Hypertension (also called high blood pressure) is a condition where the pressure at which blood moves in the blood vessels are persistently elevated above the normal reading. It is a long-term medical condition that develops over years.
Despite being a leading cause of death worldwide, hypertension might not show signs until a lot of damage has been caused in the body. This systemic condition affects almost all organs of the body including the brain and kidneys making it particularly significant. It could lead to a myriad of cardiovascular diseases including aneurysms, heart attacks and stroke.
Most often, persons with hypertension do not show signs or symptoms. It is usually an accidental finding during routine clinic visits.
Some other people may have headaches, lightheadedness nosebleeds (epistaxis) or shortness of breath. Persistently elevated blood pressure would present with symptoms of the organs subsequently affected.
The American Heart Association 2017 guidelines define the following ranges of blood pressure:
|Systolic (mmHg)||Diastolic (mmHg)|
|Normal blood pressure||Less than 120||Less than 80|
|Elevated||Between 120 and 129||Less than 80|
|Stage 1 hypertension||Between 130 and 139||Between 80 and 89|
|Stage 2 hypertension||At least 140||At least 90|
|Hypertensive crisis||Over 180||Over 120|
Hypertension could be Primary or Secondary depending on the cause.
- Primary (Essential) Hypertension
When there is no identifiable underlying cause for the hypertension it is called primary hypertension. This is usually the case most of the time
- Secondary Hypertension
There is usually an underlying condition or medication which suddenly causes an elevation in blood pressure. These conditions include:
- Adrenal diseases like Cushing Syndrome, congenital adrenal hyperplasia
- Kidney disease like glomerulonephritis, polycystic kidney disease.
- Obstructive Sleep Apnoea.
- Certain medications like oral contraceptive pills, pain medications
- Illicit drugs like cocaine
The following might predispose one to hypertension:
- Age: Risk increases with age
- Cigarette/tobacco smoking and alcohol
- Race: commoner in Africans
- Family history of hypertension puts one at risk
- Sedentary lifestyle
- Nutrition: high salt intake or low potassium
Other chronic conditions like kidney disease and diabetes also put one at risk
For secondary hypertension, the underlying cause has to be treated
Lifestyle modification is of utmost relevance in the effective management of hypertension.
- Regular physical Exercise
- Stress reduction and sufficient sleep
- Dietary changes: Reducing salt intake, cutting down on alcohol, eating more fruits and vegetables.
Medications used in the management of hypertension include
- Calcium channel blockers
- Beta-blockers and alpha-blocking
- Angiotensin-converting enzyme (ACE) inhibitors
- Angiotensin receptor blockers
Poorly controlled hypertension can lead to injury to the walls of the vessels as well as various vital organs in the body. It could lead to:
- Cerebrovascular diseases like heart attack, stroke, hypertensive heart disease, aneurysms, heart failure
- Kidney disease due to the narrowing of or injury to the vessels taking blood to the kidneys
- Eye problems: hypertensive retinopathy could lead to blindness