Heart & Blood Pressure

<h3 style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Heart and Blood Pressure</strong></span></h3> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">If you are above 40 years and have attended any kind of Medical OPD for whatever problem it may have been, You would’ve been subjected to the question “Are you hypertensive?” or “Do you have High BP?” Or else, if you are a person of very much a Type A personality or if you get angry for a lot of things or get stressed often or get too emotional, you would’ve heard someone tell you “Come on, take it easy or you are gonna get High Blood Pressure” So, Hypertension or High Blood Pressure is not an uncommon word for most of us, but does it have as much understanding as its popularity? That’s where this article will help you.</span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">High Blood Pressure is directly related to heart problems. Increased blood pressure increases the strain on the heart and results in cardiac problems.</span></p> <h3 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Definition of High Blood Pressure:</strong></span></h3> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">High Blood Pressure is a very common disease with more than 30% prevalence rate. Technically it is defined as a Systolic Blood pressure more than 140mmHg and a Diastolic Blood Pressure of more than 90mm Hg. But it can be better described as a progressive cardiovascular syndrome characterized by the presence of BP elevation to a level that places an individual at an increased risk of target organ damage in multiple vascular beds. </span></p> <h3 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Causes of High Blood Pressure :</strong></span></h3> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">It is called Primary or essential hypertension when the increase in blood pressure occurs first without any demonstrable causes. When there might be other systemic causes resulting in the elevation of blood pressure, then it is called as secondary hypertension. Both of them have different causes as follows.</span></p> <h3 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Primary or Essential Hypertension (95%)</strong></span></h3> <ul style="text-align: justify;"> <li dir="ltr"> <p dir="ltr"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Genetics</span></p> </li> <li dir="ltr"> <p dir="ltr"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Aging</span></p> </li> <li dir="ltr"> <p dir="ltr"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Obesity</span></p> </li> <li dir="ltr"> <p dir="ltr"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Sedentary Lifestyle</span></p> </li> <li dir="ltr"> <p dir="ltr"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Stress</span></p> </li> <li dir="ltr"> <p dir="ltr"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Type A Personality</span></p> </li> <li dir="ltr"> <p dir="ltr"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Excessive Alcohol Intake</span></p> </li> <li dir="ltr"> <p dir="ltr"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Insulin Resistance</span></p> </li> <li dir="ltr"> <p dir="ltr"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Salt Sensitivity </span></p> </li> </ul> <h3 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Secondary Hypertension (5%)</strong></span></h3> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"><span class="Apple-tab-span"> </span>It is secondary to disease processes like renovascular or renal parenchymal diseases, endocrinopathies, side effects of drugs, obstructive sleep apnoea or tumors like pheochromocytoma and paraganglioma</span></p> <h3 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Clinical features of High Blood Pressure :</strong></span></h3> <h4 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Symptoms</strong></span></h4> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Patients are generally asymptomatic until end-organ damage occurs. Hence Hypertension is picked up with routine BP measurements. Symptoms of End organ damage are Coronary Artery Disease (Chest pain), Heart Failure (Difficulty in Breathing or pedal edema), Prior Stroke or Transient Ischemic Attacks (Dementia or focal deficits), Peripheral Artery Disease (Claudication), Renal Disease. </span></p> <h4 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Diagnosis of high blood pressure :</strong></span></h4> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"> High Blood Pressure can also be a physiological phenomenon during times of stress, fright and flight. It can also be increased because of the anxiety associated with visiting a doctor. Hence, there is a diagnostic criterion to establish a pathological increase in blood pressure. Diagnosis of Hypertension is established by documenting an SBP of more than 140mmHg or a DBP of more than 90mmHg based on the average of two or more readings obtained on each of two or more visits.</span></p> <h4 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Management of Hypertension </strong></span></h4> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Hypertension is not curable but it is very much Treatable. The aim of treatment is to maintain the blood pressure at an optimum level so as to prevent any end-organ damages. </span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">The goal of antihypertensive therapy is to reduce the morbidity and mortality of cardiovascular (heart and blood vessels related) diseases attributable to hypertension.</span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Lifestyle modification is very important in the management of hypertension. It includes reducing weight, quitting smoking, reducing alcohol consumption, regular exercises etc.</span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Medication is generally considered appropriate for</span></p> <ul style="text-align: justify;"> <li dir="ltr"> <p dir="ltr"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Patients less than 60 years with SBP &gt;140mmHg and/or DBP &gt;90mmHg</span></p> </li> <li dir="ltr"> <p dir="ltr"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Patients more than 60 years with SBP &gt;150 mmHg and /or DBP &gt;90 mmHg</span></p> </li> </ul> <h3 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>The Various Drugs used for Hypertension are:</strong></span></h3> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Prazosin, Enalapril, Labetalol, Sodium Nitroprusside, Telmisartan, Amlodipine, Diuretics etc.</span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Complications of Hypertension:</span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">So, why is it so important to identify and treat hypertension? It is important because the complications that are associated with prolonged hypertension are life-threatening. Some of them are as follows:</span></p> <h4 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>1. Coronary Artery Disease:</strong></span></h4> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">In simple terms, it is called Heart Attack. When the pressure in the blood vessels supplying blood to your heart is raised, it can result in decreased blood supply to your heart muscles producing pain (angina) or worse (ischemia) and even death of your heart muscle tissues (infarction).</span></p> <h4 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>2. Cerebrovascular Accident:</strong></span></h4> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Stroke or Cerebrovascular accidents are a direct result of very high blood pressure resulting in either clogging or bursting of the blood vessels of your brain resulting in severe life threatening situations.</span></p> <h4 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>3. Hypertensive Encephalopathy:</strong></span></h4> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Another Disease affecting the Brain.</span></p> <h4 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>4. Hypertensive Retinopathy:</strong></span></h4> <p style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">When the Blood pressure within the vessels of your eyes increases, it can cause serious damage which might even result in the loss of your eyesight.</span></p> <h4 style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>5. Bleeding from Nose:</strong></span></h4> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">The pressure increase in the blood vessels of your nose results in bursting of those vessels and bleeding through the nose.</span></p> <h3 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Preventive Measures:</strong></span></h3> <h4 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>1. Exercise Regularly</strong></span></h4> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">About 30 minutes of brisk walking thrice a week, can do wonders to your body by releasing the necessary endorphins. Brisk walking is nothing but walking at a pace that is slightly less than your maximum threshold. You must be able to maintain a conversation without catching for breath while walking briskly.</span></p> <h4 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>2. Reduce Salt Intake</strong></span></h4> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Restricting Salt in your food is the single most effective thing that can keep your BP at optimum levels.</span></p> <h4 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>3. Eat Healthy</strong></span></h4> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Avoid Junk Food and basically packed food items because the preservatives contain high salt content that would cause your blood pressure to shoot.</span></p> <h4 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>4. Cut down on Smoking and Alcohol</strong></span></h4> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">Changing your personal habits and cutting down on smoking and alcohol can reduce your incidence of getting hypertensive complications.</span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>5.</strong></span><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"> Get your BP checked regularly by your doctor. Especially if you are 40+ or you have a family history of hypertension.</span></p> <h3 dir="ltr" style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Heart diseases associated with hypertension:</strong></span></h3> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"><strong></strong>        <strong>1.</strong> Ischemic changes in the heart</span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">     <strong>   2.</strong> Left ventricular hypertrophy</span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">       <strong> 3.</strong> Coronary artery disease</span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">        <strong>4.</strong> Angina pectoris</span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">      <strong>  5.</strong> Myocardial infarction (heart attack)</span></p> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;">       <strong> 6.</strong> Cerebrovascular accidents (stroke)</span></p> <h3 style="text-align: justify;"><span style="color: #333333; font-family: arial, helvetica, sans-serif;"><strong>Myths And Facts</strong></span></h3> <ul> <li dir="ltr" style="text-align: justify;"> <p dir="ltr"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"><strong>Myth:</strong> High Blood Pressure is a usual aging phenomenon which need not be treated.</span></p> </li> <li dir="ltr"> <p dir="ltr" style="text-align: justify;"><span style="color: #333333; font-size: medium; font-family: arial, helvetica, sans-serif;"><strong>Fact:</strong> High Blood Pressure is a lifestyle disease which needs to be managed appropriately to prevent systemic complications which might be as dangerous as death.</span></p> </li> </ul>