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Jan 17, 2008

High Blood Pressure - Hypertension

When pressure in Arteries (blood Vessels), which carries blood from heart to all the organs and tissues of body, measured high from normal values it is called Hypertension. Normal values for blood pressure is 120/80 mmHg. 120 is normal Systolic pressure: it means the maximum pressure in arteries when heart contracts(pump out) and 80 is normal diastolic pressure :it means the lowest pressure in arteries when heart relax after contraction(pump in).
Increased pressure in arteries from normal values; increase the risk of developing heart disease,kidney(Renal) disease, hardening of the arteries (atherosclerosis or arteriosclerosis), eye damage, and stroke (brain damage). These complications are called end organ damage.

End Organ Damage may be:
1.Heart Attack
2.Heart Failure
3.Stroke (Brain Damage)
4.Chronic Renal Failure (Kidney Damage)
5. Retina Damage( damage to Eye)

How Many Peoples are Suffering?

1.In USA 25% population is suffering with Hypertension.
2. In India 18% of the urban population suffers from hypertension, which leads to renal failure, stroke and cardiovascular diseases.30% of the population suffers heart attacks before age 40 years. 66% of deaths today are due to cardiovascular diseases. Cardiovascular diseases (CVDs) like heart disease and stroke are the main causes of death and disability.

Types of Hypertension

1.Primary Hypertension
When not any specific cause found as to be reason of high blood pressure,it is Known as Essential Hypertension. 95 % patients with High blood pressure are diagnosed as Essential Hypertension.

2.Secondary Hypertension
When increase in Blood pressure is secondary to any other pathology. In children mostly the cause of High Blood Pressure in found secondary to any pathology.

Causes Of Blood Pressure

1.Causes of Primary (Essential) Hypertension

A. Much Salt Intake.
B. Advance Age.
C. Obesity.
D. Genetics: High Blood Pressure run in families.Almost 30% peoples get hypertension from parents.
E. Life style: Not much physical work and high food intake.
F. Insulin Resistance: Insulin is a hormone secreted by pancreas.Insulin controls the blood glucose level.When some peoples develops insulin resistance ,pancreas increase insulin production,and higher level of insulin causes Increase in Arterial blood pressure that is Hypertension.
G. Sleep Apnea: It is important cause of Hypertension.
H. Genetics: 30% patients get hypertension in hereditary.

2.Causes of Secondary Hypertension

A. Renal Hypertension: Caused due to disorder in kidney or reduced blood circulation to kidneys.
B. Tumors of Adrenal Glands can cause Hypertension.
C. Obesity and Diabetes: Obesity causes high blood sugar levels,High blood lipids and Hypertension. Type 2 Diabetes Mellitus causes high blood pressure.
D. Hypercalcemia: High calcium can cause High Blood Pressure.
E. Medication: Non Steroidal Anti Inflammatory Drugs-NSAIDS (Motrin/ibuprofen) and steroids can cause hypertension. Ingestion of imported licorice (Glycyrrhiza glabra) can cause secondary hypoaldosteronism, which itself is a cause of hypertension.

Sign And Symptoms Of hypertension
Often peoples confuse High Blood Pressure with Stress,Mental Tension and Anxiety. Most of the cases have no symptoms that's why Hypertension is known as 'Silent Killer'.That's why Hypertension can go unnoticed for years and damage organs.Many times Hypertension is diagnosed in routine check-up.
Some people may experience symptoms such as headache, dizziness, shortness of breath, and blurred vision. The presence of symptoms compel people to consult a doctor for treatment. In many cases, a person visits or is brought to the doctor or an emergency room with a heart attack, stroke, kidney failure, or impaired vision (due to damage to the back part of the retina).
Greater public awareness and frequent blood pressure screening may help to identify patients with undiagnosed high blood pressure before significant complications have developed.

How High Blood Pressure is Defined?

If a patient has 3 consecutive readings of blood pressure above 140/90 with a gap of one week at least is defined as Hypertension.

What Tests are necessary after Diagnosis of Hypertension?

Blood tests are done to identify any damage to Organs already by Hypertension and to identify the diseases like Diabetes which can add further risk with High Blood Pressure.
Creatinine: Level of creatinine tells the functioning of kidney.Electrolytes(sodium,Potassium): Again it tells Kidney Functioning.
Glucose: To diagnose Diabetes mellitus.
Cholesterol: Levels of cholesterol ,if increased ,add the risk for cardiac disease.
ECG: To examine working of heart.
Chest X-Ray: Any cardiac enlargement or evidence of cardiac failure.

What Changes in life style can improve High Blood pressure?

Alcohol: Cut in Alcohol Intake improves Blood Pressure level.
Smoking: Directly does not increase Blood Pressure. But smoking increase the risk of heart attack and stroke in peoples who have already Hypertensive.
Coffee: 5 cups of coffee may increase mild blood pressure. Smoking and coffee combined effect more adversely.
Salt: Taking more than 6 gram per day may increase Blood Pressure.
Obesity: Obesity increase blood pressure in several ways. In obese person heart has to pump blood for extra tissues.In obese peoples arterial stiffness increase which causes Raised blood pressure. Metabolic disorder as diabetes is common among Obese person,which causes high blood pressure.
Obese person has recurrent attacks of Sleep Apnea,which further causes increase in Blood Pressure.
Exercise: Peoples without exercise have more chances to develop Hypertension. with daily exercise of 30-45 minutes can reduce blood pressure .

Treatment of Hypertension

Changes in life style can reduce blood pressure.

Goal Of Treatment

Main Goal of treatment to maintain Blood pressure in normal range (maintain below 140/85 mmHg). Constant elevation from normal range causes damage to important organs as Kidney,Heart,Eye and brain. By treating high blood pressure early we can decrease critical risk of Stroke,Heart Attack and kidney failure.

Medicines are available which acts in different way to reduce Blood Pressure. Decision is made by your physician on basis of pros and con of every group of medicine.

1.ACE inhibitors as - captopril, enalapril, fosinopril, lisinopril, quinapril, ramipril
2· Angiotensin II receptor antagonists as- irbesartan, losartan, valsartan , candesartan
3. Alpha blockers as- doxazosin, prazosin, or terazosin
4. Beta blockers as- atenolol, labetalol, metoprolol ,propranolol.
5. Calcium channel blockers such as amlodipine ,diltiazem, verapamil.
6. Diuretics as- bendroflumethiazide, chlortalidone, hydrochlorothiazide.

Every group of medicines has its own effects and side effects. And prescribed by your doctor as indicated.

Homeopathic Treatment of Hypertension

Goal in new cases is to cure hypertension. Homeopathic medicines are prescribed on basis of individual personality trait and behavioral reactions. Mental attitude, life style and environmental modalities indicate the specific medicine for a patient. Homeopathy has a 166 medicines for Hypertension.

In chronic patient of hypertension ,long term treatment is advised to maintain blood pressure in normal ranges. Homeopathic medicines has no side effect. Very safe in case of children and pregnant women.

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