High blood pressure
Pressure simply refers to force acting per unit area. Blood pressure shows how forcefully blood moves inside the body arteries. It is measured using a manual blood pressure machine, a sphygmomanometer- consisting of a pressure meter(manometer) and a stethoscope. A digital blood pressure is now available, easy and convenient to use. High blood pressure refers to elevated levels beyond normal ranges.
Blood pressure consists of 2 parameters;
Systolic blood pressure and diastolic blood pressure
- Systolic BP-maximum BP during ventricular contraction
- Diastolic BP- minimum pressure recorded prior to the next contraction
As per the American Heart Association, 100+ million Americans are living with hypertension.
Normal BP- varies from region to region eg 130/80 mmHg in the United States of America and 120/80 in some African countries like Kenya
Normal blood pressure range generally reflects good heart health.
Types
- Normal blood pressure- usually slightly lower than 120/80 mmHg
- Elevated blood pressure- systolic blood pressure increases, ranging from 120-129 mmHg while for diastolic, it is below 80 mmHg
- Stage I hypertension- Systolic blood pressure 130-139 mmHg wile diastolic blood pressure 80-89 mmHg
- Stage II hypertension- Systolic blood pressure >140 mmHg, Diastolic blood pressure is 90 mmHg or higher
Risk Factors
Non-modifiable risk factors;
- Age
- Genetics and family history
- Race
Modifiable risk factors;
- Unhealthy diet- too much salt in diet
- Physical inactivity
- Stress
Causes
- Hypertension can occur secondarily to underlying medical conditions such as acute kidney injury
- Some medications are known to raise blood pressure eg Aspirin, Stimulant ADHD medications, Immunosuppressants, Anti-depressants such as Wellbutrin, Epinephrine, Dopamine
- Unhealthy diet
- Being obese or overweight
- Physical inactivity
Isolated systolic hypertension can be due to by conditions like:
- Artery stiffness.
- An overactive thyroid, also called hyperthyroidism.
- Diabetes.
- Heart valve disease.
- Obesity.
Signs & Symptoms
Signs and symptoms occur during earlier stages of the condition
Some of them are;
- Severe headaches
- Chest pain
- Difficulty breathing
- Nausea and vomiting
- Anxiety
- Blurred vision
Diagnosis
- Chronically/ frequently elevated BP
- Results obtained from blood pressure measurement machine
- Use a BP monitoring chart to determine elevation
Prevention
- Regular monitoring of BP
- Healthy lifestyle habits —like not smoking, exercising and well balanced diets— can prevent and treat elevated/ high blood pressure. Simply put, good nutrition can save you.
- Medicine to treat high blood pressure(anti-hypertensives)
I. ACE inhibitors- Ramipril, Lisinopril, Perindopril, Captopril, Fosinopril
II. Angiotensin II receptor antagonists- Candesartan. Irbesartan, Losartan, Telmisartan
III. Diuretics- loop diuretics, thiazide diuretics, potassium-sparing diuretics, osmotic diuretics, carbonic anhydrase inhibitors
IV. Calcium channel blockers- nifedipine (safe in gestational hypertension!), verapamil
V. Beta-blockers- carvedilol, propranolol, Labetalol (safe in gestational hypertension!)
VI. Alpha-blockers- alfuzosin, tamsulosin
VII. Alpha-2 agonists- clonidine, methyldopa (safe in gestational hypertension!)
VIII. Renin-inhibitors- aliskiren
IX. Vasodilators- sodium niroprusside, hydralazine
X. Endothelin receptor antagonists- bosentan
It should be noted that each of these class of drugs has side effects that must be taken into account during prescription and administration.