Hypertension

1. What is hypertension?
2. How common is Hypertension?
3. People most likely to get Hypertension
4. Blood Pressure
5. Symptoms of Hypertension

What is hypertension?

Hypertension is the medical term for "High Blood Pressure", and is one of the leading causes of heart attack, stroke, kidney failure and early death¹. It is a disease of the cardiovascular system, which includes the heart, blood vessels and the blood. Often, people with this condition have no symptoms they are aware of, and are identified by chance - such as when having an insurance "medical" or when you go for a routine checkup. This is why hypertension is such a dangerous condition, and is referred to as the "silent disease". In many cases, the condition has gradually built up over several years before someone is identified as being "hypertensive"². Some sufferers are really unfortunate and without any warning, have a serious event, like a heart attack. Hypertension is therefore a chronic disease, and usually any treatment, be it drug therapy and/or lifestyle modifications, has to be maintained for life!

How common is Hypertension?

Hypertension is a common condition throughout the world, but it is thought to particularly affect people in "Westernized" countries, where the lifestyle (high-fat/high-salt diet, low physical exercise, high stress, etc) lends itself to this condition. A more concerning observation is the rapid increase in hypertension and cardiovascular disease seen in developing countries. In South Africa, hypertension is a major contributor to cardiovascular disease, which takes up almost 7.5% of the direct health care spend in the country. It was estimated in 2000, that some 6,300,000 South Africans suffer from hypertension, according to the criteria established in the South African Hypertension Society's Clinical Guidelines.²

People most likely to get Hypertension

Some people are more prone to developing hypertension than others; these include:

• people who have a close relative with hypertension or heart disease (a "family history")
• aging and elderly individuals (>60 years old)
• diabetics
• those of black ethnicity
• overweight (obese)people
• physical inactivity/sedentary lifestyle
• cigarette smokers
• heavy drinkers
• people who eat a high salt diet (tend to retain water)
• individuals with a low intake of potassium, magnesium and   calcium
• people with cholesterol disorders

Generally, men are at higher risk of having hypertension than women, particularly before the age of 50; however, after the menopause the risk of cardiovascular disease among women "catches up" to that of men, even surpassing it.

Low, Normal and High Blood Pressure

Blood pressure, simply referred to as "BP", is the force exerted by the heart when it pumps blood through the arteries.

The heart has to always maintain a degree of pressure to keep the blood moving throughout the blood vessels, even during the period when the heart is relaxed - the diastole. Therefore, a BP measurement is made up of two parts:

• Systolic BP (SBP)         the pressure that occurs in the arteries when the heart contracts
• Diastolic BP (DBP)       the pressure when the heart is relaxed

These two measurements of BP are then expressed like a fraction with the higher reading (SBP) over the lower measurement (DBP):

SBP/DBP

100/60
(hypotensIve)
LOW

120/80
(normotensive)
NORMAL

140/90
(hypertensive)
HIGH

Symptoms of Hypertension

Common hypertension symptoms:

All too often there are NO symptoms! This is what makes treating hypertension a challenge for the doctors. The presence of symptoms may, unfortunately, be a sign of hypertension that has become established over a long time. During this time there may have been damage to tissues and vital organs. Nevertheless, patients occasionally present with symptoms relating to their hypertension. These can be any of the following:

• headaches
• palpitations (rapid heart rate)
• nose bleeds
• tiredness
• confusion
• nausea/vomiting
• anxiety
• excessive perspiration
• muscle tremors
• pale skin
• dizziness
• blurring of vision
• angina (chest pain)

These symptoms may also occur with various other conditions and illnesses. As a result, patients may misread the underlying cause of the symptom, and the diagnosis of hypertension is delayed.

Hypertension : The Dangers and Complications

If you have hypertension, your heart works harder than it should against an increasing pressure. If this pressure isn't controlled, your heart enlarges and your arteries become scarred, hardened and less flexible. Eventually, your overworked heart may not be able to effectively pump blood through stiff arteries. These changes increase the risk of:

• heart disease (CAD - coronary artery disease), such as heart attacks (called a "myocardial   infarction")
• heart failure (the heart fails to pump enough blood to meet the body's requirements)
• stroke (blockage or burst blood vessel in the brain)
• kidney failure
• peripheral vascular disease (disorder of blood vessels outside of the heart)
• retinopathy (damage to the eyes - leading to vision loss)

The importance of treating Hypertension

The health information contained herein is provided for educational purposes only and is not intended to replace discussions with a healthcare provider. All decisions regarding patient care must be made with a healthcare provider, considering the unique characteristics of the patient.