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HYPERTENSION

Blood pressure is the force with which your heart pumps blood throughout your body. It varies from person to person. It may fluctuate from time to time when, for instance, when one gets angry or is in pain versus when one is relaxed or rested.

Blood pressure is expressed as two numbers and is measured in mm Hg (millimetres of mercury). The first number is the systolic pressure, i.e. the pressure when the heart contracts and pumps blood to the rest of the body. The second number is the diastolic pressure, which is when the heart relaxes, allowing it to fill with blood.

In general, blood pressure is classified as shown below:

Classification

Systolic (mm Hg)

Diastolic (mm Hg)

Normal

< 130

< 80

Pre-hypertensive (Borderline)

130-139

80-89

Hypertensive

≥ 140

≥ 90



When a person’s blood pressure is consistently at or greater than 140/90 mm Hg, s/he is said to have high blood pressure or Hypertension. This is a risk factor for coronary heart disease and the single most important risk factor for stroke. It causes about 50% of ischaemic strokes (caused by blockages) and increases the risk of hemorrhagic stroke (caused by bleeding) .

Hypertension  puts stress on your body’s blood vessels, causing them to clog or weaken. Hypertension can lead to atherosclerosis and narrowing of the blood vessels making them more likely to block from blood clots or bits of fatty material breaking off from the lining of the blood vessel wall. Damage to the arteries can also create weak places that rupture easily or thin spots that balloon out the artery wall resulting in an aneurysm.

In about 5% of hypertensive cases, the cause of elevated blood pressure can be attributed to a specific condition or illness such as kidney disease or a structural abnormality of the aorta. Such cases of secondary hypertension can usually be cured by appropriate medical treatment once identified. For the majority of hypertensive patients however, no explanation for their high blood pressure can be found. Evidence suggests that this form of hypertension, also known as primary hypertension, is caused by a combination of hereditary and lifestyle-related factors such as excessive salt intake, obesity, and stress. As with secondary hypertension, primary hypertension can be lowered through medication. Weight reduction, regular exercise, and salt restriction are also essential control measures.

Hypertension is often called the silent killer . This is because, even when severe, it may not give rise to any symptoms. Occasionally, you may have headaches or giddiness when the hypertension is severe. However, these symptoms are not specific to hypertension; they are also present in other diseases.

Sometimes, hypertension is only discovered when complications set in, for example, a stroke or heart attack. It is important to check your blood pressure regularly after the age of 40

If your doctor finds your blood pressure to be raised, they may arrange some further tests including blood, urine tests and ECG (heart tracing). They would also examine you for any signs of heart failure.

 You may be prescribed medication to control the blood pressure. If you are on antihypertensive drugs, it is important to be aware of the following: 

  • Treatment is often lif​​e long , 
  • Do not stop or change the dose of your medication without consulting your doctor. 
  • For effective BP control, make sure you see your doctor regularly to monitor your BP. You can also monitor your BP more frequently at home with an electronic BP monitor. 
Remember, long term effective control of blood pressure is crucial in reducing risks of serious complications of hypertension.

Leading a Healthy Lifestyle may help in the management
  • Control your weight to keep your BMI less than 23kg/m2 but not below 18.5kg/m2. 
  •  Healthy diet
  • Limit your intake of all types of fats. Try to replace saturated with unsaturated fats.
  • Limit your cholesterol intake. Major sources include organ meats (e.g. liver, brains, kidney, intestines and heart), egg yolk, squid, fish roe, shellfish, prawns, crabs and animal fats.
  • Increase fibre intake. Fibre is found in oats, oat bran, barley, fruit, vegetables, legumes and whole grains can speed up the removal of cholesterol from your blood.
  • · Exercise for 150 minutes per week, each time at least 10 minutes. Lack of exercise is associated with a low HDL - cholesterol level.
  • · Limit alcohol intake to no more than 2 standard drinks per day.
      • 2/3 small can of beer (220 ml)
      • 1 glass of wine (100ml)
      • 1 nip of spirit (30ml)
  • Stop Smoking
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Sujatha Sathiamurthy,
Oct 19, 2017, 10:45 PM