Hematology

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High Blood Pressure

Introduction:
High blood pressure (also known as hypertension) refers to a steadily increasing pressure on the blood vessels, which in turn strains the function of pumping the blood through to the heart, leading to the hardening of vessels and causing severe damage to the body's organs, particularly the heart. Hypertension is measured by the quantity of blood pumped by the heart and to what extent the artery walls resist the blood flow. Therefore, the more the quantity of blood pumped by the heart, the greater the resistance of arteries; making the blood pressure higher.

Symptoms:
Many people with high blood pressure show no signs or symptoms, and in some cases blood pressure readings reach dangerously high levels. Although the symptoms may not occur for years, for some people the symptoms may show up early, such as:

Headache.
Dizziness.
Nosebleed.
Irregular heart pulse.
Humming ear.

Causes:

Primary hypertension: Many adults may develop primary hypertension. This type of high blood pressure, called essential hypertension or primary hypertension, has no identifiable cause and it develops over many years.
Secondary hypertension: Some people have the secondary high blood pressure. This type of high blood pressure, called secondary hypertension, is caused by an underlying condition such as kidney diseases or Adrenal gland tumors; or caused by medications such as birth control pills and pain killers. The blood pressure may reach very high levels.

Persons at risk of high blood pressure:

The risk of high blood pressure increases with age and through early middle age high blood pressure is more common in men. Women are more likely to develop high blood pressure after menopause.
High blood pressure is particularly common in dark-skinned people, and they are also prone to stroke and heart attacks.
Incidence of high blood pressure in either or both of parents makes a person vulnerable to the disease.
Obesity.
Smoking.
Salty food.
Lack of potassium in food.
Lack of vitamin D in food.
Those burdened with stress.
Persons infected with some diseases such as: diabetes, cholesterol and kidney diseases.
Some pregnant women may get high blood pressure.

Complications:

Hardening of the arteries walls which can lead to heart attacks.
Weakness of blood vessels and appearance of protrusions on the walls.
Thickness of heart muscles, making the heart unable to pump enough blood through to the body, leading to heart failure.
Persons with high blood pressure are prone to other diseases such as high cholesterol, increasing the chance of having diabetes and other heart diseases.
Persons with high blood pressure may be prone to the problems of thinking, remembering and learning.

Diagnosis:

Case description	Readings	Notes
Normal blood pressure	115/75 mm Hg	When blood pressure raises above this level possibility of cardiovascular diseases increased.
Prehypertension	Between 120/80- 139/89 mm Hg	This stage signifies that you are prone to developing high blood pressure with time; so it is recommended to see a doctor
Stage 1 hypertension	Between 140/90- 159/99 mm Hg
Stage 2 hypertension	More than 160/100 mmHg

In order to correctly diagnose high blood pressure, your doctor will take several blood pressure readings, each at separate appointments, before determining whether you have high blood pressure. Sometimes, doctors ask the patient to take check pressure and record the readings in different times of the day and for several days until are sure of the blood pressure reading.
In case a high blood pressure case is confirmed, the doctor usually undergoes other tests to confirm the diagnosis. Such tests include urine tests, blood tests, electrocardiogram (ECG). Your doctor may also recommend additional tests such as cholesterol tests or certain heart tests.

Treatment:

To treat high blood pressure, your doctor may resort to the following:

Medications
Exercises
Healthy food

Medications to treat high blood pressure (The medicine varies according to the health condition of the patient):

Medication group	Drug significance
Diuretics	Medications affect your kidneys to help your body eliminate sodium and water, they are often the first choice in medication treatment; even though it is not to be used solely.
Beta blockers	They help slow down heart pulse, and reduce the stress on your heart, thus opening your blood vessels to make the flow of blood easier.
ACE inhibitors	Help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels
ARBs group	Helps relax blood vessels to help the heart when pumping the blood, facilitating the flow of blood.
Calcium blockers	Prevent calcium from entering heart cells and blood vessels, causes relax and widening of blood vessels
Renin inhibitors	Slow down the production of renin, an enzyme that increases blood pressure
Alpha blockers	Help relax blood vessels and keeps them widen and easy blood flow.
Alpha-beta blockers	Help relax blood vessels, slow heartbeat to reduce the amount of blood that must be pumped through the vessels
Central inhibitors for adrenalin	Reduce heartbeat, then slow blood pressure
Vasodilators	They widen blood vessels

Living with high blood pressure:

Take the medications regularly and follow up with your doctor.
Exercise regularly.
Maintain a healthy weight.
Eat healthy food and reduce the intake of salt.
Avoid alcohol and smoking.
Avoid stress.
Follow up your blood pressure at home.
Train on practices that would help you to better relax, breathe, and avoid stress.