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What is Blood Pressure?

Blood pressure (BP) or hypertension is the pressure exerted by blood against the artery walls each time the heartbeats. It is measured as systolic and diastolic pressures, i.e. blood pressure when the heartbeats, and blood pressure in between beats, when the heart is at rest. Normal BP is ≤120 (systolic blood pressure)/80 (diastolic blood pressure) mmHg. High blood pressure is a condition that occurs when the pressure of blood in the blood vessels is ≥140/90 mmHg.

Blood pressure varies throughout the day and depends on the level of your activity. It decreases during sleep and rises with excitation, anxiety, and activity.

In adults, blood pressure can be classified into the following categories:

Category 
Systolic (mm Hg)
Diastolic (mm Hg)
Normal
Less than 120
Less than 80
Prehypertension
120-139
80-89
High Blood Pressure- Stage 1
140-159
90-99
High Blood Pressure- Stage 2
160 or Higher
100 or Higher

Anatomy of the Heart

The heart is a muscular organ that pumps oxygen-rich blood to the entire body. It is made up of 4 chambers: 2 upper chambers called atria and 2 lower chambers called ventricles. The left ventricle is responsible for pumping oxygenated blood to the body. The pressure of blood against the arteries when the ventricle contracts are the systolic blood pressure. The dip in pressure when the ventricle relaxes to refill is the diastolic pressure.

Causes of High Blood Pressure

Although the exact cause of high blood pressure is not clear, some factors can increase your risk of developing it:

  • Obesity
  • Lack of exercise
  • The high salt content in your diet
  • Excessive alcohol consumption
  • Genetics
  • Older age
  • Smoking
  • Family history of high BP
  • Certain conditions such as chronic kidney disease and thyroid disorders

Impact of High Blood Pressure

High blood pressure can go unnoticed for years, during which time it can damage your blood vessels, heart, kidneys and other organs. It can, in turn, lead to major health risks such as heart attacks, kidney failure, blindness, stroke, and coronary heart diseases.

Symptoms of High Blood Pressure

High blood pressure usually does not show any symptoms. You realize that you have hypertension only when pressures increase to dangerously high levels, and you begin to experience symptoms such as severe headaches, shortness of breath, severe anxiety and nosebleeds.

Stages of High Blood Pressure

High blood pressure can be divided into 2 stages based on your blood pressure readings. A systolic blood pressure of 140-159 or a diastolic pressure of 90-99 is considered stage 1, and systolic pressure of 160 and above and a diastolic pressure of 100 and above is considered stage 2. Pressures of 120–139 systolic pressure and 80–89 diastolic pressure is considered prehypertension.

Diagnosis of High Blood Pressure

High blood pressure is diagnosed using a simple blood pressure test using an electronic sensor and a blood pressure cuff. This test is performed repeatedly to confirm high BP. If the readings are higher than 140/90 over time, you are likely to have high blood pressure.

What Happens When High Blood Pressure is Untreated?

When high blood pressure is left untreated it can lead to stroke, heart attack, heart failure, aneurysms (weak and bulged blood vessels), narrowing of blood vessels in the kidneys and eyes, and metabolic syndrome (high cholesterol and insulin levels).

Treatment for High Blood Pressure

Options

High blood pressure can damage different organs of the body such as the brain, heart, and kidneys. Various medications are prescribed to control high blood pressure. If a single drug is ineffective, a combination of two or more drugs may be used.

Other

Simple lifestyle modifications can prevent the progression of pre-hypertension to hypertension and improve the efficacy of the prescribed medications. Some of the common lifestyle modifications include:

  • Weight loss in obese or overweight individuals
  • Regular exercise such as walking for 30- 60 minutes a day for at least 5 days a week
  • Eating a healthy diet rich in whole grains, nuts, fruits, and vegetables, while restricting sweets, added sugar, saturated fats, cholesterol or total fats and dairy products
  • Reduction in salt intake to 2,300 mg/day in normal individuals and 1,500 mg/day in patients with high blood pressure
  • Abstinence from alcohol
  • Reduction in consumption of coffee or caffeinated beverages
  • Yoga or meditation to reduce stress and anxiety
  • Regular check-ups with your doctor, once every 6 -12 months or as recommended
  • Support from family and friends in the form of encouragement and motivation to improve adherence to these lifestyle changes.

Outcome

Hypertension cannot be cured but should be managed for the rest of your life. By taking your medications regularly and maintaining a good healthy lifestyle, you will be able to prevent the progression of the disease into probable life-threatening complications.

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  • American College of Physicians
  • Andrews Research & Education Foundation
  • American Board of Internal Medicine
  • JJM Medical College