What is hypertension?
High blood pressure (hypertension) is persistently high pressure in the arteries.
Defined as systolic blood pressure above 139 mmhg or diastolic blood pressure above 89 mmHg or both
What are the risk factors?
Primary hypertension: High blood pressure with no known cause
Secondary hypertension: High blood pressure with a known cause. In many cases, high blood pressure results from a kidney disorder but also in some people it is due to hormonal disorder, or by the use of certain drugs, such as birth control pills
What are the symptoms of hypertension?
In most people, high blood pressure causes no symptoms, despite the coincidental occurrence of certain symptoms that are not specific such as headaches, nosebleeds, dizziness, a flushed face, and fatigue.
How is hypertension managed?
Diet and exercise
Drugs to lower blood pressure
Thiazides like Diuretics: may be the first drug given to treat high blood pressure. Diuretics cause blood vessels to dilate. Diuretics also help the kidneys eliminate sodium and water, decreasing fluid volume throughout the body and thus lowering blood pressure.
Adrenergic blockers: these drugs block the effects of the sympathetic division, the part of the nervous system that can rapidly respond to stress by increasing blood pressure. The most commonly used adrenergic blockers are the beta-blockers.
Centrally acting alpha-agonists: these drugs are rarely used now. They lower blood pressure by stimulating certain receptors in the brain stem; these agonists inhibit the effects of the sympathetic division of the nervous system.
Angiotensin-converting enzyme (ACE) inhibitors lower blood pressure in part by dilating arterioles. These inhibitors block the action of angiotensin-converting enzyme, which converts angiotensin I to angiotensin II. These drugs are particularly useful for people with coronary artery disease or heart failure, Caucasians, young people, people with protein in their urine because of chronic kidney disease or diabetic kidney disease, and men who develop sexual dysfunction as a side effect of another antihypertensive drug. The main adverse events are hypotension, coughing and angioedema.
Angiotensin II receptor blockers (ARBs) they directly block the action of angiotensin II, which causes arterioles to constrict. Because the mechanism is more direct, angiotensin II receptor blockers may cause fewer side effects.
Calcium channel blockers cause arterioles to dilate. They are particularly useful for black descendants and older people. Calcium channel blockers are also useful for people who have angina pectoris, certain types of rapid heart rate, or migraine headaches. Most common adverse events are hypotension and leg edema.
What lifestyle modifications are needed?
Overweight people with high blood pressure are advised to lose weight. Losing as few as 10 pounds (4.5 kilograms) can lower blood pressure.
For people who are obese or who have diabetes or high cholesterol levels, changes in diet (one rich in fruits, vegetables, and low-fat dairy products, with reduced saturated and total fat content) are important for reducing the risk of heart and blood vessel disease.
Smokers should stop smoking.
Reducing the intake of alcohol and sodium (while maintaining an adequate intake of calcium, magnesium, and potassium) may help avoid drug therapy for high blood pressure.
Moderate aerobic exercise is helpful. People with primary hypertension do not have to restrict their physical activity as long as their blood pressure is controlled. Regular exercise helps reduce blood pressure and weight and improves the functioning of the heart and overall health