Quick facts- Systematic Hypertension

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by Dr. Izuagba Kelechi. U.

INTRODUCTION

  • Hypertension also known as high blood pressure is a medical condition in which there’s persistently elevated systolic and diastolic blood pressure of > or = 140/90 mmHg in adults (WHO)
  • It is a non-communicable disease, very common and can be “Asymptomatic” and if it is not detected and controlled, it can often lead to lethal complications.
  • The prevalence of hypertension increases with advancing age and it is a major risk factor for coronary artery diseases, heart failure, stroke and renal insufficiency.
  • Because hypertension is almost without symptoms except for headaches in some people, it hides without knowing it and is therefore referred to as a “SILENT KILLER”.
  • Higher in both extremes of socio-economic groups.
  • Commoner in blacks/black population
  • Prevalence in Nigeria is 11.2% in adults
  • Increasing awareness and early diagnosis will improve the control of high blood pressure. This will help to reduce cardiovascular complications which can lead to morbidity and mortality
  • Effective BP control is possible and can be achieved

CLASSIFICATION OF HYPERTENSION

Based on JNC-7 classification, it can be

  1. Normal BP = <120/<80 mmHg
  2. Optimum BP = 120/80 mmHg
  3. Pre-hypertension = 120-139/80-89 mmHg
  4. Stage 1 hypertension = 140-159/90-99 mmHg
  5. Stage 2 hypertension = >or=160/>or =100 mmHg

Based on the cause / aetiology:

  1. Primary hypertension / essential / idiopathic(unknown)
  2. Secondary hypertension

The primary/essential hypertension is the “commonest” accounting for 95% of cases

Because the cause is unknown, it is non-curable; and treatment is for life

The primary hypertension is likely due to interplay between factors (risk factors) which maybe different among individuals

The secondary hypertension accounts for the remaining 5% of cases.

RISK FACTORS OF HYPERTENSION (PRIMARY TYPE)

  • Hereditary/generic factors i.e. family history
  • Advancing age (45years and above)
  • Obesity
  • Dietary factors e.g. excessive salt intake, low k+ , low vegetables/fresh fruits, saturated fats (hyperlipidemia)
  • Excessive alcohol consumption
  • Physical inactivity
  • Smoking
  • Socio-economic status (both high and low)
  • Gender factor – less in pre-menopausal women, more in men (oestrogen is protective)
  • Geographical factors e.g. in KOMA people of Nigeria, high blood pressure is virtually non-existent and there’s no rise with age than in western organized societies.

FACTORS THAT TRANSIENTLY INCREASE BP

  • Anxiety
  • Cold
  • Sexual orgasm
  • Exercise (brisk rise in systolic BP)

N/B: The secondary types are usually due to underlying systematic diseases e.g. renal, endocrine, neurological and exogenous factors and are not the focus of discussion.

COMMON PRESENTATIONS OF HYPERTENSION

  • Asymptomatic (i.e. no symptoms hence called a “silent killer”)
  • Occasional symptoms e.g.
  • Headache
  • Dizziness
  • Palpitations (awareness of one’s heart beat)

TREATMENT

  • Non-medical treatment: lifestyle modification e.g.
  • Weight reduction
  • Exercise
  • Reduced salt and alcohol intake
  • Stop smoking
  • Dietary approach e.g. take more fruits and vegetables
  • Reduce intake of refined sugar
  • Medical treatment: The use of drugs (anti-hypertensives) e.g. Thiazides (hydrochlorothiazide), calcium channel blockers (Amlodipine), etc.

N/B: Always adhere to your medications with lifestyle modifications. This will help reduce the blood pressure and will prevent fatal complications of the disease.

CONCLUSION

  • Hypertension is a very common disorder in aged people and it is associated with higher risk of cardiovascular morbidity and mortality
  • Effective blood pressure control can be achieved with strict adherence to medications and life style changes
  • Every adult must “routinely” check his/her blood pressure at least 2 times weekly if “undiagnosed” as this disease does not show or give clues hence referred to a silent killer
  • For the “diagnosed” patients, they must have a personal BP apparatus with the assistance of a medical personnel (nurses) to always check their blood pressure daily to control the BP in addition to strictly adhering to their daily medications and lifestyle modifications
  • Visit your doctor if there are complaints
  • Early diagnosis and prompt intervention are key to management of hypertension

GO CHECK YOUR BLOOD PRESSURE TODAY!

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