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 THE FIT HEART 

The Way To A Healthy Heart

HIGH BLOOD PRESSURE - HYPERTENSION

Blood pressure is the pressure of blood in your blood vessels (arteries). Blood pressure is measured in millimeters of mercury (mm Hg). Your blood pressure is recorded as two figures. For example, 130/80 mm Hg. This is read as 130 over 80.

  • The first number is the systolic pressure. This is the pressure in the arteries when the heart contracts.
  • The second number is the diastolic pressure. This is the pressure in the arteries when the heart rests between each heartbeat.

High blood pressure is a blood pressure that is 140/90 mm Hg or above each time it is taken (or home or ambulatory readings always more than 135/85 mm Hg). That is, it is sustained at this level.

 

                                                                                             

A single blood pressure reading that is high does not mean that you have 'hypertension'. Your blood pressure varies throughout the day. It may be high for a short time if you are anxious, stressed, or  exercising.You have HYPERTENSION if you have several blood pressure readings that are high, and which are taken on different occasions when you are relaxed. 

For a long time (even years together), patient may not have any complains at all. Diagnosing Hypertension on the basis of symptoms (complaints) usually delays the diagnosis and many times the patient presents with one of the complications as the first presentation of high BP. The symptoms and complications are described in the figure below:

                       

The cause is unknown in most of the cases (the Primary Hypertension).  It is thought that some narrowing of the arteries increases the resistance to blood flow, which increases the blood pressure. This may be multifactorial.

In some cases the blood pressure is high secondary to diseases of other organ system such as thyroid disease, kidney disease etc. (Secondary Hypertension)

High blood pressure usually causes no complaints. You will not know if you have high blood pressure unless you have your blood pressure checked. Therefore, everyone should have regular blood pressure checks at least every five years especially after 40 years of age. The check should be more often (at least once a year) in:

  • Older people.
  • People with history of previous high reading (>/=140/90 mmHg)
  • People who have had a previous reading between 130/85 mm Hg and 139/89 mmHg (borderline cases).
  • People with diabetes, heart disease, kidney disease, thyroid disease.
  • People with history of hypertension in their family.

Why one should worry?

High BP does not produce any symptoms for long time. Which means it will go on doing damages without getting noticed for a long times. These damages can be in the form of damage to the heart, kidney and even brain. They can be severe and an undiagnosed patient may present for the first time itself with life threatening complications like heart attack, heart failure, stroke etc. And hence regular BP check up becomes necessary especially in high risk individuals as explained above.

                                                                          

 

Treatment

Life style modifications

  • Lose weight if you are overweight

  • Regular physical activity / Exercises
  • Eat a healthy diet (High in fresh fruits, vegetables, low in fat, more fish intake etc.)
  • Have a low salt intake
  • Restrict your coffee/tea intake
  • Quit smoking
  • Drink alcohol in moderate amounts

Medicines

There are several medicines to treat hypertension. The choice depends on:

  • Whether you have other medical problems like diabetes, kidney disease etc.
  • Whether you take other medication which can interact with the BP medicines.
  • Possible side-effects of the BP medicine.
  • Your age.

How long to take the medicines..??

The answer is - Life long in most of the cases. However in some patients where the hypertension is secondary to some other disease, the control of this disease may reduce or even eliminate the need for BP medicines. Rarely even in primary hypertension, your doctor may be able stop the BP medicines altogether.

What is the target to be achieved??

  • For most people who are otherwise well, the target is to reduce blood pressure to 140/90 mmHg or below.
  • In some people, the target is to get the blood pressure to an even lower level eg. diabetics, kidney disease patients etc.