Hypertension – The Silent Killer

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Cardiovascular Diseases

Patients often have the wrong idea about elevated blood pressure symptoms. It is not until they experience symptoms such as headaches, tiredness, dizziness, eye pain or feelings of being ‘unwell’ that they run to check their blood pressure. However, hypertension, or high blood pressure, is referred to as the silent killer since most of the time it doesn’t present any visible symptoms and can be lethal if left untreated.  Prolonged hypertension can have serious effects such as damage to blood vessels (due to high pressure against the vessels), heart failure (because the heart needs to work harder to pump blood through damaged and constricted vessels) and stroke (if blood vessels in the brain burst from high pressure). The majority of hypertension cases are categorized as ‘essential hypertension,’ which is the term for hypertension that has no known cause (e.g. it is not due to medication use or an underlying chronic disease).

The Mechanics of Blood Pressure-How It Works

Blood serves as the vehicle to transport nutrients, oxygen and water throughout the body. Blood pressure is a measure of the force exerted against the wall of an artery as blood moves through it. This can be compared to the pressure of water through a garden hose. If the water flow is increased, or if the hose is squeezed tighter, the pressure inside the hose increases.  If this pressure remains elevated, the inside of the hose will begin to wear and tear (such as the inside of an artery).

Blood pressure is never constant in the body. The circulatory system will adapt to different circumstances by either decreasing or increasing blood pressure. For example, during and shortly after a workout, the heart works over-time: beating faster and harder in order to supply the muscles with more blood because of an increased energy demand. As a result, blood will course through the veins and arteries faster and harder. Alternatively, when you are sitting or lying down, blood pressure is lower because your heart isn’t fighting gravity to pump blood up from your legs. This is why when you stand up too quickly you might get dizzy- you haven’t given your body enough time to adjust blood pressure!

A healthy blood pressure reading is, on average, 120/80. The top number (120) is the measure of the systolic pressure, and the bottom number (80) is a measure of the diastolic pressure. The systolic pressure refers to the pressure in the arteries when your heart contracts and the diastolic pressure refers to the pressure in the arteries when your heart relaxes. Pressure rises as the heart contracts, and pressure lowers as the heart relaxes which is why the top number is greater than the bottom number. You can have high blood pressure when either one of the numbers are too high.

Risk Factors and Prevention

Unchangeable risk factors for hypertension include age, gender, and genetic make-up. Men are at a higher risk for hypertension than women, and those of older age tend to have a higher prevalence of high blood pressure.  Others unfortunately just have bad genes for blood pressure and are prone to hypertension.

Fortunately, lifestyle plays a great role in maintaining a healthy blood pressure. Things like body weight, frequency of smoking, and diet all contribute to hypertension. Exercise is a very important aspect in maintaining a healthy blood pressure reading. Something as moderate as a daily 20-30 minute walk will do wonders for controlling blood pressure over time. Another important factor is eating a healthy diet. This should include foods that are not high in fat, cholesterol, or salt. Reducing alcohol consumption and keeping a healthy weight (extra weight increases strain on the heart) will also aid in maintaining a normal blood pressure. The nicotine in cigarettes is another factor contributing to elevated blood pressure. Nicotine acts as a stimulant and increases blood pressure, which, over time, can lead to the hardening of artery walls.

Sometimes, even with these precautions, hypertension may occur. In such cases, medications such as diuretics, beta blockers, calcium channel blockers, and vasodilators are effective in controlling hypertension.

Keeping a normal blood pressure is essential to good health, and since symptoms of hypertension are virtually unnoticeable, it is important to regularly monitor your blood pressure.

 Fun Facts

Some people will have a high blood pressure reading at their doctor’s office when their blood pressure is usually normal.  This is referred to as the white coat syndrome and is believed to be due to the anxiety that some people feel when being assessed by a doctor or ‘white coat’.  This just goes to show that there is an intricate relationship between stress and health.  But don’t easily dismiss a high blood pressure reading as nerves.  The best way to know if you really have long term high blood pressure is to regularly check it!

Average blood pressure lowers in most people for up to 24 hours after moderate intensity exercise (e.g. 30 minutes of walking).  So if you want to lower your blood pressure, start by exercising at the same time every day (for example go for a walk every evening at 7 pm).  Make sure you talk to a doctor (and buy comfortable shoes!) before you start an exercise regimen.