Dr. Sushil Kumar Sharma
Elevated Blood pressure is a major risk factor for coronary Heart Disease, Heart Failure, cerebrovascular disease, renal failure and artial fibrillation. The patient with an elevated blood pressure more commonly have other risk factors for cardiovascular disease (i.e. diabetes , Insulin resistance, dyslipidemia) and target organ damage. Because risk factors may interact the overall risk for cardiovascular related diseases in hypertensive patients is increased, even in those with only mild or moderate blood pressure elevation.
The Theme for World Hypertension Day is Know Your Numbers with a goal of increasing high blood pressure (BP) awareness in all populations around the world.
Prevalence: High blood pressure (BP) is a major public health problem in India and its prevalence is rapidly increasing among both urban and rural populations. One in Three adults worldwide has high blood pressure. In fact, in India hypertension is the most prevalent chronic disease. The prevalence of hypertension ranges from 20-40% in urban adults and 12-17% among rural adults. The number of people with hypertension is projected to increase from 118 million in 2000 to 214 million in 2025, with nearly equal numbers of men and women.
Signs and Symptoms:-
High blood pressure is called the silent killer because it often does not produce any signs or symptoms to some patients. Few of the Patient may have headache, dizziness, epistaxis, palpitation, muscle cramps, giddiness, burning of eyes, distended neck veins, insomnia, neck pain & vertigo. But some patients have high blood pressure for years without knowing it and that is why referred to colloquially as “the silent killer” . Sign and symptoms typically don’t occur until high blood pressure has advanced to a higher possibility of life threatening-stage like cerebrovascular or renal disease
Healthy Bolld Pressure
Risk factors for developing high blood pressure
* Family History
* Advanced Age
* Gender Related risk pattern
* Lack of Physical Activity
* Poor Diet, especially one that includes too much salt
* Overweight and obesity
* Alcohol Consumption
* Stress and Ethnic back ground
Possible contributing factors
There is some connection between blood pressure and these factors but science has not proven that they actually cause high blood pressure.
* Stress
* Second Hand Smoke
* Sleep Apnea
Secondary hypertension: HBP caused by a pre-existing problem
In 5-10 percent of high blood pressure cases, the HBP is caused by a pre-existing problem. This type of HBP is called secondary hypertension because another problem was present first.
Factors that may lead to secondary hypertension include:
* Kidney abnormality, including a tumour on the adrenal gland, which is located on top of the kidneys
* A structural abnormality of the aorta (the large blood vessel leaving the heart) that has existed since birth
* Narrowing of certain arteries
The good news is that these pre-existing problems can usually be fixed. For example, doctors can repair a narrowed artery that supplies blood to a kidney means by doing renal angioplasty or the recent renal denervation therapy. Once the root cause of secondary hypertension is corrected, blood pressure typically returns to normal. For those with HBP, a physical exam and some tests can help your physician determine whether your high blood pressure is primary or secondary hypertension
Hazards of High Blood Pressure
Hypertensive patients have stiffer arteries, and arteriosclerotic patients may have particularly high systolic blood pressure and wide pulse pressure as a conquences of decreased vascular compliance due to structure changes in the vascular wall. Recent evidence suggests that arterial stiffness has independent predictive value of cardiovascular events. Clinically, a number of devices are available to evaluate arterial stiffness or Compliance, including ultrasound and magnetic resonance imaging (MRI).
Why High Blood pressure matters –
High blood pressure can lead to serious health problems .These potential consequences can motivate you to take care of your arteries and live a healthy life
Possible health consequences that can happen over time when high blood pressure is left untreated include:
* Damage to the heart and coronary arteries, including heart attack, heart disease, congestive heart failure, aortic dissection and atherosclerosis (fatty build ups in the arteries that cause them to harden)
* Stroke
* Kidney damage
* Vision loss
* Erectile dysfunction
* Memory loss
* Fluid in the lungs
* Angina
* Peripheral artery disease
Prevention of High Blood Pressure
High blood pressure is preventable and treatable. The old adage, ‘Prevention is better than cure’ is especially true for high blood pressure
Lifestyle modification to manage hypertension
Weight Reduction Attain and maintain BMI < 25kg/m2
Dietary salt Reduction < 6g Nacl /d
Adapt DASH – type dietary plan Diet rich in fruits, vegetables, and low – fat dairy products with reduced content of saturated and total fat.
Moderate alcohol consumption For those who drink alcohol, consume 2drinks/day in men and 1 drink/day in women
Physical activity Regular aerobic activity, e.g., brisk walking for 30 min/day at least five days a week.
The ultimate goal of World Hypertension Day observation is to give awareness of the consequences of Hypertension to the General Population, so that we can prevent, heart attack, heart failure, stroke, kidney failure, retinal haemorrhage and atherosclerosis. Hypertension though a huge burden could easily be tackled with improved system of healthcare for widespread screening for Hypertension so that it can be detected. Once detected, effective BP control and reduce cardiovascular risk is best achieved by appropriate drug therapy with good adherence. Such a public health approach shall lead to enormous improvement in clinical outcomes of hypertension in India.
(The author is Head Department of Cardiology, GMC, Jammu)
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