What is hypertension?
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This article, previously posted on June 4, 2022, has been republished to include website enhancements.
Hypertension is also known as high blood pressure. It is defined as transitory (short-lived) or chronic elevation of the blood pressure in the arteries. This elevation may lead to cardiovascular damage. When left untreated, the damage to the circulatory system can cause heart attack, stroke, heart failure, heart disease and kidney failure.
Hypertension is a major cause of premature death worldwide, according to the WHO, with about 46% of adults unaware of their condition, 42% of adults being diagnosed and treated and about 21% of adults having their hypertension under control.
Pressure numbers
Blood pressure is broken into systolic and diastolic values. The systolic measurement (top number) is the peak pressure in the arteries, and the diastolic measurement (bottom number) is the minimum pressure in the arteries. Normal blood pressure is defined as being below 120/80, where 120 represents the systolic (maximum) measurement and 80 represents the diastolic (minimum) measurement.
Hypertension occurs when the blood pressure reaches above 140/90. The risk for hypertension is increased in a condition known as prehypertension, which occurs when the blood pressure is between 120/80 and 139/89.
Types of hypertension
The two types of hypertension are essential or secondary. High blood pressure with an unknown cause is essential hypertension and tends to develop over many years.
High blood pressure with a known or direct cause is secondary hypertension. This type of hypertension tends to appear suddenly and can be caused by conditions such as obstructive sleep apnea, kidney disease, adrenal gland tumors, thyroid problems or medications such as use of birth control pills or illegal drugs like cocaine and amphetamines.
Hypertension is diagnosed by a health care professional who uses a sphygmomanometer to measure blood pressure. However, the results of a sphygmomanometer measurement may be skewed by stress, so further inquiry about family history and other risk factors is often required to make a complete and accurate diagnosis. When hypertension is suspected, electrocardiograms, echocardiograms or blood tests may be used to further evaluate the heart or identify possible causes of secondary hypertension.
Rates and risk factors
Risk of hypertension increases with age. It is more common in men (50%), while women (44%) are more likely to develop hypertension after age 65.
Hypertension is more common among non-Hispanic black adults (56%) compared with non-Hispanic white adults (48%), non-Hispanic Asian adults (46%) and Hispanic adults (39%). Conditions, such as stroke, heart attack and kidney failure, are also more common in the non-Hispanic black group as well.
Physical traits and lifestyle choices play a part in how a patient may be at greater risk for high blood pressure. The most common causes of hypertension include smoking, obesity or being overweight, diabetes, having a sedentary lifestyle, lack of physical activity, high salt or alcohol intake levels, insufficient consumption of calcium, potassium or magnesium, a deficiency in vitamin D, stress, aging, chronic kidney disease and adrenal and thyroid conditions or tumors.
Some individuals may also be genetically predisposed to hypertension. Pregnancy can also sometimes be a cause of high blood pressure (gestational hypertension or preeclampsia).
“Silent killer”
Known as a “silent killer,” many cases of high blood pressure are asymptomatic. However, headaches, fatigue, confusion, dizziness, nausea, vision problems, chest pains, breathing problems, irregular heartbeat and blood in the urine are all symptoms of hypertension.
Uncontrolled hypertension can lead to complications such as aneurysms, damage to blood vessels in the kidneys or eyes, metabolic syndrome, memory loss or trouble with comprehension and dementia.
Fortunately, high blood pressure is easily detectible and treatable with lifestyle changes and medications.
Treatment and prevention
Hypertension is treated by changing lifestyle factors including eating, smoking and exercise habits. Pharmaceutical interventions include ACE inhibitors, ARB drugs, beta-blockers, diuretics, calcium channel blockers, alpha-blockers and peripheral vasodilators. The best way to prevent hypertension is to eat healthy and get exercise. Eating more fruits and vegetables and limiting saturated fats and eliminating trans fats are helpful ways to prevent hypertension.
Reduction of stress, salt intake and alcohol intake are also helpful ways to prevent hypertension. Regularly checking blood pressure, staying on track with treatment (diet, exercise and medication) and managing other medical conditions can help patients manage their hypertension.
Additional information can be found by searching the following websites:
www.cdc.gov/bloodpressure/facts.htm
www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure
my.clevelandclinic.org/health/diseases/4314-hypertension-high-blood-pressure
www.nlm.nih.gov/medlineplus/highbloodpressure.html
www.who.int/news-room/fact-sheets/detail/hypertension