Health & Wellness

Hypertension: A Global Public Health Challenge

What Is Hypertension?

Hypertension, otherwise known as high blood pressure, is a condition where there is increased blood pressure against the walls of the artery.

The amount of blood which the heart pumps (systolic pressure) and the amount of force of blood against the arteries (diastolic pressure) determine the blood pressure of the person. If the heart pumps more blood against a narrowed artery, the person’s blood pressure will be higher.

Since hypertension displays no symptoms, a person may have it for years and may not be aware. But even in the absence of symptoms, hypertensions continues to damage the heart and the blood vessels.

Typically, hypertension develops over the course of years. And it can affect everyone. It is easy to detect hypertension; once detected, you can work it out with your doctor for its control.

Hypertension is a global problem. It is the leading cause of disability and death. Statistics showed that more than 1 billion people worldwide are affected by hypertensions, and that number is continuously increasing. 

The single largest contributor to cardiovascular disease is untreated or uncontrolled hypertension, including coronary artery disease, stroke, aneurysm, and heart failure. The major cause of kidney disease is also attributed to hypertension.

Categories Of Blood Pressure

There are four classifications to be considered when we speak of blood pressure conditions. 

Normal Blood Pressure (Healthy)

The healthy person has a systolic blood pressure of less than 120 mmHg and diastolic blood pressure of less than 80 mmHg. 

No treatment is required, but to ensure that it remains within the normal range, continuous monitoring of blood pressure is suggested.

Prehypertension (Elevated Blood Pressure)

The person with elevated blood pressure has a systolic blood pressure of 120 to 129 mmHg, and the diastolic pressure is less than 80 mmHg.

Prehypertension is a stage wherein the person is at risk of developing hypertension. As a preventative measure, lifestyle change is highly recommended, but antihypertensive medications are not necessary. 

Stage 1 Hypertension

The person’s systolic pressure is between 130 to 139 mmHg and a diastolic of 80 to 89 mmHg.

Same with prehypertension, lifestyle change is recommended. Prescription of medicine is also given to control the blood pressure and protect the person from heart disease and stroke.

Stage 2 Hypertension

A more severe form of hypertension. Stage 2 hypertension has a systolic pressure of 140 mmHg or higher and a diastolic pressure of 90 mmHg.

Together with lifestyle changes, antihypertensive medications are essential to lower down the blood pressure. 

Hypertensive Crisis

The systolic pressure goes over 180 mmHg and a diastolic pressure of higher than 120 mmHg. 

For some patients, aside from the recommendation of lifestyle change, to get the blood pressure down, two-drug therapy is prescribed. This stage, especially when accompanied by any symptoms like headache, chest pains, visual changes, or shortness of breath, requires immediate medical attention.

Note: If the systolic and diastolic pressures fall into different stages, the higher number will be considered to determine which category of hypertensions the person belongs to. For instance, a systolic pressure of 145 mmHg and a diastolic pressure of 80 mmHg, the person will be classified as stage 1 hypertensive. But for those above 50 years of age, the number that best predicts the risk of cardiovascular disease is the diastolic number.

Types Of Hypertension Based On Cause

Primary (Essential) Hypertension

The diagnosis of this comes after three consecutive high blood pressure results with no identifiable cause and is not related to any medical conditions.

Usually, people with essential hyper-tension show no symptoms, but may occasionally experience dizziness, tiredness, flushing, headaches, visual changes, shortness of breath, chest pains, or some nose bleeding.

Although with unknown secondary causes, some factors are still considered to contribute to this primary hypertension like stress, lack of sleep, diet, alcohol, smoking, obesity, and heredity.

Secondary Hypertension

Some underlying medical conditions may lead to secondary hypertension’s. This type of hypertensions may suddenly appear and may result in higher blood pressure as compared to primary hypertension. 

Various conditions and medications that may lead to secondary hypertensions include:

  • Kidney problems
  • Thyroid problems
  • Adrenal gland tumors
  • Obstructive sleep apnea
  • Congenital defects in blood vessels
  • Illegal drugs like amphetamines and cocaine
  • Some medications like decongestants, pain relievers, birth control pills, and other prescription drugs

Secondary hypertension can often be controlled once the underlying cause is identified.

Types Of Hypertension Based On Specific Diagnostic Criteria

Isolated Systolic Hypertension

A normal blood pressure reading is under 120/80 mmHg. With isolated systolic hypertensions, the systolic pressure rises above 140 mmHg, and the diastolic pressure stays within a normal range.

This is the most common form of hyper-tension among people over the age of 65, and this is attributed to the loss of elasticity in the arteries. For the risk of cardiovascular disease in an older person, diastolic pressure is much more important than the systolic pressure.

Malignant Hypertension

A rare form of hypertensions occurs in only about 1% of people with hypertension. Malignant hypertension is more common in younger adults among African-American men and for those pregnant women with toxemia (preeclampsia). 

In malignant hypertension, blood pressure tends to rise abruptly. This should be treated in the hospital under a medical emergency. Some significant symptoms are headache, blurred vision, chest pain, confusion, and numbness in the arms and legs.

Resistant Hypertension

The person could be suffering from resistance hyper-tension if the blood pressure remains to be high despite the treatment of underlying causes.

Studies showed that about 20 to 30 percent of high blood pressure cases fall under resistant hypertension. This type of hypertension may be of genetic origin and is common among African American women, old, and obese. Other contributory factors may include kidney disease or diabetes. 

Normal levels of blood pressure are particularly important for the proper functioning of our vital organs such as the brain, heart, kidney, and overall well-being and total health. Monitoring our blood pressure and keeping it under control is essential in preserving our health.

Health2Wellness

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