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Question 1. What is High Blood Pressure (BP)?

Medical term for high Blood Pressure is hypertension. Blood travels through blood vessels much like water through a garden hose. The blood in the vessels is under pressure just like the water in a hose when the tap is turned on.

 

With each heartbeat more blood is pumped into the vessels - like turning up the tap - so the pressure rises. This is the systolic blood pressure, the first number in the blood pressure measurement, which is normally around 120.

Between heartbeats, while the heart is resting, the pressure in the arteries is lower. This is the diastolic pressure, second number in the blood pressure measurement, which is normally around 80.

You can increase the pressure in a hose either by turning up the tap or by putting a crimp in the hose (that is, by narrowing the hose). In this same way, the blood pressure in blood vessels will rise if fluid flows more forcefully or if the arteries are narrowed.

 

Pressure in a hose can be regulated either by controlling the rate at which fluid passes through it or by widening it. Likewise, the pressure in the blood vessels can be controlled, with medications that act on the heart or blood vessels and with certain lifestyle modifications.

 

 

Question 2. What causes high BP?

 

There are three types of hypertension:

 

             Primary hypertension (essential hypertension). This is high blood pressure for which no cause can be found. Most people with high blood pressure (90 to 95 percent) have this type of hypertension. Doctors suspect that a combination of lifestyle, diet, heredity, age, gender, race/ethnicity, hormone levels, and other factors all contribute to high blood pressure.

 

             Secondary hypertension (non-essential hypertension). This is high blood pressure for which a definite cause can be found. This type of high blood pressure accounts for only 5 to 10 percent of all cases of hypertension. Some of these causes are temporary or controllable - for instance, pregnancy or the use of certain medications - while others are chronic conditions like hormonal diseases, kidney disease, or head injuries.

 

             Isolated systolic hypertension (ISH). Older people are sometimes susceptible to another form of high blood pressure, called isolated systolic hypertension. In people with this condition, blood pressure is higher than normal when the heart beats, but returns to normal in between beats of the heart. The large difference in pressure can place additional strain on artery walls.

 

 

Question 3. How do I know I have high Blood Pressure?

 

Most individuals walk around without even knowing that they have hypertension until complications arise or detected during routine doctors or hospital visit for check-up. However, you should have your BP check if you have following:

 

Tired all the time

Headaches

Vision disturbance

Increased urination

Diabetes

Heart disease/Angina

Kidney disease

Sexual dysfunction

Menstrual irregularities

Palpitation/Fast or slow heart beat

 

Question 4. How is BP measured?

 

Your health care provider will probably use a blood pressure cuff and stethoscope to measure your blood pressure. The blood pressure cuff, also called a sphygmomanometer, consists of a cuff with an inflatable bladder, a rubber hand bulb with a valve used to inflate and deflate the cuff, and a pressure gauge.

 

First, the cuff is wrapped snugly around your upper arm. The cuff is then rapidly inflated until the pulse in the upper arm is no longer felt. At this point blood flow in the underlying blood vessel is cut off by pressure in the cuff. The health care provider will continue to inflate the cuff a bit beyond this point.

 

Next, a stethoscope is placed over the brachial artery at the elbow and the cuff is slowly deflated, while the health care provider listens for sounds produced by turbulent blood flow in the artery.

 

 

The health care provider listens through the stethoscope until he or she hears the heartbeats. At this point, cuff pressure matches pressure in the artery, and blood flow resumes. This is the systolic blood pressure (SBP).

 

 

The health care provider continues to slowly deflate the cuff until the sounds stop. This is the diastolic blood pressure (DBP).

 

 

Experts recommend that to help make sure your blood pressure measurement is accurate:

 

-Avoid smoking and eating or drinking anything that contains caffeine for 30 minutes before the test. Generally, blood pressure will go up at certain times - for instance, if you smoke a cigarette, win the lottery, or witness a car crash - and will return to normal when the stressful or exciting event has passed.

 

-Rest for five minutes before the measurement is taken

 

-Two or more readings (separated by two minutes) be taken to determine an average blood pressure for the visit.  If the first two readings differ by more than 5 mm Hg, additional readings should be obtained and averaged.

 

Question 5. When should I be treated?

Blood pressure is measured in millimeters of mercury (mm Hg). A typical normal blood pressure is 120/80 mm Hg, or "120 over 80."The first number represents the pressure when the heart contracts. The second number represents the pressure when the heart relaxes. Blood pressure greater than 140/90 mm Hg is considered high. Generally BP above these needs treatment. However, you should see your doctor for advice as other factors may influence drug treatment, for example, for diabetics or individuals with complications of high BP treatment threshold may be much lower. 

 

Question 6. What treatments are available for high BP?

Treatments include weight management, exercise, diet control and drug treatment. Various drug groups are available. The major drug groups help to decrease force of contraction of heart or open-up channels (vessel) for blood flow hence reduce pressure. Your doctor will help choose drugs appropriate to your circumstances.

 

Question 7. How long should I be treated?

In general, hypertensive treatment is long term. Only in few instances, your treatment will be short-term, for example, if you are able to control your BP with diet and weight control and exercise.

 

Question 8. What will happen if my high BP is untreated?

When blood pressure is high all the time, the continuous increased force on blood vessel walls can damage blood vessels and organs, including the heart, kidneys, eyes, and brain. Untreated hypertension causes stroke, heart attack and heart failure, kidney failure and blindness. The risk is even greater if you also have high cholesterol, overweight and diabetes and smokes and takes alcohol.

 

Question 9. Is there any side effects of drug Treatment?

Many antihypertensive medicines are well-tolerated. However, occasional side effects do occur such as dizziness, headache and cough particularly at the beginning  of treatments. Hence, the need for regular follow-up of hypertension treatment. See your doctor for further advice.

 

Question 10. How often can I monitor my BP?

Complication of treatment is more likely to arise in the first week of treatment than later. Close monitoring is important when starting new BP medications. See your doctor for advice.