Hypertension – a silent killer

Guest Column: Dr. N Prabhudev

Necessary precautions need of the hour for healthcare

High Blood pressure is a silent killer
Hypertension is a leading risk factor for death and disability worldwide.

Anyone, even children, can develop high blood pressure. The risk for hypertension rises with age. In 95% of cases the underlying cause can’t be found. This is called essential hypertension. 5% is secondary hypertension- BP is secondary to a known cause like kidney disease, tumor etc.

Hypertension is a silent killer- you could have it for years and not know. Often People experience dizziness, shortness of breath, headaches, and nosebleeds. 
Dangers of a high blood pressure.
High blood pressure can quietly damage your body for years before symptoms develop- Heart attack, Stroke and mini strokes- Transient ischemic attacks, Kidney failure, Vision loss or blindness or retinopathy.

A diagnosis of hypertension usually requires at least three elevated blood pressure readings taken at least a few days apart. Resting blood pressure is considered more accurate.

Normal BP – 120/80 –Mean arterial pressure- 100 mm of hg
Pressures less than 90/60 are regarded as hypotension or Low BP
Pre Hypertension is Elevated systolic blood pressure -120 to 129/80. We can prevent this high blood pressure through diet, weight loss, and physical activity.

Stage 1 high blood pressure – hypertension – 130-139/80 to 89- Needs medication and life style changes
Stage 2 high blood pressure – hypertension – 140 and above/ 90 and above- Needs early and multiple Medication and life style changes
Hypertensive crisis 180 and above/ 120and above – with signs of organ failure, such as dizziness, confusion, and shortness of breath and general fatigue and weakness. Needs emergency treatment, immediate control of BP and multiple medications and life style changes.

Risk Factors:

• Smoking, Diabetes, Obesity, no exercise, Drinking Alcohol regularly,
• Unhealthy diet – high in salt – aim for use of less than 2,500 milligrams of sodium per day.
• Genes are 30 to 50 % impact on blood pressure.

Which number is more important?
Systolic and diastolic- both are important! The mean arterial pressure- MAP is a good measure of cardiovascular risk and death. The risk of death from ischemic heart disease and stroke doubles with every 20 mm Hg systolic or 10 mm Hg diastolic increase among people from age 40 to 89.
Blood Tests – Blood tests may be needed to determine if you have secondary hypertension due to a serious or treatable health condition. Blood tests – Electrolyte levels, Blood glucose, Thyroid function tests, Kidney function tests: blood urea nitrogen and creatinine levels etc.
Echocardiography, ECG, CT scan / MRI.
BP monitoring!

• Electronic blood pressure devices are readily available. a process referred to as home blood pressure monitoring and it is now a viable option to  diagnose and to manage BP
• Ambulatory Blood Pressure Monitoring: The diagnosis of hypertension with ABPM has been well-validated and is more accurate for diagnosing stage 1 hypertension than a single reading!
• Treatment goal – systolic- 120- the risk of having a cardiovascular complication such as a heart attack or stroke is reduced by 25%, and the risk of death from all causes is reduced by 27%

The Keys to Blood Pressure Health- Absolute No to smoking, keep the BP and sugar under control, good physical activity, watch your weight, keep salt to the minimum and avoid fast food and red meat. DASH – Dietary Approaches to Stop Hypertension – a diet to go on for a healthy lifestyle for life.

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