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The silent stalker: Raised Blood Pressure and how it is treated

A widely prevalent disease, hypertension, commonly referred to as high blood pressure, is the bane of industrialized socie­ties. Estimated to affect 3-6% of the adult population in the country, with a pronounced. urban bias, the disease is a silent stalker causing serious and potentially lethal complications within the body of its victim. Affecting the heart, the kidneys, the retina, and the central nervous system, it often works quietly until the damage is done or an incidental medical check-up discovers its presence. For this reason, many writers like to call it the silent killer. Although the cause is observed in 90-95% of the cases, the disease is usually easily treatable, given the variety of anti-hypertensive medications available to the doctors today. General measures and changes in living help a long way.

Herbal Cure for Heart - Complete Pack
Total Heart Support
Arjuna
Arjun Tea
Arjun Saar
Kumari Saar
Total Price
Divine Remedies Total Heart Support is herbal treatment for High Cholesterol, High Blood Pressure natural remedy, herbal solution for congestive heart failure, blocked coronary arteries, irregular heart beat, blocked circulation in extremeties, Natural Rejuvenation for Your Heart, Natural cleansing for circulatory system Arjun Tea is herbal, natural way to control cholesterol, blood pressure,coronary artery diseases

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$ 274.55
Price after Discount 20%
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Click here to buy Individual herbal products for heart care, heart herbal cure, herbs for heart

What is blood pressure?
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What are its normal values in healthy people?

How is high blood pressure defined? What is its prevalence and what factors affect its distribution in a population?

What are the prime causes of sustained hypertension?

What are the symptoms of high blood pressure?

What are the effects, or complications, arising from changes brought on vital body organs from sustained elevated blood pressure?

What investigations are necessary for an evaluation of the disease?

Is hypertension curable? If yes, how?

What are the recommended non-drug measures which help bring the pressures to normal?

What kind of medication helps control raised blood pressure?

 

What is blood pressure?   Top  

Put simply, it is the pressure at which blood flows in the major arteries. In actual measure, it reflects the pressure at which it gets pumped by the heart. As the heart contracts (systole) and relaxes (diastole) with each beat, the arterial pressure also waxes and wanes. The highest pressure pro¬duced while the heart contracts to eject the blood into the arteries is for this reason called the systolic pressure. The pressure that remains in the arteries when the heart is relaxing between the two successive beats is named the diastolic pressure.

It is these two readings, the high and the low, which a doctor takes while measuring a person's blood pressure. The read¬ings are traditionally expressed in millimetres, indicating the height of a column of mercury that this much pressure would support. The reading is usually written in this fashion: 140/90, or whatever the figures are.

What are its normal values in healthy people?   Top  

The values are not absolute, there being a range for both the upper and the lower normal readings. Pressures from 100 to 140 (mm Hg) for the systolic and 60 to 90 (mm Hg) for the diastolic are considered to be normal for healthy young adults.

It has been further observed that the pressure, particularly the systolic, increase gradually with advancing years, when there is a normal decrease in the general elasticity of the arterial walls. So common is this occurrence that many consider this rise to be normal. Others do not subscribe to the view and make environmental factors common to the population responsible. The decline in blood pressure with age in more primitive cultures seems to reaffirm the latter view.

Nevertheless, the consensus of opinion today is to treat people with diastolic pressure greater than 90 mm Hg with adequate therapy, though this need not necessarily mean drug treatment.

Other than the lasting effects of age and race, transient variations, possibly of twenty or thirty points, are common with many states of mind and body. Nervousness, heated arguments, anger, excitement, physical exertion and love¬making, all tend to push up the pressure momentarily. Ciga¬rette smoking too does the same, the effect lasting up to a few minutes.

How is high blood pressure defined? What is its prevalence and what factors affect its distribution in a population?   Top  

Consistently high levels of pressure, recorded on three or more occasions with the patient at rest and in quiet surroundings, warrants a diagnosis of hypertension or high blood pressure.

Studies among Western populations place the prevalence at as high as 15%.

Such large studies have not been conducted till date among Indian populations. But small, scattered studies have put the prevalence at 3-6% among adult populations, with a clear-cut predilection for urban areas as compared to villages. Thus, while Delhi was estimated to have a 6% prevalence among its adult population, Ballabhgarh, a neighbouring rural region, had a 3.5% estimated prevalence. In contrast, Bombay was found to have a strikingly high figure of 15% among its adult population.

As opposed to other cardiovascular disorders, women are equally, or more, prone to develop hypertension when compared with men.

For purposes of clinical grading, the disease has been variously categorized with reference to diastolic pressure. Thus, the American Heart Association places diastolic pressures between 90 and 104 as mild, 105 to 114 as moderate and above 115 as severe hypertension. A raised systolic pressure alone of more. than 160 mm Hg has been classified as isolated systolic hypertension.

What are the prime causes of sustained hypertension?   Top  

Although much advancement in the basic understanding of the pathophysiology of elevated blood pressure has been achieved in the recent years, the exact cause still remains unidentified in 90-95% of the cases. This form of high blood pressure with no definable cause has been termed primary, essential, or idiopathic hypertension. Yet, there are some pecu¬liar characteristics common to many patients in this group which suggest that they may have a strong relationship with the root cause(s). Thus, overweight, non-vegetarianism, in creased alcohol consumption, increased salt intake, and a sedentary life may have a role to play in the causation. Stress physical, social, and business-is another important factor, particularly in urban life. It indeed, in combination with some other factors, may be the prime reason why cases of hypertension are growing with rapidity in urban areas.

Heredity also is perhaps to blame. Data supporting this view is available from human population studies. If parents are hypertensive, there is a very real risk of their children being. similarly affected.

In the remaining 5-10% hypertensives, a cause can be found by a methodical search. Its discovery is important, as it has a marked effect on the outcome. There is a large number of conditions which can be the cause of sustained high arterial pressure. They range from many kinds of kidney diseases to endocrinal (hormonal) and neurogenic disorders, and by birth narrowing of the main arterial trunk (coarctation of aorta), hormonal therapy and oral pills (contraceptive), and toxaemia of pregnancy. This group of cases with an identifiable cause of high blood pressure is termed secondary hypertension.

What are the symptoms of high blood pressure?   Top  

Generally speaking, essential hypertension is often symptomless. It may be present for many years, the patient completely unaware of its existence. Very often it is discovered fortuitously, during a general medical check-up for health, or at a medical examination done for other purposes.

Symptoms which bring the patient. to the physician fall into three categories. They are related to (1) the elevated pressure itself, (2) its effects on the body's organ systems, and (3) the underlying disease in secondary hypertension.

Though popularly considered a -symptom of raised blood pressure, headache is a feature only of severe hypertension; most commonly it is localized to back (occipital region) of the head, is present when the patient awakens in the morning, and subsides on its own after several hours. Other possibly related
. symptoms include dizziness, palpitations, and easy fatigue or tiredness.

The symptoms in the second setting arise from the effects of long-standing hypertension on some vital body organs. In many patients, this may be the first indication of the disease.

Examples of symptoms related to the underlying disease in secondary hypertension are increased thirst, increased urination and muscle weakness in patients with hormonal disorder of primary aldosteronism, or swelling of feet and ankles, and small amounts of blood in the urine in patients with kidney disease. In the Cushing syndrome, another hormonal disorder related to secondary hypertension, there will be weight gain, a moon-like face, and emotional instability.

What are the effects, or complications, arising from changes brought on vital body organs from sustained elevated blood pressure?   Top  

The effects of uncontrolled high blood pressure are many and of serious nature.

The heart, working under a continuous high .arterial pressure, must work harder each time it beats. As a result, understandably, the heart gradualy suffers.

The left ventricle, the chamber that pumps blood into the aorta, wearies of this continual strain. Its muscles hypertrophy (thicken) to fight only a losing battle, as this adds to its oxygen requirements, which it may not be able to procure. It tends to enlarge, weaken, and become less effective.

Gradually, this may lead to heart failure. The patient tends to become breathless, first, at night when he is in a recumbent position, but later, at any time. Swelling of the feet may develop, which may spread to other parts of the body.

Other than the heart itself, sustained high blood pressure puts stress on arterial walls, particularly the arteries of the heart muscle, the aorta, the vessels of the brain, and the small arteries of the retina-the sensitive organ at the back of the eye.

As a result of sustained insult, the vessel walls become hard and less elastic; their roughened inner surface allows quick fat deposits, and thus, setting in of premature atherosclerosis. This is a serious condition, as has been pointed out many times previously. When this occurs, it heightens the risk of clot (thrombus) formation, and complications arising from this. The most dangerous complication is the possibility of myocardial infarction supervening in the heart area, or a cerebral thrombus or haemorrhage in the brain. Each can occur sud¬denly and end tragically in death, or compromise the general well-being of the patient. A clot blocking a vital vessel of the brain could result in paralysis of half or part of the body, the loss of ability to talk, or facial paralysis, or some other equally serious disability.

The affection of the tiny blood vessels of the kidneys leads to irreparable damage and eventually, chronic renal failure. The kidneys fail in their job as scavengers, resulting in the accumu¬lation of unhealthy chemicals inside the body and electrolyte disturbances. Such patients need repeated dialysis for survival.
With the blood vessels of retina suffering haemorrhages and extrusion of fluid, blurring of vision occurs. This may damage the eyesight permanently. Incidentally, this is the only part of the body .where arterial blood vessels can be seen under direct vision. The doctor uses a, special instrument called the ophthalmoscope and peers into the. eye of the patient to look at the fine blood vessels coursing over the retina. This may give him a good idea of the extent of damage that has occurred.

In some patients, the pressure rises to very high levels all of a sudden, affecting various organs acutely. The term malignant hypertension is applied to this condition, and it demands radical therapy.

What investigations are necessary for an evaluation of the disease?   Top  

A wide range of tests (see the table below) are requisitioned by most physicians. They help rule in or exclude secondary forms of hypertension, establish a base line, and guide the line of treatment.
More specialized studies may be indicated if initial tests suggest a secondary form of hypertension and/ or arterial pressure is not controlled after first-step therapy.

TABLE
Laboratory Tests and Special Studies for Evaluation of Hypertension

I. Basic Studies

  1. Urine for protein, blood; glucose, and microscopic analysis
  2. Haematocrit
  3. Serum Potassium
  4. Serum creatinine and/ or blood urea
  5. Blood glucose
  6. Serum cholesterol, and triglycerides
  7. Serum uric acid
  8. Electrocardiogram
  9. Chest X-ray

II. Special studies to screen for secondary hypertension
A. Renovascular

  1. Rapid sequence IVP (contrast X-rays of the urinary system)
  2. Radioisotope renogram (nuclear scan of the kidneys)
  3. Saralasin test (a drug test)

B. Pheochromocytoma

  1. Plasma catecholamines
  2. 24-hour urine for creatinine, metanephrines and catecholamines

C. Cushing's Syndrome

Overnight dexamethasone suppression test

Is hypertension curable? If yes, how?   Top  

In many cases of secondary forms of hypertension, complete cure is possible either through corrective surgery or medical means. But admittedly, such cases are in a very small minority.

In 90-95% patients who have essential hypertension, no curative treatment is available. Yet, ample therapeutic means ,exist to keep the arterial pressure totally in control. This is mandatory to check the serious complications of the disease which are otherwise inevitable.

The therapeutic means are two-pronged: non-drug measures and medications of many kinds.

What are the recommended non-drug measures which help bring the pressures to normal?   Top  

The general measures employed include (1) relief of stress, (2) dietary control, (3) regular exercise, and (4) control of other risk factors adding to the risk of atherosclerosis.

Relief of emotional and environmental stress can help in a big way. Though it is virtually impossible to extricate oneself from all internal and external stresses, an earnest effort to avoid all unnecessary tensions should be the motto. A positive family environment-caring spouse and children, good interpersonal communication (which is becoming rare in today's city life), positive self-reinforcements, good time-scheduling, tolerance, finding time for hobbies and sports, can all be very helpful. Mental relaxation techniques, yoga and meditation, and the more recent biofeedback relaxation techniques are beneficial in bringing tensions and pressures down.

Dietary control has three aspects: (1) Restriction (not drastic curtailment) of salt intake to 5 grams a day. This effectively means no extra pinch of salt and salt-free salad. (2) Caloric restriction for the overweight individual to bring the weight down to the desired level. This itself will cause significant reduction in blood pressure in many patients. (3) A moderate restriction in intake of cholesterol and saturated fats to dimin¬ish the risk of atherosclerotic complications. Another significant step in this direction would be to give up cigarette smoking totally and for good.

Regular, moderate physical exercise is beneficial within the limits of the patient's cardiovascular status. Not only does it help control weight, but in addition there is evidence that it may by itself help lower the arterial pressure. Brisk walking and swimming are two good isotonic exercises recommended to the patients. Sports activities can help likewise.

These measures are recommended not only to hypertensives but to all people, especially those who run a high risk of developing high blood pressure any time in their lives.

What kind of medication helps control raised blood pressure?   Top  

Today, there is a very wide range of medications available for management of hypertension.

But those which seem to be most popular are the diuretics such as thiazides (Esidrex, Nephril); beta blockers such as atenolol; centrally acting antiadrenergic drugs such as c1o¬nidone (Arkamin, Catapres) and methyldbpa (Addomet, Emdopa); vasodilators such as hydralazine (Nepresol, Corbet¬azine) and verapamil; and the recent entrant, angiotensin blockers such as captopril (Ace ten, Angiopril).

A single, or a combination, of these and other drugs is chosen for a patient, keeping in view the degree of raised blood pressure, other accompanying diseases, risk factors, and the individual choice(s) of the treating physician. If any side effects or inconveniences develop, drugs can be altered or counter¬acted suitably.

Tranquillizers such as diazepam (Calmod, Calmpose) can be effective too by alleviating anxiety and tensions.
For the more serious form of malignant hypertension, proper medication is available too.

All in all, hypertension is usually easily treatable, provided the patient realizes that for her, or him, medication has to be continued and made very much a part of regular routine. A lifetime resolve is necessary. Regular follow-ups with the treat¬ing doctor, check-ups of blood pressure readings (today, do-it-yourself electronic sphygmomanometers are also available), and efficiently kept medical records are all part of it. Otherwise, the silent stalker may strike and then it may be too late.

 

Herbal Cure for Heart - Complete Pack
Total Heart Support
Arjuna
Arjun Tea
Arjun Saar
Kumari Saar
Total Price
Divine Remedies Total Heart Support is herbal treatment for High Cholesterol, High Blood Pressure natural remedy, herbal solution for congestive heart failure, blocked coronary arteries, irregular heart beat, blocked circulation in extremeties, Natural Rejuvenation for Your Heart, Natural cleansing for circulatory system Arjun Tea is herbal, natural way to control cholesterol, blood pressure,coronary artery diseases

Free Shipping and Handling
Worldwide!
No Side Effects!
2 Bottles
1 Bottle
1 Pack
4 Bottles
4 Bottles
$47.90
$ 31.00
$ 14.95
$ 75.80
$ 75.80
$ 274.55
Price after Discount 20%
$ 220.00
Buy This Pack for Just $ 220.00
Free Shipping and Handling Worldwide! No Side Effects!

Click here to buy Individual herbal products for heart care, heart herbal cure, herbs for heart

Divine Remedies provide the pure herbal supplements, Dietary Supplements, Raw herbs, herbal extracts, natural Products, ayurveda Products which are 100% vegetarian. Divine Remedies provides some of the best herbal products in the world.