Hypertension: Symptoms, Causes, Diagnosis and Treatment
Dr. Nikhil Eric Saldanha
December 6, 2022
Dr. Nikhil Eric Saldanha
December 6, 2022
In general, hypertension, commonly known as HTN, is scientifically defined as a condition in which the blood pressure exceeds 140/90 mm Hg and becomes severe if the pressure reaches above 180/120 mm Hg.
High blood pressure occurs when blood flow against the artery walls is very high. Usually, we don’t feel anything different about ourselves. But, if left untreated, it may cause severe health conditions like cardiovascular diseases and heart strokes over time.
Following a healthy diet pattern with less salt, engaging in physical activities, and regular exercising can help lower blood pressure levels. Moreover, certain medications, if necessary, help in lowering blood pressure. Although, do not opt for any medicines without a doctor’s prescription.
One of the most troublesome facts about this condition is that one may not even know that they have hypertension. According to WHO, around 46% of adults experiencing high blood pressure aren’t even aware of it. Hypertension doesn’t show any signs or symptoms unless it gets very severe. This is because high blood pressure is usually not symptomatic.
Periodic health checkups are ideal for determining if your blood pressure is high. However, you can also check your blood pressure levels at home. It is crucial, especially if you have a close relative or friend who experiences hypertension. These are some of the common symptoms of severe hypertension.
Blood pressure is the evaluation of blood force that pushes against arterial walls. The heart beats and pumps blood into the blood vessels. It then carries it throughout the human body. You would commonly know hypertension as high blood pressure. It is a severe condition because it pressurises the heart to work harder. As a result, it increases the blood flow to the body, which results in the hardening of the arteries, leading to conditions like atherosclerosis, heart strokes, chronic kidney diseases, and heart failure.
There are 2 types of causes – essential hypertension that occurs due to the risk factors below. And secondary hypertension that occurs due to an existing medical condition. Essential hypertension being the more common (in 90%), we can focus on that.
It can be due to various reasons. Although the exact causes are not very clear, several things might play a role that includes the following:
High blood pressure is a “silent disease”. Therefore, one usually doesn’t know that it has occurred. Generally, there are no or negligible signs and symptoms unless severe. Nevertheless, it harms the body and might lead to chronic heart disease, kidney disease, etc. That being the reason, regular monitoring of blood pressure is crucial. Therefore, this is mandatory if one has experienced it before or has a family history of hypertension.
Doctors recommend that individuals above 18 years of age should be screened for hypertension every once in a while to treat it while it gets severe.
Our blood pressure regulates from time to time throughout the day in response to factors like our fluid status, anxiety levels, activity level, and other contributing factors. It simply implies that the reading at a healthcare provider’s clinic is just about time. An average of readings usually gives a clearer picture of the blood pressure status. Healthcare providers or doctors may often ask for a blood or urine test to suspect secondary hypertension.
You can measure your blood pressure levels at home using a sphygmomanometer. It is a device that uses a non-invasive cuff that detects the blood pressure within the arteries and conveys them in a numeral value on the meter. Your doctor may ask you to record your blood pressure at home to provide additional information and confirm if you have high blood pressure. Your doctor might also recommend specific lab or imaging tests to diagnose any complications or causes related to hypertension.
Monitoring your blood pressure levels at home is an ideal, easy and cost-effective way to diagnose elevation in blood pressure. In addition, individuals usually do it to check if their body is responding to treatments.
Blood pressure monitoring devices are inexpensive and available easily across the globe. Also, one doesn’t even need a prescription to purchase one. However, these devices may have specific limitations. Therefore, one should use them for regular monitoring of blood pressure levels and not as a substitute for a doctor’s visit.
Keep in mind using a validated device and check for the cuff fits. You can also take the monitor to your doctor’s office to confirm its accuracy every six months and get an idea of how to use it at home correctly.
Your doctor will likely recommend the following tests to confirm the condition of your high blood pressure and to check for principal conditions that can cause hypertension.
Making changes to your lifestyle can prove helpful in controlling as well as managing high blood pressure levels. Some of the lifestyle changes your doctor might suggest you may include:
The kind of medication your health care provider recommends for high blood pressure will depend on the level of severity of the condition and your general health. Two or more medicines or drugs often prove to work better than one alone. Also, finding the most successful medication or combination of drugs is a task of hit and miss.
Your aim should be for a treatment goal of blood pressure lower than 130/80 mm Hg if:
Consult your doctor for your blood pressure treatment goal.
The perfect blood pressure or hypertension treatment goal will vary with age. The other parameters are family history, health conditions and certain other factors, specifically, if your age is 65 years or above.
The general medications used in the treatment of high blood pressure usually include:
Water pills support your kidneys to eliminate sodium and water from the body. These drugs are generally the first medicines to lower your blood pressure levels.
These diuretic drugs have various classifications, including potassium-sparing, loop, and thiazide. Your health care provider will recommend these drugs depending upon your blood pressure measurements along with other health conditions, like kidney diseases, heart health, etc. Some popular diuretics for blood pressure treatments are hydrochlorothiazide (Microzide) and chlorthalidone.
A widespread side effect of using diuretics is an increased urge for urination, which might lower potassium levels in the body. Although, If your potassium levels fall, the doctor might include a potassium-sparing diuretic in your treatment. These may be spironolactone (Aldactone) or triamterene (Dyazide, Maxine).
This medication includes benazepril (Lotensin), captopril, lisinopril (Prinivil, Zestril) etc. They help relax blood vessels and block the formation of a natural chemical that naturally narrows down the blood vessels.
These drugs help relax blood vessels. However, they block the action and not the formation of a natural chemical known to narrow blood vessels. ARBs include candesartan (Atacand), losartan (Cozaar) and others.
These drugs include diltiazem (Cardizem, Tiazac, others), amlodipine (Norvasc), and others. They help in relaxing the muscles of our blood vessels. Some of these drugs sometimes slow the heart rate. These channel blockers might prove better for old individuals and individuals of African heritage than ACE inhibitors do alone.
An important point is not consuming or drinking grapefruit while taking these blockers. Grapefruits increase blood levels of certain calcium channel blockers that might prove dangerous. It is best to consult the doctor or the pharmacist about any interaction related concerns.
Hypertension is a condition in which blood flow against the artery walls is very high. It is a condition that doesn’t always show up with symptoms. However, treatment should commence in time to avoid developing severe diseases like cardiovascular diseases, chronic heart disease, etc.
You can diagnose hypertension or high blood pressure levels at home through a sphygmomanometer device. The other lab tests are urinalysis, echocardiogram, electrocardiogram and ambulatory monitoring.
Naturally, following a balanced diet with healthy food choices, less salt usage in cooking, regular engagement in physical activities and exercising can help lower blood pressure levels. Lastly, if your blood pressure levels do not follow a healthy level, certain medications will help lower blood pressure levels. But do not follow any medications without consulting your doctor.