Hypertension

Introduction

Hypertension also known as blood pressure is a serious health issue that affects many worldwide. Recent statistical studies of WHO depicts that in coming years the patients of hypertension may increase upto 1.57 billions by the year 2025. The fluid connective tissue blood is transported to various body parts via arteries. Blood pressure refers to the pressure exerted by blood on the walls of the arteries. Hypertension refers to high blood pressure, in which blood pressure value reads greater than 140mmHg and 90mmHg. A device known as a sphygmomanometer is used to measure blood pressure. The first readings of pressure in which the heart pumps the blood through the body is known as the systolic pressure. The second reading of pressure is one in which the heart relaxes and refills the blood, this is known as the diastolic pressure. High blood pressure is often referred to as ‘silent killer’ because one may be unaware of the damage that is happening in their body.

Types of Hypertension

Hypertension is basically divided into two distinct parts:

• Primary hypertension: this type of hypertension occurs when one has abnormally high blood pressure, which is not the result of any medical condition, rather it is due to obesity, family history or having an unhealthy diet. This hypertension is also known as Essential Hypertension

• Secondary hypertension: this type of hypertension is caused due to any medical condition, such as conditions affecting kidney, heart, arteries or the endocrine system. This condition is also seen during pregnancy

Causes of Hypertension

Stress and unfavourable environmental factors are the main reasons for an increased blood pressure in normal and healthy individuals. Hypertension is dangerous as it makes the heart work harder in pumping blood out of the body and contributes in hardening of the arteries leading to atherosclerosis, stroke, kidney diseases and also heart failure. Two, much alcohol consumption may lead to an increase in blood pressure. Lack of physical activities and being overweight also causes hypertension. Consuming foods having high sodium content is another major cause.

Symptoms of Hypertension

Hypertension is an asymptomatic disease as it does not show any clear indication, this is why we call hypertension a “silent killer” as it may affect the cardiovascular system. Prolonged exposure to hypertension may lead to plaque formation and narrowing of blood vessels. Few people having high blood pressure may show symptoms of headache, shortness of breath or even nose bleeding. Systolic pressure readings of 180mmHg and a diastolic pressure value of 110mm Hg indicate the sign of hypersensitive crisis that requires immediate medical action.

Diagnosis of Hypertension

Diagnosis is generally carried out in patients using a sphygmomanometer, at least three different elevated readings are taken into consideration for diagnosing this condition. Some additional tests also help to determine the cause of high blood pressure and any other complications. These tests includes:

• ECG tests

• Blood tests

• Urine tests

• Kidney ultrasound tests

• Echocardiogram

Blood pressure using a sphygmomanometer is measured in both arms, to determine any difference. An appropriate sized cuff should be used in diagnosis. A pressure value of 120/80 is considered as normal blood pressure. Systolic pressure values between 120-129mmHg and a diastolic pressure below 80mmHg are considered as elevated blood pressure; it is also known as prehypertension. If not treated properly it gets worse over time. Lastly, if the pressure ranges 180/120 then it refers to an emergency situation that requires urgent medical attention, this condition is known as hypertension crisis.

Treatment of Hypertension

• Regular exercising and weight loss is required as high blood pressure is concerned with obesity

• A well balanced diet consisting of whole grains, fruits, vegetables and low-fat dairy products are recommended

• Foods having high amounts of LDL cholesterol should be avoided

• Reducing the intake of sodium diets, and increasing the intake of calcium and vitamin D rich diets are proved to be helpful in hypertension cases

Intracranial Hypertension

It refers to an increase in pressure around the brain, occurring when cerebrospinal fluid builds up in the skull. This creates pressure in the brain and optic nerve that helps us to see. It is also known as “idiopathic intracranial hypertension”  idiopathic means “no known cause” intracranial means “ inside the skull”. Earlier it was also known as “pseudotumor cerebri” meaning ‘false brain tumor’ as its symptoms were found to be similar to brain tumor symptoms. Studies have found that women between ages 20-50 years are most likely to develop IIH. It is also seen in person having:

• Iron deficiency i.e. anemia

• Persons suffering from polycythaemia vera 

• Having body mass index i.e. BMI above 30

Causes of Intracranial Hypertension

It is caused due to unknown medical issues. Few people suffer from chronic IIH due to conditions like brain tumors or blood clots. Aute or sudden IIH occurs due to: 

• Collection of pus and swelling in the brain

• Any brain injury or traumatic brain injury

• Stroke

Symptoms of Intracranial Hypertension

Common symptom of IIH is a sudden, severe and painful headache. There is also a problem in vision, people may have double vision or sudden blind spots, few people have loss of peripheral vision (i.e. side vision). Shoulder and neck pain, continuous ringing ears are other few symptoms. 

Diagnosis of Intracranial Hypertension

It can be diagnosed through the following tests:

• Brain CT scan or MRI

• Visual Field Test is done to check blind spots in vision

• Spinal tap (lumbar puncture) to determine CSF

• Eye examination to determine any swelling near the optic region

Prevention of Intracranial Hypertension

• Exercise: regular exercising helps in reducing BMI that lowers the symptoms of IIH

• Medication: certain medicines are used to lower the symptoms of IIH. Diamox is prescribed to help the body produce less CSF

• Surgery: surgery can be done in the brain or near the optic nerve that allows excess CSF drain out

Conclusion

Hypertension turns serious if it is left unchecked. So, timely monitoring of blood pressure is suggested. However exercise and following a strict diet helps in lowering pressure.