Overview

High blood pressure, also known as hypertension, is a common condition that can lead to serious complications if left untreated. While it is prevalent, hypertension can result in severe issues such as stroke, heart failure, heart attack, and kidney damage. Many individuals with high blood pressure may not experience symptoms, so regular blood pressure checks are essential. Effective treatments for reducing blood pressure include making dietary changes (such as reducing sodium intake and increasing potassium intake), exercising, and losing weight for those who are overweight.

How is Blood Pressure Measured?

The American College of Cardiology and the American Heart Association (ACC/AHA, 2017) categorize blood pressure into four general categories:

• Normal blood pressure: Less than 120/80 mmHg
• Elevated blood pressure: 120-129/80 mmHg
• Hypertension:
• Stage 1: 130-139/80-89 mmHg
• Stage 2: 130-139/80-89 mmHg

What are the Risk Factors For High Blood Pressure?

Modifiable Risk Factors

Several risk factors could be modified or controlled.

• Unhealthy diets (high in salt, saturated fat, and trans fats, and low in fruits and vegetables)
• Physical inactivity
• Tobacco and alcohol consumption
• Being overweight or obese
• Environmental factors, with air pollution being a significant contributor

Non-modifiable Risk Factors

Several risk factors could not be modified or controlled like

• Family history of hypertension
• Age over 65 years
• Co-existing conditions, such as diabetes or kidney disease

Symptoms

Most people with hypertension don’t feel any symptoms. High blood pressure can cause headaches, blurred vision, chest pain and other symptoms.

Checking your blood pressure is the best way to know if you have high blood pressure. If hypertension isn’t treated, it can cause other health conditions like kidney disease, heart disease and stroke. People with very high blood pressure (usually 180/120 or higher) can experience symptoms including:

• Severe headaches
• Chest pain
• Dizziness
• Difficulty breathing
• Nausea
• Vomiting
• Blurred vision or other vision changes
• Anxiety
• Confusion
• Buzzing in the ears
• Nosebleeds
• Abnormal heart rhythm

If you are experiencing any of these symptoms and high blood pressure, seek care immediately. The only way to detect hypertension is to have a health professional measure blood pressure. Having blood pressure measured is quick and painless. Although individuals can measure their own blood pressure using automated devices, an evaluation by a health professional is important for the assessment of risk and associated conditions.

NON-PHARMACOLOGICAL TREATMENT

This includes lifestyle modifications like diet, exercise, weight reduction, and smoking cessation.

Making changes to what you eat can help control high blood pressure.

• Reduce sodium (salt) — Reducing the amount of sodium you consume can lower blood pressure if you have hypertension or elevated blood pressure. The main source of sodium in the diet does not come from the salt shaker; it comes from the salt contained in packaged and processed foods and in foods from restaurants. The body requires a small amount of sodium in the diet, and most people consume more sodium than they need (over 3 grams per day). A low-sodium diet contains fewer than 2.4 grams (2400 milligrams) of sodium per day. Although the ideal target for daily sodium intake remains controversial, the optimal goal is less than 1500 mg per day.
• Reduce alcohol — Drinking a lot of alcohol increases your risk of developing high blood pressure. A "drink" is defined as 5 oz of wine, 12 oz of beer, or 1 oz of hard liquor. Drinking more than two drinks per day increases the risk of high blood pressure compared with not drinking, and it also makes hypertension more difficult to control. Binge drinking (consuming four to five drinks within two hours) is an even greater problem for overall health and hypertension.
• Eat more fruits and vegetables — Adding more fruits and vegetables to your diet may reduce high blood pressure or protect against developing high blood pressure; it can also help improve your health in general.
• Eat more Fiber — Eating an increased amount of fibre may decrease blood pressure. The recommended amount of dietary Fiber is 20 to 35 grams of Fiber per day. Many breakfast cereals are excellent sources of dietary fibre. Eat more fish — Eating more fish may help to lower blood pressure, especially when combined with weight loss.
• Caffeine — Caffeine can temporarily increase blood pressure in people who don't consume it regularly. In regular caffeine users, a moderate amount of caffeine (equivalent to approximately two cups of coffee daily) usually does not affect blood pressure. However, excessive amounts of caffeine (such as in many supplements and large-size beverages) may raise blood pressure in susceptible people.

Dietary Approaches to Stop Hypertension (DASH) Eating Plan

The DASH eating plan combines many of the dietary interventions noted above. It is high in fruits, vegetables, whole grains, Fibers and low-fat dairy products, with reduced saturated fat, total fat, and meat intake. All people, including those with and without high blood pressure, who strictly follow the DASH eating plan can have significant reductions in blood pressure, particularly when combined with a low-sodium diet.

Regular exercise can lower your blood pressure even if you don't lose weight. Recommendations from the American Heart Association suggest that achieving substantial health benefits requires 150 to 300 minutes per week of moderate-intensity aerobic activity (such as brisk walking) or 75 to 150 minutes per week of vigorous-intensity aerobic activity (such as jogging) plus muscle-strengthening exercises (resistance training) involving all major muscle groups at least twice per week. Isometric exercises (e.g., repeated handgrip contraction) may also be of benefit.

Exercise will not only help lower blood pressure but also improve cholesterol levels. However, to maintain this benefit, you must continue to exercise regularly. Although this level of exercise is recommended to get substantial reductions in blood pressure (4 to 5 mmHg systolic), any amount of physical activity is better than none. Even gentle forms of exercise, like walking, have health benefits.

WEIGHT LOSS AND BLOOD PRESSURE

Being overweight or obese increases your risk of high blood pressure, diabetes, and cardiovascular disease. The definitions of overweight and obese are based upon a calculation called body mass index (BMI). You can find your BMI using an online calculator (calculator 1 and calculator 2). A person is considered overweight if their BMI is greater than 25, while a person with a BMI of 30 or greater is classified as having obesity.

People who are overweight or obese can see significant reductions in blood pressure with even modest weight loss. On average, every kilogram of weight loss is associated with a 1 mmHg reduction in systolic blood pressure.

AVOID TAKING MEDICATIONS AND SUPPLEMENTS THAT INCREASE BLOOD PRESSURE

In susceptible individuals, nonsteroidal anti-inflammatory drugs or "NSAIDs" (such as ibuprofen and naproxen) can increase blood pressure. Oral contraceptive (birth control) pills may increase blood pressure in some people. Additionally, any stimulant, including those found in some decongestants, weight loss products, and illegal drugs, can increase blood pressure. If you are regularly consuming any of these substances, you should talk to your healthcare provider.

WHAT IF I STILL HAVE HIGH BLOOD PRESSURE?

Suppose you continue to have high blood pressure despite making lifestyle modifications, including changes in your diet, exercising more, and losing weight. In that case, you may need medication to reduce your blood pressure.

PHARMACOLOGICAL TREATMENT

This includes a list of recommended drugs according to individual needs. So, a regular long-term follow-up with a physician is highly recommended.

our doctor may recommend one or more medicines if you have high blood pressure. Your recommended blood pressure goal may depend on what other health conditions you have.

For most people, the goal is to have a blood pressure of less than 130/80.

There are several common blood pressure medicines:

• ACE inhibitors, including enalapril and lisinopril, relax blood vessels and prevent kidney damage.
• Angiotensin-2 receptor blockers (ARBs), including losartan and telmisartan, relax blood vessels and prevent kidney damage.
• Calcium channel blockers, including amlodipine and felodipine, relax blood vessels.
• Diuretics, including hydrochlorothiazide and chlorthalidone, eliminate extra water from the body, lowering blood pressure.

COMPLICATION OF UNCONTROLLED HYPERTENSION

Among other complications, hypertension can cause serious damage to the heart. Excessive pressure can harden arteries, decreasing the flow of blood and oxygen to the heart. This elevated pressure and reduced blood flow can cause:

• Chest pain, also called as angina.
• Heart Attack, which occurs when the blood supply to the heart is blocked, and heart muscle cells die from lack of oxygen. The longer the blood flow is blocked, the greater the damage to the heart.
• Heart Failure, which occurs when the heart cannot pump enough blood and oxygen to other vital body organs; and irregular heartbeat which can lead to a sudden death.
• Hypertension can also burst or block arteries that supply blood and oxygen to the brain, causing a stroke.
• In addition, hypertension can cause kidney damage, leading to Kidney Failure.