Hypertension

Hypertension, commonly known as high blood pressure, is a condition where the force of blood against the artery walls is consistently too high. Here are some key points about hypertension:

?

According to the American Heart Association, blood pressure is categorized as follows:

Normal: Systolic less than 120 mm Hg and diastolic less than 80 mm Hg.

Elevated: Systolic 120-129 mm Hg and diastolic less than 80 mm Hg.

Hypertension Stage 1: Systolic 130-139 mm Hg or diastolic 80-89 mm Hg.

Hypertension Stage 2: Systolic 140 mm Hg or higher or diastolic 90 mm Hg or higher.

Hypertensive Crisis: Systolic over 180 mm Hg and/or diastolic over 120 mm Hg, which requires immediate medical attention.

1. Prevalence: An estimated 1.28 billion adults aged 30–79 years worldwide have hypertension, with two-thirds living in low- and middle-income countries.
2. Risk Factors: Factors that increase the risk of hypertension include older age, genetics, being overweight or obese, physical inactivity, a high-salt diet, and excessive alcohol consumption.
3. Symptoms: Most people with hypertension do not experience symptoms. However, very high blood pressure can cause headaches, blurred vision, chest pain, and other symptoms.
4. Diagnosis: Hypertension is diagnosed if blood pressure readings on two different days show a systolic pressure of 140 mmHg or higher and/or a diastolic pressure of 90 mmHg or higher.
5. Management: Lifestyle changes such as a healthier diet, quitting tobacco, and increasing physical activity can help manage hypertension. Some individuals may also need medication
6. Complications: If left untreated, hypertension can lead to serious health issues like heart disease, stroke, and kidney disease.

?

The DASH diet, which stands for Dietary Approaches to Stop Hypertension, is specifically designed to help manage and lower high blood pressure. Here are the key components-

?

1. Fruits and Vegetables: Emphasizes the consumption of a variety of fruits and vegetables, which are rich in potassium, magnesium, and fiber.
2. Whole Grains: Encourages whole grains like brown rice, whole wheat bread, and oatmeal, which provide essential nutrients and fiber.
3. Low-Fat Dairy: Includes low-fat or fat-free dairy products such as milk, yogurt, and cheese, which are good sources of calcium and protein.
4. Lean Proteins: Focuses on lean protein sources like poultry, fish, and nuts, while limiting red meat and fatty cuts.
5. Reduced Sodium: Limits sodium intake to help lower blood pressure. The diet recommends consuming no more than 2,300 mg of sodium per day, with an ideal limit of 1,500 mg per day for those with hypertension.
6. Healthy Fats: Encourages the use of healthy fats from sources like olive oil, avocados, and nuts, while avoiding saturated and trans fats.
7. Limited Sweets and Sugary Beverages: Reduces the intake of sweets, added sugars, and sugary beverages.

?

The DASH diet is not only effective in lowering blood pressure but also supports overall heart health and can help with weight management.

?

TREATMENT OF HTN

Treating hypertension (high blood pressure) typically involves a combination of lifestyle changes and medications. Here are the main approaches:

Lifestyle Changes

1. Diet: Adopting a heart-healthy diet like the DASH diet, which emphasizes fruits, vegetables, whole grains, and low-fat dairy products, while reducing salt, saturated fats, and sugars.
2. Physical Activity: Regular exercise, such as 150 minutes of moderate-intensity aerobic activity per week, can help lower blood pressure.
3. Weight Management: Maintaining a healthy weight or losing weight if overweight can significantly reduce blood pressure.
4. Limiting Alcohol: Reducing alcohol intake to no more than one drink per day for women and two for men.
5. Quitting Smoking: Smoking cessation can improve overall cardiovascular health and lower blood pressure.
6. Stress Management: Techniques such as meditation, deep breathing, and yoga can help manage stress, which can contribute to high blood pressure.

Medications

When lifestyle changes are not enough, medications may be prescribed. Common types include:

1. Diuretics: Help the kidneys remove excess sodium and water, reducing blood volume (e.g., hydrochlorothiazide).
2. ACE Inhibitors: Relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels (e.g., lisinopril).
3. Angiotensin II Receptor Blockers (ARBs): Help relax blood vessels by blocking the action of a natural chemical that narrows blood vessels (e.g., losartan).
4. Calcium Channel Blockers: Prevent calcium from entering heart and blood vessel muscle cells, leading to more relaxed blood vessels (e.g., amlodipine).
5. Beta Blockers: Reduce the workload on the heart and open blood vessels, causing the heart to beat slower and with less force (e.g., metoprolol).
6. Renin Inhibitors: Slow down the production of renin, an enzyme produced by the kidneys that starts a chain of chemical steps that increases blood pressure (e.g., aliskiren).

?

Blood pressure medications can have various side effects, depending on the type of medication. Here are some common types of blood pressure medications and their potential side effects:

?

Diuretics (Water Pills)

• Common Side Effects: Increased urination, weakness, leg cramps, fatigue, and electrolyte imbalances.
• Less Common Side Effects: Decreased libido, skin rash, and sensitivity to sunlight.

Beta-Blockers

• Common Side Effects: Fatigue, weakness, cold hands and feet, and dry mouth, eyes, and skin.
• Less Common Side Effects: Slow heart rate, wheezing, difficulty breathing, and swelling of the hands or feet.

ACE Inhibitors

• Common Side Effects: Persistent dry cough, elevated blood potassium levels, and fatigue.
• Less Common Side Effects: Dizziness, headaches, and loss of taste.

Angiotensin II Receptor Blockers (ARBs)

• Common Side Effects: Dizziness, muscle cramps, and elevated blood potassium levels.
• Less Common Side Effects: Diarrhea, kidney dysfunction, and nasal congestion.

Calcium Channel Blockers

• Common Side Effects: Swelling in the lower extremities, dizziness, and fatigue.
• Less Common Side Effects: Heartburn, nausea, and constipation.

Alpha-Blockers

• Common Side Effects: Dizziness, headache, and fatigue.
• Less Common Side Effects: Palpitations and nasal congestion.

Renin Inhibitors

• Common Side Effects: Diarrhea, dizziness, and flu-like symptoms.
• Less Common Side Effects: Rash and elevated blood potassium levels.

?

Author: Dr. Ria Adlakha: MBBS

Doctor @ Novel Healthtech Solutions Pvt. Ltd.