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High Blood Pressure
What is high blood pressure?
High blood pressure or hypertension is simply a condition where the blood pressure in the body is higher than what we consider to be normal.
Blood pressure is measured as two values. The systolic (heart contracting) is the higher one and the diastolic (heart relaxing) is the lower one.
- The value for normal is less than 120/80 mmHg.
- High-normal is 120-139/80-89 mmHg.
- Grade 1 (mild) hypertension is 140-159/90-99
- Grade 2 (moderate)hypertension is 160-179/100-109
- Grade 3 (severe) hypertension is ≥ 180/ ≥110
How is high blood pressure diagnosed?
Blood pressure is measured using a sphygmomanometer. It is important that the cuff is the correct size. If the cuff is too small, a false large reading will be produced.
The measurements must be taken on several occasions. Occasionally a recording machine can be worn for 24 hours.
Certain factors can increase blood pressure temporarily, including visiting the doctor, rushing around, a cigarette, pain or illness.
What causes high blood pressure?
Blood pressure is the pressure of the blood in the arteries and veins in the body. The pressure is dependent on the heart pumping, the blood being in enough volume, and the size and elasticity of the arteries that carry the blood from the heart. All of these are regulated by the nerves and hormones and chemicals in the body.
If any of these factors are altered or damaged, then they can cause high blood pressure.
The most common cause for high blood pressure is damage to the vessels through atherosclerosis and aging. Also obesity, smoking, poor fitness also have important roles.
What problems can high blood pressure cause?
Blood is delivered around the body to all the tissues and organs. This must be delivered at the correct pressure. Imagine watering small plants with a hose. If the pressure in the hose is weak then hardly any water will dribble out to water the plants. If the pressure is too high it will damage the plants. So the pressure needs to be just right to water the plants. Same goes in the body.
If the blood pressure is too high it will damage all the areas it supplies. Some important organs are the heart, brain, kidneys, penis, legs and eyes.
Damage usually occurs gradually over time. Rarely does high blood pressure cause immediate damage – though this can occur if it goes high very high quickly.
How is high blood pressure treated?
High blood pressure is treated by looking at weight, diet, moderate salt intake, management of sleep apnoea, improvement of raised cholesterol, alcohol, smoking, exercise, stress and lifestyle. Improving all these can make a big change.
If the blood pressure remains high after attending to these modifiable factors then medication can be used.
There is a range of different medications. These all have different mechanisms of action. Patients with high blood pressure commonly require two medications to get the blood pressure down.