High Blood Pressure

High blood pressure (Hypertension) is one of the most common chronic diseases in the world. Hypertension is characterized by elevated blood pressure in the arteries of the body. The table given below summarizes the salient features of this condition.

Table: Overview of High blood pressure

Definition

Systolic blood pressure 120 mm Hg or more and/or

Diastolic blood pressure 80 mm Hg or more.

(Further classified into Prehypertension, and Stage 1 Hypertension and Stage 2 Hypertension)

Symptoms

Headache, lightheadedness, palpitations, easy fatigability, erectile dysfunction may occur

Other symptoms depending on complications or cause.

Majority of affected people are asymptomatic.

Risk Factor

Old Age, Family History, Smoking, Alcohol, Obesity, Sedentary Lifestyle, High Salt Intake

Causes

Cause unknown in most of the cases (Essential Hypertension)

Sometimes secondary to other conditions (Renal Diseases, Endocrine diseases, Drugs, Genetic Diseases, Cardiovascular Diseases etc.)

Complications

Hypertension can cause damage to heart, brain, kidney, peripheral arteries, etc.

May result in hypertensive emergencies like Malignant Hypertension, Stroke, Myocardial Infarction, etc.

Treatment

Lifestyle Modifications: Stop smoking, Reduce alcohol, Dietary Modifications, Exercise, Weight Control, Reduced Salt Intake, Relaxation techniques

Pharmacological: Anti-hypertensive Drugs

Treatment of primary cause (if any)

Normal systolic blood pressure is 90 to 119 mm of Hg and normal diastolic blood pressure is 60 to 79 mm Hg. Blood pressures above this are classified into various grades of hypertension (Prehypertension, Stage 1 Hypertension, Stage 2 Hypertension, Isolated Systolic Hypertension, etc.)

Most patients with high blood pressure are asymptomatic in the early stages. This makes screening for this silent killer very important as future complications can be prevented by reducing the blood pressure. Symptoms often first appear when one or more complications of the hypertension have occurred. Long standing uncontrolled hypertension damages various structures in the body like heart, kidney, retina, peripheral arteries, etc. and can cause numerous diseases. Extremely high blood pressure (Systolic >180 mm Hg and/or Diastolic >110 mm Hg) can result in numerous life-threatening complications (Hypertensive encephalopathy, Stroke, Aortic dissection, Malignant Hypertension, etc.). Such high blood pressures require immediate medical treatment.

In most cases of high blood pressure, no cause is evident and they are referred to as essential hypertension or primary hypertension. In some cases, there may be some other disease condition secondarily causing hypertension. High blood pressure is such cases can be cured by addressing the primary cause. Essential hypertension is a multifactorial disease, and numerous risk factors have been found to be associated with it. Primary hypertension is believed to be result of complex interaction between various environmental factors (smoking, alcohol, obesity, etc.) and genetic factors (family history, ethnicity, etc.).

Blood pressure can be reduced by lifestyle modifications and anti-hypertensive drugs. For slightly elevated blood pressure (prehypertension), only lifestyle modifications are recommended. Others require drugs also in addition to lifestyle modifications for control of blood pressure. Hypertension, if secondary to other cause, then the treatment of primary condition often cures the hypertension.