Coping With Hypertension: Diagnosis & Complications

Hypertension is a non-communicable disease that can kill its victims without notification.

According to the World Health Organization (WHO) 2021, an estimated 1.28 billion adults aged 30-79 years worldwide have hypertension, and many of these hypertensive patients are unaware of their status. This is because of the asymptomatic nature of hypertension and the lack of regular monitoring by the subjects.

What is hypertension?

Hypertension is a persistent increase in blood pressure. Blood pressure is the force exerted by the blood as it flows through the arteries (the major blood vessels that carry blood from the heart to the other parts of the body). It is recorded in a fraction format: systolic/diastolic.

Systolic blood pressure is the pressure recorded when the heart beats/contracts while diastolic is the pressure when the heart relaxes (in between beats).

There are so many factors that influence blood pressure, but two are of utmost importance. They are:

Cardiac output: This is the amount of blood pumped by the heart per minute. Blood pressure increases as cardiac output increases.
Total peripheral vascular resistance: This is the resistance of the arteries to blood flow through systemic circulation. It is affected by three factors: The flexibility of the arterial wall (Rigid walls cause the blood pressure to increase); The diameter of the arteries (The smaller the diameter, the higher the blood pressure); and The thickness of the blood (blood viscosity – Thicker blood increases blood pressure).

Generally, blood pressure increases as the total peripheral resistance increases.

Causes of Hypertension

Many factors have been found to place a person at risk of hypertension. These factors are:

Genetic factors: Hypertension can be transferred genetically from parents to children. People with familial tendencies should take precautions and reduce the chances of developing hypertension.
Dietary factors: Such as excessive salt consumption, smoking, excessive alcohol consumption, feeding on processed and ultra-processed foods, etc.
Existing health conditions: For example, kidney diseases, cardiovascular diseases, diabetes, hormonal disorders, etc.
Physical inactivity: Lack of exercise can increase a person’s risk of developing hypertension.

Symptoms of Hypertension

Hypertension at its early stage is asymptomatic. This is why it is called a ‘silent killer.’

If left undiagnosed and untreated, it can lead to symptoms like severe headache, blurry vision, confusion, fatigue, chest pain, etc.

Check your blood pressure regularly to know your baseline blood pressure and know when it’s deviating from normalcy.

How is Hypertension Diagnosed?

Hypertension is diagnosed when your blood pressure is checked 2–3 times by a health professional on different days and it’s 140 mmHg and above for systolic and 90 mmHg and above for diastolic on those occasions.

The healthcare provider will also need to ask you about your dietary and behavioural patterns, familial tendency, etc. to ascertain the possible risk factors for hypertension.

However, whenever you experience 2 or more of the above symptoms simultaneously, visit the nearest healthcare centre to have your blood pressure checked.

Management of Hypertension

Management involves both pharmacological and non-pharmacological interventions. However, lifestyle modification is the most important part of hypertension management.

Pharmacological interventions

This is the use of drugs in the treatment of hypertension. Different groups of drugs are used concurrently in this management such as:

Angiotensin-converting enzyme (ACE) inhibitor: This group of drugs stops the conversion of angiotensinogen, the inactive form, to angiotensin, the potent one, thereby disrupting the RAAS which is involved in raising blood pressure. For example, lisinopril, captopril, etc.
Angiotensin receptor blockers: Blocks the action of angiotensin at the receptor site, preventing the available angiotensin from taking action. For example, losartan, valsartan, etc.
Beta-blockers: Block the action of adrenergic hormones (hormones that stimulate the heart and cause it to beat faster), causing the heart to beat more slowly and maintain blood pressure. For example, propranolol, atenolol, etc.
Diuretics: Increases the excretion of sodium and water which plays a major role in blood pressure elevation. For example, furosemide, hydrochlorothiazide, spironolactone, etc.
Calcium channel blockers: Calcium causes the heart to contract more strongly. By blocking calcium from entering the heart, the heart contraction is slowed down, causing the blood vessels to relax and open. For example, nifedipine, and amlodipine.

Non-pharmacological interventions

Aside from medications, dietary and lifestyle management can help treat hypertension. To help regulate your blood pressure level, your doctor may advise you to do the following:

Reduce salt intake
Take foods that are low in fat
Consume fruits and vegetables
Decrease or stop the consumption of alcohol
Avoid smoking
Engage in regular exercises (brisk walking, jogging, evening walks, etc.)
Lose weight, if overweight
Reduce consumption of processed and ultra-processed foods

Complications

Poor management of hypertension can lead to severe medical conditions such as:

Heart attack
Heart failure
Cerebrovascular accident/stroke
Kidney damage
Vascular dementia
Erectile dysfunction
Vision loss

Conclusion

Hypertension has led to some complications in the lives of people, especially when it is undiagnosed and poorly managed. Having your blood pressure regularly checked by a healthcare professional is a good step to early diagnosis and prompt management, which helps in reducing the risk of complications and/or death.

Always visit a nearby health centre or hospital to have your blood pressure checked.