Hypertension or high blood pressure is
a disease that is silent until a complication of the disease like heart attack,
stroke or renal failure occurs. That is
why it is known as silent killer. Even in
developed countries only half of the people who suffer from hypertension are
aware of their condition and those who are aware only a few percent are under
adequate treatment.
Blood pressure is measured generally by an
apparatus – sphygmomanometer – BP apparatus, measured as systolic and diastolic
BP.
Now electronic gadgets have come
with which any individual can check his/her BP.
Systolic pressure is the pressure with which heart pumps the blood and
diastolic is the resistance of the vessels to the flow of blood.
Various factors affect this systolic and
diastolic BP. In general in any person at any given time the blood pressure
should not be more than 130/80 mm.Hg. (millimeters of mercury), 130 being
systolic and 80 being diastolic BP.
When
the BP crosses this it is regarded as hypertension or high BP.
What ever may be the cause it needs
treatment.
In fact, present studies
indicate that a person whose BP is around 130/80mm.Hg should follow life style
modification (LSM) to prevent any further increase in BP.
This LSM includes restriction of salt intake
to less than 5gm/day, restriction of alcohol intake, reduction in weight in
case of obese individuals, regular physical exercise and following some
relaxing methods like meditation and yoga.
The causes of Hypertension are known only
in about 10% of the patient. The most
important cause is kidney disease and pregnancy induced hypertension. There are other causes like vascular (blood
vessel) diseases and rarely tumors of adrenal glands. This is called secondary hypertension, the
cause may sometimes be corrected or treated and high blood pressure is brought
to normal levels. In more than 90% of
cases where the cause is not known it is called essential hypertension or
primary hypertension. Genetic factor contributes to a great extent and environmental
factors – physical and mental wellbeing will add to it. When the systolic BP is 140 or more and
diastolic is 90 or more mm.Hg definite treatment apart from LSM is needed. After ruling out any known causes of high BP,
considering other health factors of the individual, drugs are prescribed. Until BP comes down to 130/80mm.Hg regular
follow-up weekly or fortnightly (depending on severity of hypertension) is
required for adjusting appropriate dosage of appropriate drug/drugs.
Once hypertension (HTN) is diagnosed
patient is evaluated not only for the cause of HTN but also for any organ
damage. As said early, HTN itself does
not present any symptom unless some organ damage has occurred. Usually it is diagnosed when an individual
goes to the doctor with some fever or nonspecific complaints. In the initial stages patients do not want to
accept that they have HTN. Though for
milder forms LSM is suggested even that is ignored that they never had any ‘BP’
in the past. They fail to accept that
though they never had it previously now they have it. The failure of compliance of the patient
leads to early organ damage and life threatening complications.
Though
all organs are affected by HTN, the vital organs that are affected and causing
complications are the heart, kidney and brain.
The degree of HTN is not important, even mild forms when untreated can
result in complications like renal (kidney) failure, heart attack or stroke. Severe forms definitely lead to complication
some time in future. In India
stroke is more common than heart attack in patients with HTN.
To
avoid or delay organ damage and complications it is best to take physician’s
advice and be adequately treated with proper drugs to maintain BP at ‘normal’
level. Once BP is maintained at normal
level medication should be continued regularly with periodic check-up by
physician to note any signs of organ damage or any change required in
medication. Generally patients once
declared to have normal BP, they stop medications. This is because of lack of understanding that
the medication they are using is maintaining the BP at normal level. Once
medication is stopped complications are liable to occur. Once
diagnosed and treated with drugs,
continuation of medication is life long for a long life. This is to be remembered by patients under
treatment for essential/primary hypertension.
To have a disease and not using medication is being diseased. Using treatment for the disease is being
eased out of disease and maintaining almost normal healthy life.
I
wanted to write this highly simplified presentation of HTN just to make people
aware of the fact that HTN is a silent
killer, hence though they do not have any symptoms but diagnosed to have BP
at regular health check-up must strictly follow the advice of the physician and
take treatment. There should not be
delay or irregular treatment which will increase complications. It is good for individuals to have general
regular health check-up once a year after the age of 30yrs even without any
obvious health problems.
I
wish everyone a tension free life with proper health precautions.