Hypertension is another name for high blood pressure.
It is that condition when the pressure inside of your large arteries
is too high. Because it does not usually produce any symptoms, the
only way to detect hypertension is to have your blood pressure measured.
Hypertension is a very common problem that affects about8 million
FIlipinos . It is also the most common cardiovascular condition
in the world. It is more common as people grow older and it occurs
equally in men and women. Hypertension is not simply being tense
or nervous. Back
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More than 9 of every 10 people who have hypertension
do not have a cause for it that can be identified.
We do know that you can inherit the tendency to
hypertension from your parents. If your parents have hypertension (one
or both), you are more likely to develop it than if your parents had normal
blood pressure. Although less likely, you can still get hypertension even
if your parents have normal blood pressure.
Your environment also plays a very important role.
For example, you have a chance to avoid hypertension by keeping your weight,
under control, keeping physically fit, eating a healthy diet, limiting
your alcohol intake (no more than one mixed drink or one 12 oz. can of
beer or one 6 oz. glass of wine daily), and avoiding smoking and medications
that might increase your blood pressure. You cannot choose your own parents,
but you can help reduce your chance of getting hypertension by leading
a very healthy lifestyle.
There are other less common causes of hypertension.
Most are due to disorders of the kidneys or endocrine glands. Your doctor
can determine if the disorders are related to your hypertension by taking
your history, performing a physical examination, and doing a few simple
blood and urine tests. More sophisticated testing is not often required. Back
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Yes, hypertension can lead to other serious health
problems or even death. Hypertension is often called “the silent
killer” for two reasons. First, it produces no specific symptoms.
Such things as dizziness, nervousness, nosebleeds or headaches rarely
have anything to do with hypertension. Hypertension can be detected only
by measuring your blood pressure. Secondly, people who have hypertension
that is not treated are much more likely to die from or be disabled by
cardiovascular complications such as strokes, heart attacks, heart failure,
heart rhythm irregularities, and kidney failure than people who have normal
blood pressure. Back
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The only way to know your blood pressure is to
have it measured. Although this is a very simple process, it is important
that it be measured correctly. You should be seated for about 5 minutes
before your blood pressure is determined. If the reading is made while
you are agitated, excited or angry, it may be high due to your emotional
state. This can lead to unnecessary treatment or treatment with too much
medication. You should also avoid food, alcohol, caffeine and tobacco
in the 30-60 minutes before your blood pressure is determined. If you
are seated, your back should be supported. Your arm should be at the level
of your heart. If you are taking medication to lower your blood pressure,
it is a good idea to have your blood pressure taken in the standing position
as well. This procedure will help to reduce the risk of getting dizzy
from too much medication. Back
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Your blood pressure is usually represented as two
numbers, for example 118/76 or 118 over 76. The top number is called the
systolic pressure. It indicates the peak pressure in your arteries that
is generated when your heart beats. The bottom number is called the diastolic
pressure. It indicates the pressure in your arteries when your heart is
relaxing between heartbeats. It gives a clue to how much resistance your
small arteries are putting up to the flow of blood. The pressure in your
large arteries is a combination of the force of the heartbeat and the
resistance of the small arteries. Younger people with hypertension tend
to have a more forceful heartbeat, while older hypertensives tend to have
higher resistance. Some people, particularly older individuals, have a
high systolic pressure but a normal or low diastolic pressure. This is
called isolated systolic hypertension and suggests that their arteries
have become very stiff. Back
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Blood pressure is not a fixed number. It varies
with physical activity, excitement, time of day or night, and with emotional
factors. This is why it is important to have your blood pressure taken
under proper conditions and on more than one occasion. Optimal or normal
blood pressure, the level associated with the lowest cardiovascular risk,
is less than 120/80 (measured in millimeters of mercury or mm Hg). It
may be perfectly normal for a young, healthy woman to have a blood pressure
of 90/60. Once blood pressure rises continuously above 120/80, the risk
of cardiovascular disease begins to increase. A state of pre-hypertension
is said to be present when the BP is persistently between 120-139 mm Hg
systolic or 80-89 mm Hg diastolic. Hypertension is said to be present
when the blood pressure is consistently above 140 systolic or 90 diastolic.
The higher the blood pressure, the greater the cardiovascular risk. The
longer the duration of hypertension, the greater the cardiovascular risk.
People with diabetes or kidney disease should try to keep their blood
pressure at less than 120/80 because they are at higher risk for the consequences
of hypertension. Back
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Your full participation in your own care
is the most important part of your treatment. You should establish good
communication with your doctor and have a say in how you are being treated.
Talk with your doctor about the desired level for your blood pressure.
Keep your own personal record of your blood pressure readings. Be open
with your doctor to get help in resolving any problems that might block
you from achieving your blood pressure goal. Every hypertensive patient
or individual at high risk of developing hypertension should follow a
healthy lifestyle. This means losing weight if you are overweight, reducing
any excess amount of salt that you eat, increasing the amount of potassium
and calcium in your diet, avoiding excess alcohol intake (more than one
drink a day), getting proper exercise, and never ever smoking. Avoid excessive
use of drugs that can increase your blood pressure such as decongestant
tablets or nasal sprays and pain medications called non-steroidal anti-inflammatory
drugs (NSAIDs). If your blood pressure remains or becomes high, your doctor
may prescribe medication. Back
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Yes, hypertension can be treated successfully.
Although it cannot be cured, it can be controlled and one of the great
advances in medicine in the past 40 years is treating hypertension with
medicines that have become available since 1958. Unfortunately, most people
with hypertension don’t even know that they have it and only about
one in ten Filipino hypertensive patients is receiving adequate treatment
to control their hypertension. Back
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One must first start with the healthy lifestyle
changes as previously mentioned. Some people with very minimal elevations
of blood pressure will respond to this non-drug treatment alone. Even
with adherence to a healthy lifestyle, a person’s blood pressure
may rise as they grow older and they may, at some point, require drug
treatment. Even if medication is required, a healthy lifestyle should
be continued. That will make the medications more effective and possibly
reduce the amount of drugs required. Once medications are started, it
is extremely important to continue with the treatment. People who stop
treatment almost always return to their original blood pressure level
or higher. The treatment for most patients is life-long. If you have a
problem with a medication, always tell your doctor. Do not just stop a
medication on your own. Back
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Your doctor can prescribe a wide variety of medications
to control your blood pressure. In general, doctors try to find a single
drug that is best for the individual patient. Since all patients are different,
the doctor will consider whether your hypertension is completely uncomplicated,
whether you have another disease such as diabetes or a heart problem,
whether you have some specific indication or contraindication for a specific
drug, and whether your past experience with hypertension treatment dictates
a choice of drug. Your individual age, race, and lifestyle may influence
the choice of treatment. If the first drug is not effective or causes
adverse effects, your doctor will choose an alternate drug or drugs. Back
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• Diuretics, which initially increase urination
to reduce salt and water retention
and lower blood volume. They are useful alone or in combination
with other
drugs.
• Beta-blockers (BB’s), which slow the heart rate and lower
the output of the
heart.
• Angiotensin converting enzyme (ACE) inhibitors, which block production
of a
specialized hormone called angiotensin II. Angiotensin II
causes the arteries to
constrict and also stimulates the release of another hormone
that causes the
kidneys to retain salt.
• Angiotensin II receptor blockers (ARBs or A II A’s), which
relax blood
vessels by blocking the action of angiotensin II.
• Calcium channel blockers (CCB’s)of which there are two types:
dihydropyridines (DHPs), and heart rate slowing calcium channel
blockers.
Both types relax blood vessels by slowing the entry of calcium
into cells.
The DHPs increase the heart rate a little while the others
slow it a little.
• Alpha-1 blockers work on the blood vessels to block the effect
of constricting
hormones such as norepinephrine. These are also commonly
used to treat
prostate problems.
• Alpha-2 agonists, which work in the brain to decrease the action
of the nervous
system to constrict blood vessels.
• Direct vasodilators, which relax the artery walls.
• Sympathetic nerve blockers, which prevent those nerves from constricting
blood vessels. Back
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In order to control hypertension or any other illness
and have the most benefit from treatment, patients must follow medical
advice. This includes living a healthy lifestyle and taking their medicine
in the amounts and at the times recommended. Most people, however, have
some difficulty maintaining healthy habits and taking their medicine as
prescribed. Many people simply forget to take their medication. Others
stop taking their medication because they believe that it makes them feel
worse or because it is too expensive. Others stop because they feel better
and mistakenly believe that they no longer need the medication. Some stop
because their blood pressure became normal with treatment and they mistakenly
thought that they were “cured”. Uncontrolled hypertension
is a serious problem. It can cause heart disease, heart attack, stroke
or kidney failure. If you experience side effects from your medication
or have other difficulties taking it as prescribed, continue taking it
but contact your doctor or pharmacist quickly to discuss the issue. Back
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People with hypertension who keep an accurate record
of their blood pressure readings can discuss them with their doctor at
their regular examination or any time their “numbers” change
drastically. They become much more involved in their own care. If you
measure your blood pressure at home, be sure to have your monitoring device
calibrated at your doctor’s office to assure accurate readings.
Talk with your doctor about how often you should measure your blood pressure
and how you should share this information. You might arrange to transmit
your readings by fax or by e-mail. Your blood pressure readings will vary
with the time of day and may be higher if you are under stress or in pain.
Take your blood pressure at the same time every day for the most accurate
results. The most precise blood pressure readings, however, are those
taken by your trained health care provider. Back
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