Hypertension (High Blood Pressure) is a common chronic condition that is often associated with and causes other health issues such as cardiac disease. It is also known as the “Silent Killer” condition because you will not know when it will attack. Its onset can be insidious and afflicted patients might not be aware of their status until later on in life. However, an asymptomatic individual still has the same risks for developing further health problems, inclusive of heart attacks and stroke.
What are the Symptoms of Hypertension?
Hypertension is usually asymptomatic, even at extreme levels. Patients reporting symptoms usually report headaches, shortness of breath, nose bleeds, and tinnitus (ringing in the ears). However, these symptoms are usually non-specific and patients with poorly controlled hypertension might not manifest any symptoms at all.
Blood pressure is often taken routinely during medical consults. If concerned, ask your doctor to check your blood pressure on your next visit. If you are aged 40 years or older, or if you have a family history of hypertension, it is advisable to have your blood pressure checked as a routine. Alternatively, there are automated blood pressure machines available for purchase over the counter for home monitoring.
Types of Hypertension
Primary (Essential) Hypertension
This refers to the group of adults with no identifiable cause for hypertension. It is usually insidious and develops gradually over many years.
Secondary Hypertension
This refers to the group where there are identifiable causes for hypertension. These causes can include:
- Hormonal imbalances eg thyroid issues
- Renal issues
- Occult tumors of the adrenal gland
- Congenital birth defects
- Obstructive sleep apnoea
- Smoking
- Alcohol abuse
- Medication-induced hypertension
Risk Factors
- Age. The risk of hypertension increases around about age 45. It is more common in men than women though the risk profile for women approximates their male counterparts after menopause.
- Race. It has been found that patients of black origin have a higher tendency to develop hypertension.
- Positive Family History of Hypertension. There is a genetic link for hypertension.
- High Body Mass Index (BMI) (Overweight / Obese Categories) Patients with a high BMI tend to develop hypertension compared to their thin counterparts.
- Generalized Lethargy. Patients who tend to lead inactive lifestyles usually have higher heart rates and have higher BMIs, which in turn increases their risk for hypertension.
- Smoking. Smoking causes a rise in blood pressure and in the long term, causes hardening and narrowing of blood vessels. This effect is also observed in passive second-hand smokers.
- Sodium (Table Salt) and Potassium Intake. Table salt, sodium chloride, when consumed in excessive amounts, causes retention of fluid within the body, which in turn, increases blood pressure. Potassium, on the other hand, acts in opposition to sodium. Hence an excess of sodium or lack of potassium will both result in Blood Pressure fluctuations.
- Alcohol Intake. Alcohol causes global effects on the body. Excessive consumption of alcohol will cause Blood Pressure fluctuations.
- Associated Chronic Conditions. Chronic renal failure, diabetes, sleep apnoea, etc, and even chronic stress all contribute to hypertension.
- Special Conditions. Pre-eclampsia, or Hypertension during Pregnancy, congenital defects, are examples of special conditions causing hypertension.
Complications
Cardiac Effects:
- Heart attacks – This is by far the most widely known complication of hypertension.
- Cerebrovascular Accidents – Commonly known as strokes.
- Aneurysms – Prolonged hypertension can cause weakening of arterial walls, causing arteries to bulge, forming aneurysms.
- Cardiac failure – Defined as the inability of the heart to pump blood around the body consummate to the required needs, cardiac failure is a consequence of prolonged, untreated hypertension. Prolonged hypertension causes thickening of cardiac muscle, resulting in uneven contractions that eventually result in cardiac failure.
- Renal Failure – It is important to note that while renal failure can cause hypertension, hypertension, in turn, causes weakening of vessels within the kidneys, resulting in renal failure.
- Ophthalmological Complications – Damage to the tiny blood vessels within the eyeball can result in visual disturbances or even vision loss in severe cases.
- Non-specific effects – It has been documented that patients with prolonged and untreated hypertension suffer more frequently from poorer mental function, memory loss, and non-specific groups of symptoms like Metabolic Syndrome.
Treatment
It is important to speak with your treating physician if you are concerned that you might have hypertension. When seeing your physician, no special preparations are necessary though it is important that you maintain calm during the examination as anxiety can and will cause blood pressure readings to increase.
Be aware as well that the first consultation can potentially belong as there will be much to discuss prior to commencing medications to treat hypertension if present.
You should inform your physician of the following:
- Any Symptoms you have experienced – eg shortness of breath, chest pain, tinnitus, etc.
- Your family history, especially if there is a family history of hypertension.
- Your current medication regime.
- Your current medical history, especially if you also have associated chronic illnesses like diabetes, thyroid abnormalities, and raised cholesterol levels.
- Your current lifestyle in all honesty – This includes diet, exercise, alcohol consumption, smoking.
- Your last Blood Pressure reading if available.
Your physician will measure your Blood Pressure and inform you of your Blood pressure reading.
- Blood Pressure is described with two readings:
- Systolic BP (Higher reading)
- Diastolic BP (Lower reading)
There are many categories of hypertension in relation to the systolic and diastolic blood pressure because the definition of Blood Pressure varies with age and race. Your physician will decide after taking your blood pressure, likely after several readings on different occasions.
In certain situations, your physician might recommend 24hr monitoring of blood pressure to provide a more accurate picture of your blood pressure fluctuations throughout the day. This means you will need to perform your own home BP monitoring.
Additional tests your physician might order include:
- Urine tests to check for protein in the urine
- Blood tests to ascertain cholesterol levels
- Electrocardiograms (ECGs)
Upon confirmation of the diagnosis, your physician will likely recommend lifestyle changes as the first line of treatment, followed by pharmaceutical treatment after.
