Hypertension also known as high blood pressure is often referred to as the Silent Killer because many individuals may have the disease without even knowing it.

Your blood pressure is dependent on the amount of blood your heart pumps and the level of resistance your heart has to pump against present in your arteries.

Blood pressure varies and may increase with activity and decrease at rest. It may also vary slightly with each heartbeat. High blood pressure left uncontrolled could lead to a series of life-threatening health problems.

Most individuals with hypertension have No Symptoms. Early in the disease some individuals may present with dull headaches and in more advanced cases dizziness and nosebleeds may occur.

A simple test to check blood pressure should be done periodically (at least every 2 years). Blood pressure is measured with a device known as a sphygmomanometer which is made up of an inflatable arm cuff and a pressure-measuring device.

The blood pressure reading consists of two numbers (systolic/diastolic). The upper number indicates systolic pressure which measures the amount of pressure generated by the heart when pumping blood through the arteries while the lower or diastolic pressure measures the amount of pressure in the arteries between heartbeats when the heart is at rest.

Blood pressure is considered to be normal when it is recorded to be below 120/80 mmHg (mm of Mercury) although more recent data has shown that 115/75 mmHg should be considered as the acceptable normal reading.

The risk of cardiovascular disease increases once blood pressure rises above the normal level.

Blood pressure readings found in Prehypertension range between 120-139 mmHg systolic and 80-89 mmHg diastolic. In Stage 1 Hypertension readings range between 140-159 mmHg systolic and 90-99 mmHg diastolic. Stage 2 Hypertension is the most severe form with systolic pressures of 160 mmHg or more and diastolic pressures of 100 mmHg and above.

There is no identifiable cause of hypertension in more than 90% of cases. This form of hypertension is referred to as Essential or Primary Hypertension. When hypertension is as a result of an underlying cause, it is referred to Secondary Hypertension.

Underlying causes of secondary hypertension include Kidney and Adrenal disease, Thyroid disorders, Abnormal blood vessels, Sleep Apnoea and Pre-eclampsia. Certain drugs such as Oral contraceptives, decongestants and pain relievers may also lead to secondary hypertension. Illegal drugs like cocaine and amphetamines may increase blood pressure too.

Primary hypertension tends to develop gradually over time while secondary hypertension may develop rapidly with very high pressure readings. Hypertension in children is uncommon and is usually as a result of an underlying condition.

The major risk factors for developing hypertension are Race as the black race has the highest incidence of hypertension than any other ethnic group; Age as the risk increases with advancing age; Sex as the incidence is higher in men than women under the age of 60 years but the reverse is the case after this age; Family History shows that hypertension tends to run in some families. Other risk factors which are controllable include Obesity and Inactivity because with more weight an increased blood supply is needed to deliver oxygen and nutrients to tissues which increases pressure on the arterial walls.

The fat deposits also produce chemicals injurious to the heart and blood vessels; Smoking leads to damage of the arterial walls which encourages cholesterol plaque formation and nicotine found in cigarettes may constrict blood vessels creating a greater resistance against the heart’s pumping action; Alcohol consumed excessively over time may damage the heart; Stress episodes may lead to temporary high blood pressure and may also encourage habits such as smoking, drinking alcohol and overeating which are known to contribute to high blood pressure; Sodium Sensitivity predisposes individuals to fluid retention so salt should be used sparingly; Inadequate Potassium intake leads to sodium retention.

High blood pressure is commonly detected during routine medical checks but a single reading is not enough to diagnose the condition.

An individual is considered hypertensive if 2 or more consecutive blood pressure readings are found to be high weeks or months apart. In the past, doctors and healthcare professionals focused on high diastolic pressure leading to end-organ damage but of recent it has been appreciated that high systolic pressure is equally important.

Individuals with a normal diastolic blood pressure and an elevated systolic pressure have Isolated Systolic Hypertension (ISH). If a person is found to be hypertensive tests such as Urinalysis, Blood tests, Electrocardiogram (ECG), Ultrasound, Magnetic Resonance Imaging (MRI), angiography or nuclear scanning may be carried out to help determine the extent of damage or a possible underlying cause.
Complications as a result of high blood pressure include damage to arteries, thickening of the left ventricle of the heart, stroke, kidney failure, blindness and metabolic syndrome.

Uncontrolled hypertension may affect memory, the ability to learn and the ability to think. In addition, hypertension has been linked to dementia and cognitive decline.

Treatment is aimed at preventing complications associated with high blood pressure. This includes the use of medications and alterations in certain lifestyle choices.

A blood pressure reading below 140/90mmHg is usually the aim but in patients with kidney disease or diabetes, the aim is a pressure below 130/80mmHg. Medications used for the treatment of hypertension include Diuretics which act on the kidney to encourage elimination of sodium and water thus reducing blood volume.

These are the first line of treatment and are often the most effective; Beta-blockers block the effect of adrenaline-related chemicals which helps reduce heart rate and the pumping force of the heart; Angiotensin-converting enzyme (ACE) Inhibitors act by relaxing blood vessels by blocking the production of the chemical responsible for constricting blood vessels and is commonly used in patients with coronary artery disease, kidney failure or heart failure; Angiotensin II receptor blockers help block receptors for the chemical responsible for constricting blood vessels; Calcium channel blockers (Calcium antagonists) work to relax the muscles of the blood vessels and slow heart rate.

Some doctors may prescribe a combination of these drugs or may add Alpha Blockers or Vasodilators to treatment.

Lifestyle changes include eating a healthful diet, restricting salt intake, exercising, achieving and maintaining a healthy weight, limiting alcohol and caffeine intake, stopping the habit of smoking, managing stress and getting enough sleep.