Q: When can you say a person is hypertensive and what are the cause and treatment for this condition?
--ellen_q@yahoo.com
A: Blood pressure refers to the force that blood exerts against the walls of arteries, the blood vessels that carry blood from the heart to the tissues. It has two components: systolic blood pressure, the force on the arteries when the heart beats; and, diastolic blood pressure, the force on the arteries between heart beats. In a blood pressure reading, which is usually expressed as a fraction (e.g., 120/80 mmHg), the numerator is the systolic while the denominator is the diastolic blood pressure.
Hypertension or high blood pressure occurs if a person's blood pressure at rest is persistently high (i.e., systolic pressure that is equal or greater than 140 mmHg and/or diastolic pressure that is equal or greater than 90 mmHg).
Hypertension is sometimes caused by an underlying disease (usually of the kidney or endocrine organs), in which case it is called secondary hypertension, and treatment is directed at the underlying disease. In 90-95% of cases, however, the cause of hypertension remains unknown even after a thorough medical examination. In these instances, the hypertension is called primary or essential hypertension. Practically everyone, i.e., more than 95% of all people, will develop essential hypertension at some point in their life, although some at a much later age than others.
Essential hypertension results from the interplay of numerous genetic and environmental and lifestyle factors such as excessive salt intake, insufficient potassium intake, obesity, excessive alcohol intake, sedentary lifestyle and psychological stress. It is a chronic condition that cannot be cured nor totally prevented, but it can be controlled, i.e., a person with the condition can keep his/her blood pressure within normal levels throughout the day with the proper intervention.
Uncontrolled hypertension is a serious health issue because it invariably causes damage to many vital organs. It is, in fact, one of the major underlying causes of strokes, heart attacks and heart failures, aneurysm of the arteries, peripheral arterial diseases and chronic kidney disease. People with uncontrolled hypertension are four times more likely to die of stroke and three times more likely to die of heart disease than people with normal blood pressure or with controlled hypertension.
Hypertension is a major public health problem in the Philippines because one in every four adult Filipino suffers from it and more than half of them do not have the condition under control.
Hypertension can sometimes be controlled by:
• Shifting to a low-salt, high fiber diet that is rich in fish and vegetables. Low-sodium simply means "no sawsawan." Food can still be cooked with salt, but only to taste.
• Moderating one's alcohol consumption. Better still, no alcohol at all.
• Reducing to, and maintaining, a desirable body weight
• Exercising regularly
• Adopting stress management measures such as enough sleep, recreation, meditation and relaxation techniques.
A good number of people will, however, not be able to control their hypertension by just dietary and lifestyle changes. These people need to take anti-hypertensive drugs. There are several classes of anti-hypertensive drugs in the market. But, treatment with these drugs should be highly individualized and carried out under the supervision of a physician.
Incidentally, hypertension presents no symptoms initially. Hence, adults are well-advised to have their blood pressure taken periodically so that the condition, if it develops, can be detected and treated in its very early stages.
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