High blood pressure is very common. About 46% of Nigerians above 25 years of age have hypertension, and most of them do not know.
Blood pressure is the force of blood against your artery walls as it circulates through your body. It is determined by both the amount of blood your heart pumps and the amount of resistance to blood flow in your arteries. The more blood your heart pumps and the narrower your arteries, the higher your blood pressure.
What is Hypertension?
Hypertension (High Blood Pressure) is defined as systolic blood pressure greater or equal to 140mmHg and diastolic blood pressure greater or equal to 90 mmHg (mmHG=millimetres of mercury).
You are diagnosed hypertensive when one or both readings are high; Systolic blood pressure is the pressure in the arteries as the heart pumps out blood while diastolic blood pressure is the pressure in the arteries as the heart relaxes and refills with blood.
What are the warning signs of hypertension?
Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach dangerously high levels.
A few people with high blood pressure may have headaches, shortness of breath or nosebleeds, but these signs and symptoms aren’t specific and usually don’t occur until high blood pressure has reached a severe or life-threatening stage.
What are the causes of hypertension?
There are two types of high blood pressure;
Primary (essential) hypertension
For most adults, there’s no identifiable cause of high blood pressure. This type of high blood pressure, called primary (essential) hypertension, tends to develop gradually over many years.
It appears suddenly and the blood pressure is higher than in primary hypertension. Causes include;
Obstructive sleep apnea
Adrenal gland tumors
Thyroid gland diseases
blood vessel defects present from birth (congenital)
Drugs; such as birth control pills, cold remedies, decongestants etc.
Illegal drugs, such as cocaine and amphetamines
Alcohol abuse or chronic alcohol use
Who are the people at high risk of hypertension?
Age; The risk of high blood pressure increases as you age.
Race; Hypertension is commoner in Africans and it occurs at an earlier age than in other races.
Family history; You’re more likely to develop high blood pressure if you have a family member with hypertension.
Being overweight or obese.
Lack of exercise.
Too much salt (sodium) in your diet
Too little potassium in your diet
Drinking too much alcohol.
What are the effects of high blood pressure?
Heart attack or stroke; High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications.
Aneurysm; Occurs when your blood vessels weaken and bulge from high blood pressure. A burst aneurysm is life-threatening.
Heart failure; The heart muscle has to thicken to pump blood against high pressure. After sometime, this thickening will not be enough to pump enough blood resulting in heart failure.
Loss of vision
How can hypertension be treated?
A) Lifestyle modification which includes;
Dietary change; DASH (Dietary approach to Stop Hypertension) diet. Requires less carbohydrate and salt, more vegetables, fruits, proteins and water.
Regular exercise; You should engage in aerobic and anaerobic at least 3 times a week.
Limiting the amount of alcohol you drink
Maintaining a healthy weight or losing weight if you’re overweight or obese
B) Medications; Sometimes, lifestyle modifications are not enough to treat hypertension and medications may be required. The commonly used drugs are;
Diuretics; E.g Hydrochlorothiazide. Are drugs that act on kidneys and increase their ability to excrete water and sodium reducing the amount of water in the body.
Beta blockers; E.g Atenolol, Labetalol. Dilate the blood vessels and make the heart beat slower and with less force.
Angiotensin-converting enzyme (ACE) inhibitors; E.g Lisinopril. They help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels. People with chronic kidney disease may benefit from having an ACE inhibitor as one of their medications.
Angiotensin II receptor blockers (ARBs); E.g Candersatan (Atacand). They relax blood vessels by blocking the action, not the formation, of a natural chemical that narrows blood vessels.
Calcium channel blockers; E.g Amlodipine(Norvasc). They relax the muscles of your blood vessels and may slow your heart rate.
Centrally acting agents; E.g Methyldopa. They prevent the brain from causing increase in heart rate and lower blood pressure.
Other anti-hypertensives include;
Blood pressure treatment goals*
120/80 mm Hg or lower is the ideal blood pressure goal
Less than 150/90 mm Hg If you’re a healthy adult age 60 or older
Less than140/90 mm Hg if you’re a healthy adult younger than age 60
Less than140/90 mm Hg if you have chronic kidney disease, diabetes or coronary artery disease or are at high risk of coronary artery disease