood Pressure :

It is called Primary or essential hypertension when the increase in blood pressure occurs first without any demonstrable causes. When there might be other systemic causes resulting in the elevation of blood pressure, then it is called as secondary hypertension. Both of them have different causes as follows.

Primary or Essential Hypertension (95%)

• Genetics

• Aging

• Obesity

• Sedentary Lifestyle

• Stress

• Type A Personality

• Excessive Alcohol Intake

• Insulin Resistance

• Salt Sensitivity

Secondary Hypertension (5%)

It is secondary to disease processes like renovascular or renal parenchymal diseases, endocrinopathies, side effects of drugs, obstructive sleep apnoea or tumors like pheochromocytoma and paraganglioma

Clinical features of High Blood Pressure :

Symptoms

Patients are generally asymptomatic until end-organ damage occurs. Hence Hypertension is picked up with routine BP measurements. Symptoms of End organ damage are Coronary Artery Disease (Chest pain), Heart Failure (Difficulty in Breathing or pedal edema), Prior Stroke or Transient Ischemic Attacks (Dementia or focal deficits), Peripheral Artery Disease (Claudication), Renal Disease.

Diagnosis of high blood pressure :

High Blood Pressure can also be a physiological phenomenon during times of stress, fright and flight. It can also be increased because of the anxiety associated with visiting a doctor. Hence, there is a diagnostic criterion to establish a pathological increase in blood pressure. Diagnosis of Hypertension is established by documenting an SBP of more than 140mmHg or a DBP of more than 90mmHg based on the average of two or more readings obtained on each of two or more visits.

Management of Hypertension

Hypertension is not curable but it is very much Treatable. The aim of treatment is to maintain the blood pressure at an optimum level so as to prevent any end-organ damages.

The goal of antihypertensive therapy is to reduce the morbidity and mortality of cardiovascular (heart and blood vessels related) diseases attributable to hypertension.

Lifestyle modification is very important in the management of hypertension. It includes reducing weight, quitting smoking, reducing alcohol consumption, regular exercises etc.

Medication is generally considered appropriate for

• Patients less than 60 years with SBP >140mmHg and/or DBP >90mmHg

• Patients more than 60 years with SBP >150 mmHg and /or DBP >90 mmHg

The Various Drugs used for Hypertension are:

Prazosin, Enalapril, Labetalol, Sodium Nitroprusside, Telmisartan, Amlodipine, Diuretics etc.

Complications of Hypertension:

So, why is it so important to identify and treat hypertension? It is important because the complications that are associated with prolonged hypertension are life-threatening. Some of them are as follows:

1. Coronary Artery Disease:

In simple terms, it is called Heart Attack. When the pressure in the blood vessels supplying blood to your heart is raised, it can result in decreased blood supply to your heart muscles producing pain (angina) or worse (ischemia) and even death of your heart muscle tissues (infarction).

2. Cerebrovascular Accident:

Stroke or Cerebrovascular accidents are a direct result of very high blood pressure resulting in either clogging or bursting of the blood vessels of your brain resulting in severe life threatening situations.

3. Hypertensive Encephalopathy:

Another Disease affecting the Brain.

4. Hypertensive Retinopathy:

When the Blood pressure within the vessels of your eyes increases, it can cause serious damage which might even result in the loss of your eyesight.

5. Bleeding from Nose:

The pressure increase in the blood vessels of your nose results in bursting of those vessels and bleeding through the nose.

Preventive Measures:

1. Exercise Regularly

About 30 minutes of brisk walking thrice a week, can do wonders to your body by releasing the necessary endorphins. Brisk walking is nothing but walking at a pace that is slightly less than your maximum threshold. You must be able to maintain a conversation without catching for breath while walking briskly.

2. Reduce Salt Intake

Restricting Salt in your food is the single most effective thing that can keep your BP at optimum levels.

3. Eat Healthy

Avoid Junk Food and basically packed food items because the preservatives contain high salt content that would cause your blood pressure to shoot.

4. Cut down on Smoking and Alcohol

Changing your personal habits and cutting down on smoking and alcohol can reduce your incidence of getting hypertensive complications.

5. Get your BP checked regularly by your doctor. Especially if you are 40+ or you have a family history of hypertension.

Heart diseases associated with hypertension:

        1. Ischemic changes in the heart

        2. Left ventricular hypertrophy

        3. Coronary artery disease

        4. Angina pectoris

        5. Myocardial infarction (heart attack)

        6. Cerebrovascular accidents (stroke)

Myths And Facts

• Myth: High Blood Pressure is a usual aging phenomenon which need not be treated.

• Fact: High Blood Pressure is a lifestyle disease which needs to be managed appropriately to prevent systemic complications which might be as dangerous as death.