What Is a High Blood Pressure (Hypertension)

High blood pressure (hypertension) is a condition in which the pressure in the arteries is higher than the normal range.

  • Disorders of the kidneys or the endocrine system may be the underlying cause of high blood pressure but not necessarily so. Often, no identifiable cause can be found.
  • Some people may be inherently predisposed to developing high blood pressure. For them, additional risk factors such as stress, smoking, excessive alcohol consumption, inactivity, obesity and excess salt intake can accelerate the development of high blood pressure.
  • Lifestyle changes recommended include regular exercise, diet low in fats and salt, and weight loss.
  • Drug therapy consists of drugs that help bring down the blood pressure called anti hypertensive drugs.

 The medical term hypertension, when used to refer to high blood pressure, many people assume that it is about the increase in the mental tension or excess stress. But medically, it is a physical condition characterized by the high pressure prevailing in the arteries which may eventually lead to the damage of vital organs. Unless kept under control, by either lifestyle changes or through appropriate medication, hypertension can have far reaching consequences such as heart failure leading to heart attack, aneurysms of the arteries, kidney failure and even stroke.

Incidence of hypertension is quite high in the general population, with around 65 million Americans alone, having this condition.  Blacks and people of Asian origin are more prone to developing hypertension. While 23% incidence is seen in whites and people of American origin, it is much higher at 32% in blacks. The other disorders resulting from the condition are also more severe in them.

Older people are more prone to hypertension; 75% women and 65% men above the age of 75 having this condition, while it occurs only in 25% of people below 75years. In addition to age, obesity also makes people prone to high blood pressure, the incidence of hypertension in them being almost twice of that in non-obese people.

Not all cases of hypertension are diagnosed, mainly due to the lack of symptoms. In the United States, only less than three fourths of the existing cases are clinically diagnosed and over three fourths of known cases undergo treatment. Even among those who are treated, only just over 50% achieve proper control over hypertension.

Blood pressure is expressed in two numbers, as in a fraction, the upper number standing for systolic pressure and the lower number, which incidentally is of lower value too, representing diastolic pressure. Systole is the contraction of the heart and during this time, the pressure is highest in the arteries. After every contraction, a period of relaxation follows, during which blood pours into the heart from the rest of the body; this is termed diastole and blood pressure in the arteries decreases at this time. Arteries have the lowest pressure right before the next contraction. The higher systolic pressure is expressed over the lower diastolic pressure like this -120/80 mm Hg- and it is read as 120 over 80, which incidentally is the normal reading for blood pressure.

What does high blood pressure mean ? When a few, subsequent, blood pressure readings present values higher than the normal range, the person is diagnosed as having hypertension. A systolic pressure above 140 mm Hg and diastolic reading above 90 mm Hg fall in this category. Within the range generally considered normal too, the lower the readings are, the lesser the risk of damage to other organs. In people with hypertension, either one of the readings or both, could be high. When hypertension appears early in life, systolic pressure as well as diastolic pressure are found to be high. But isolated systolic hypertension is usually found among older people with high blood pressure, in which, the systolic pressure is very high, while the blood pressure at the time of diastole remains within range.

Blood pressure readings above 180/120 mm Hg indicates a condition called hypertensive urgency, but it may often go unnoticed because organ damage due to this condition may not have become severe enough to bring it to the notice of doctors. Though asymptomatic, this condition steadily worsens and silently precipitates a variety of disorders, in several internal organs, including the kidneys and the heart.

Malignant hypertension is a potentially fatal form of hypertensive emergency, which can severely damage eyes and occasionally kidneys too. Unless diagnosed in time and treated immediately, malignant hypertension results in death within 6 months from the onset of symptoms. The incidence of this dangerous condition is reported in one out of every two hundred people with hypertension, but it is more common among economically weaker sections of society than in those of higher economic status and blacks, when compared to whites and men, compared to women.

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Yasser Elnahas

MD, PHD, Professor Of CardioVascular Surgery
Dr. Yasser Elnahas, Is an associate Professor of Cardiovascular Surgery. Dr. Elnahas was trained as a fellow At Texas Heart Institute And Mayo Clinic Foundation.Dr. Elnahas is dedicated to educating the general public about different disease conditions and simplifying the medical knowledge in an easy to understand terminology.

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