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Understanding The Silent Killer
Hypertension (high blood pressure) is a common chronic condition that is often associated with and causes other health problems such as heart disease. Its onset can be insidious and affected patients may not be aware of their condition until later in life. However, an asymptomatic person still has the same risks of developing other health problems, including heart attacks and strokes.
Hypertension is usually asymptomatic, even at extreme levels.
Patients reporting symptoms typically report headaches, shortness of breath, nosebleeds, and tinnitus (ringing in the ears). However, these symptoms are usually nonspecific, and patients with poorly controlled hypertension may have no symptoms.
Blood pressure is often taken systematically during medical consultations. If you’re worried, ask your doctor to check your blood pressure at your next visit.
If you are 40 or older, or have a family history of hypertension, it is advisable to have your blood pressure checked routinely.
Alternatively, there are automated blood pressure monitors available for purchase over-the-counter for home monitoring.
Types of hypertension
Primary (essential) hypertension
This is the group of adults with no identifiable cause of hypertension. It is usually insidious and develops gradually over many years.
This is the group where there are identifiable causes of hypertension. These causes may include:
Hormonal imbalances, for example thyroid problems
Occult tumors of the adrenal gland
congenital birth defects
Obstructive sleep apnea
- Age. The risk of hypertension increases around the age of 45. It is more common in men than in women, although women’s risk profile approximates that of their male counterparts after menopause.
- Race. It has been found that black patients 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 an inactive lifestyle typically have a higher heart rate and higher BMI, which increases their risk of hypertension.
- Smoking. Smoking causes blood pressure to rise and in the long run causes hardening and narrowing of blood vessels. This effect is also observed in second-hand passive smokers.
- Sodium (table salt) and potassium intake. Table salt, sodium chloride, when consumed in excessive amounts, causes fluid retention in the body, which increases blood pressure. Potassium, on the other hand, works against sodium. Therefore, an excess of sodium or a lack of potassium will both cause fluctuations in blood pressure. .
- Alcohol consumption. Alcohol causes global effects in the body. Excessive alcohol consumption will cause fluctuations in blood pressure.
- Associated chronic conditions. Chronic renal failure, diabetes, sleep apnea, etc. and even chronic stress all contribute to hypertension.
- Special Terms. Pre-eclampsia or hypertension during pregnancy, birth defects, are examples of particular conditions causing hypertension.
- heart attacks – It is by far the most well-known complication of hypertension.
- Stroke – Commonly referred to as strokes.
- Aneurysms – Prolonged hypertension can cause the arterial walls to weaken, causing the arteries to swell, forming aneurysms.
- Heart failure – Defined as the inability of the heart to pump blood throughout the body to meet the required needs, heart failure is the consequence of prolonged and untreated hypertension. Prolonged hypertension causes the heart muscle to thicken, leading to uneven contractions that eventually lead to heart failure.
- Renal failure – It is important to note that while kidney failure can cause hypertension, hypertension in turn causes weakening of the vessels in the kidneys, leading to kidney failure.
- Ophthalmological complications – Damage to the tiny blood vessels in the eyeball can lead to visual disturbances or even loss of vision in severe cases.
- Non-specific effects – It has been documented that patients with prolonged, untreated hypertension more frequently suffer from lower mental function, memory loss, and non-specific symptom clusters like metabolic syndrome.
It is important to talk to your GP if you are concerned that you have high blood pressure.
When you see your doctor, no special preparation is needed, but it is important that you remain calm during the exam, as anxiety can and will cause blood pressure readings to rise.
Also be aware that the first consultation can potentially be long as there will be a lot to discuss before starting medications to treat high blood pressure, if any.
You should tell your doctor about 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 high blood pressure.
Your current medication regimen.
Your current medical history, particularly if you also have associated chronic conditions such as diabetes, thyroid abnormalities, and high cholesterol.
Your current lifestyle in all honesty – This includes diet, exercise, alcohol consumption, smoking.
Your last blood pressure reading if available.
Your doctor will measure your blood pressure and inform you of your blood pressure reading.
Blood pressure is described with two readings:
Systolic BP (upper reading)
Diastolic BP (lower reading)
There are many categories of hypertension in relation to systolic and diastolic blood pressure, as the definition of blood pressure varies by age and race. Your doctor will decide after taking your blood pressure, probably after several readings on different occasions.
In some situations, your doctor may recommend 24-hour blood pressure monitoring to provide a more accurate picture of your blood pressure fluctuations throughout the day. This means that you will need to do your own home blood pressure monitoring.
Additional tests your doctor might order include:
Urine tests to check for protein in urine
Blood tests to determine cholesterol levels
After diagnoses are confirmed, your doctor will likely recommend lifestyle changes as the first line of treatment, followed by pharmaceutical treatment thereafter.
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