HIGH BLOOD PRESSURE

What is Blood Pressure?

The blood is the tissue responsible of transporting oxygen from the lungs to the rest of the organs and carbon dioxide from the organs back to the lungs. To achieve this, the blood needs to be pumped through the blood vessels. The force exerted against the wall of the vessel is what we call “Blood Pressure” (BP).

BP can be subdivided in two types: Systolic BP (SBP), which refers to the pressure during the heartbeat, and Diastolic BP (DBP), which refers to the pressure between the heartbeats.

In normal conditions, the human SBP is under 120 mmHg (millimeters of mercury) and DBP is under 80 mmHg. As a conventional rule, BP numbers are represented with the SBP above the DBP (120/80 mmHg).

What Is High Blood Pressure?

Physiologically, the BP is not the same during all day. It normally varies, being low when we are sleeping and getting higher when we wake up. But, there is a situation in which it stays persistently high during all day and it´s called “Hypertension” or “High Blood Pressure” (HBP).

It has a negative impact on general health and promotes the development of renal and/or cardiac disease.

Signs and Symptoms of HBP

HBP doesn´t have a similar clinical presentation in all patients. In fact, it doesn´t have particular signs or symptoms.  People with HBP usually complaints about having a hard headache but, as it was said, many diseases may induce this sign. On the other hand, the only symptom of HBP is having two or more abnormal BP readings.

High Blood Pressure Numbers

Because of the reasons described above, it has been difficult to diagnostic new patients and to subclassify them according to the clinical presentation. A lot of people may be living with HBP during a long period of time without concerning about it.

In 2003 the Seventh Report of the United States Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High BP (JNC 7) proposed a classification that has been widely used.  According to this classification, BP can be divided in:

  • Normal BP
  • Prehypertension” (SBP between 120-139 mmHg and DBP between 80- 89 mmHg)
  • Hypertension:

-Stage 1 HBP (SBP between 140-159 mmHg and/or DBP between 90-99 mmHg)

-Stage 2 HBP (SBP 160 mmHg or higher and/or DBP 100 mmHg or higher)

Causes of High Blood Pressure

Despite the years of research, most of the factor that causes HBP remains unclear. These patients, with no apparent cause, are diagnosed with “Essential HBP” (95-98% of the total number of cases) while the rest, usually associated with renal or cardiac disease, are diagnosed with “Secondary HBP” (2-5% of the total number of cases).

Nevertheless, epidemiology has allowed to determine the main risk factors associated with HBP. Among the most important are:

  • Older age:

BP usually gets higher with age and it seems to be greater in women than in men.  More than 60% of adults with an age over 65 have any type of HBP. Teenage population with records of abnormal BP readings tends to develop HBP later in life.

  • Bad lifestyle habits:

This is the widest category. Most of the population fits inside of it. Smoking, sedentarism, a sodium-rich diet, low potassium intake or alcoholism are the most common risk factors. All of them act directly by hurting all the organs and tissues that participate in BP regulation.

  • Gender:

Despite both, men and women can be affected by HBP, it has been seen that men under an age of 45 years are likely to develop it. In contrast, the risk is higher women older than 65.

  • Race/ ethnicity:

Again, it has to be said that any individual may suffer from HBP. But, epidemiology has shown that the most affected populations around the world are African Americans and Puerto Ricans.

  • Obesity/Overweight:

Most of the time it is involved in secondary HBP. Overweight alters the correct blood circulation and is associated with cardiac diseases.

  • Pregnancy and HBP:

This is an important risk factor to be considered because it is the most common medical problem during pregnancy. Hypertensive disorders during pregnancy are diverse in clinical presentation and involves four types of affections:

  1. Chronic hypertension (CH): refers to the HBP developed either before the pregnancy, diagnosed within the firs 20 weeks of gestation or not resolved 12 weeks postpartum. This type of HBP needs to be deeply studied by the doctor because it can lead to harmful manifestations like pre-eclampsia or eclampsia.
  2. Pre-eclampsia/eclampsia: This is a very complex, multiorgan clinical presentation. Its causal agent is not yet known but, some studies suggest a possible immunological alteration. It is characterized by elevation of BP after 20 gestational weeks and presence of proteins in urine.  The harmful form, eclampsia, is accompanied by convulsive episodes due to cerebral ischemia or edema.  
  3. Gestational hypertension: It has been considered a transitory form of HBP in women with no previous episodes of abnormal BP. It is diagnosed after the week number 20 of gestation and gets to normal numbers in 12 weeks postpartum.

How to diagnose HBP

HBP is really ease to diagnose with a blood pressure test. To be diagnosed with HBP it is necessary to have an abnormal reading several times. Some preparations are suggested previous to the test. For example, it is recommended:  to be quiet, sit down if it´s possible at least 5 minutes, don´t smoke or drink coffee 30 minutes previous to test and go to bathroom before the test. The doctor establishes the diagnose with a BP of 140/90 mmHg or higher over the time.  In case or diabetic or renal patients this criterion downs until 130/80 mmHg.

The second step in diagnosing HBP is to investigate the risk factors associated with the patient. This allows to determine a possible causal agent and to assess the risk of developing cardiac or renal disease. A previous history of a close family member with HBP along with one of the risks factors described above are strongly suggestive of HBP with worst outcomes.

How to low BP

Having HBP is not the end of the road. Current medical advances have allowed to find a wide range of alternatives that help in controlling HBP numbers. The treatment basically consists in modifications of lifestyle habits and medication. The last depends on medical criteria and the suspected cause of HBP but, basically, it consists in pharmacological or homemade remedies.  In any case, the treatment goal, mainly consists in getting the HBP under 140/90 mmHg.

Change in lifestyle habits

It is very impressive how changing bad habits can help people with HBP. These changes include:

  • Healthy Diet: The most recommended by doctors is the Dietary Approaches to Stop Hypertension (DAHS) diet. It is based in a high intake of fruits and vegetables and a low intake of red meats and sugars. This kind of diet is rich in minerals such potassium, that helps in regulation of sodium intake, one of the mainly causes of HBP.
  • Physical exercise: Doing sports or any kind of physical exercise helps in loosing weight and having a better blood circulation, Also, it helps to release free radicals that, in many, cases contribute to the destruction of blood vessels and cardiac affection.
  • Stops drinking alcohol and smoking: These activities contribute to the destruction on lungs, liver and blood vessels. Avoiding them helps the body to restore the normal functionality and stops the progression to worst clinical outcomes.

Medication

The current medication used for treating HBP is very wide. It comprises a lot of alternatives aimed to modify any of the biological key points responsible of modulating the blood pressure.  The medicines used more often are: Diuretics, Calcium Channel Blockers, Adrenergic Receptor Agonist/Antagonist and Vasodilators.

Nowadays, trying to avoid the possible side effects of pharmacological medicines, it has been studied the beneficial effects of local plants in treatment of HBP. With this, a new line of home medicines and herbal alternatives have arisen.

Below are listed the top 10 plants or herbs associated with potential antihypertensive properties:

  • Allium sativum
  • Aristolochia manshuriensis
  • Blond psyllium
  • Cassia absus
  • Daucus carota
  • Hibiscus sabdariffa
  • Lumnitzera racemose
  • Moringa oleifera
  • Sesamum indicum
  • Zingiber officinale

Conclusions

This article aimed to be a little guide to introduce lectors to this important topic. HPB is not a game. It needs to be early diagnosed and treated to avoid complications. So, if you suspect you may be suffering of it, consult your doctor and ask him for a BP test. On the other hand, if you are already diagnosed with HBP, consult the newest treatment available. If you reach to low your BP under the risk numbers you will be out of danger.

Change your lifestyle, be healthy and defeat High Blood Pressure!


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