Also known as high blood pressure, hypertension is a common condition in which there is increased pressure of your blood against the inner walls of your arteries as it is pumped by your heart. Hypertension can contribute to several serious diseases including heart disease, stroke and kidney failure. The prevalence of hypertension is high and increasing worldwide. During 2005-2008 in the United States, 1 in 3 adults aged over 18 years (68 million persons) had hypertension, the nation's most common primary diagnosis, and its annual estimated costs (direct plus indirect) were $50.6 billion.
Blood travelling through an artery creates pressure against its walls (blue arrows).
A blood vessel carrying blood saturated with oxygen from the heart to the body's tissues.
A pair of organs responsible primarily for regulating the water balance in the body and filtering the blood.
The causes of hypertension can be divided into two main types.
Primary hypertension, also known as 'essential hypertension', has no specific underlying cause. It tends to develop slowly over many years.
This type of hypertension is caused by an underlying medical condition. Secondary hypertension can appear more suddenly than primary hypertension. Some conditions contributing to secondary hypertension can include:
A pair of organs responsible primarily for regulating the water balance in the body and filtering the blood.
There are many risk factors associated with hypertension. Most of these are lifestyle-related, for example, obesity and a lack of physical activity. If you are overweight or obese, more blood is needed to supply oxygen and nutrients to your tissues. As more blood is circulating through your blood vessels, the pressure on the walls of your arteries increase. People who are less physically active also tend to have a higher heart rate. If you have a high heart rate, your heart has to work harder with each contraction, which causes more pressure on your arteries. Other risk factors can include:
A blood vessel carrying blood saturated with oxygen from the heart to the body's tissues.
A type of fat produced by the body that is necessary for metabolism.
Most people with hypertension do not show any signs or symptoms, even when blood pressure readings are extremely high. Others may experience dull headaches, dizzy spells or nosebleeds.
To diagnose hypertension, your blood pressure will be measured by your doctor using an inflatable arm cuff, called a blood pressure monitor. As the heart pumps blood through your arteries, your blood pressure peaks (known as 'systole') and falls as your heart relaxes (known as 'diastole'). The reading of your blood pressure is measured in millimeters of mercury (mm Hg) and has two numbers, the systolic (upper reading) and diastolic (lower reading) pressure.
Your blood pressure may be checked on two separate visits before you are diagnosed with hypertension. Alternatively, your doctor may advise you to keep a record of your blood pressure readings taken at home using an automated monitor, or recommend an ambulatory monitor, to get a more accurate overview of your blood pressure on a daily basis. This may be done because your blood pressure can be artificially high when it is checked in a medical clinic, known as 'white coat syndrome', for a number of reasons, such as anxiety. Other factors that can increase your blood pressure and are best to avoid at least an hour before having your blood pressure checked, include caffeinated drinks (such as coffee and tea), smoking cigarettes and strenuous physical activity.
A blood pressure test.
A blood vessel carrying blood saturated with oxygen from the heart to the body's tissues.
Blood pressure readings not only help diagnose hypertension, but they can also help assess its severity.
|
| Systolic BP (mm Hg) |
| Diastolic BP (mm Hg) |
| Normal blood pressure | 100 to 119 | or | 60 to 79 |
| High-normal blood pressure | 120 to 139 | or | 80 to 89 |
| Mild hypertension | 140 to 159 | or | 90 to 99 |
| Moderate hypertension | 160 to 179 | or | 100 to 109 |
| Severe hypertension | 180 or greater | or | 110 or greater |
| Isolated systolic hypertension | 140 or greater | and | greater than 90 |
A healthy lifestyle is a good way to help control your blood pressure. This could involve a healthy diet with less salt and reduced alcohol intake, maintaining a healthy body weight and regular exercise. In addition to this, medications may also be used to lower your blood pressure. Medications are normally started in low doses and are sometimes used in combination, if recommended by your doctor. Common medications include:
Other medications that can be used to treat high blood pressure include:
Substances that hinder the activity of hormones such as adrenaline by blocking the beta receptors, found in many organs but particularly the heart and blood vessels. These are used to treat a range of conditions including high blood pressure and migraines.
Also called a calcium antagonist. A group of medications that is used to treat high blood pressure and other conditions. It works by blocking calcium from entering cells of the heart and blood vessels, which ultimately lowers blood pressure.
Potential complications associated with hypertension can include:
Resistant hypertension refers to blood pressure that is resistant to treatment. This means that your hypertension remains after taking at least three different types of medications, so you may need four or more different types of antihypertensive medications to control it.
Hypertension can lead to a stroke by causing hardening of the arteries. A stroke occurs when an artery in the brain is blocked or ruptured. This causes brain cells to be starved of oxygen and die. A stroke can sometimes be fatal.
Hypertension can also lead to a heart attack by causing hardening of the arteries. A heart attack is caused by a sudden stoppage of blood flow to your heart when a clot blocks one of your coronary arteries. If the artery is not unblocked quickly, heart muscle cells that are supplied blood from that artery will begin to die. Any damage that is done is permanent, as these cells cannot be replaced. It is a serious medical emergency. Some heart attacks are fatal, or can leave you with chronic health issues, while others see you make a full recovery after treatment.
Hypertension makes your heart work harder than it needs to. Over time, as your heart pumps blood against the higher pressure in your vessels, the heart muscle thickens. The thickened heart muscle may eventually not be able to pump enough blood to meet the requirements of your body, which can lead to heart failure.
High blood pressure for a sustained period of time can cause your blood vessels to bulge and weaken, forming an aneurysm. If an aneurysm ruptures, it may be life-threatening.
Hypertension can lead to thickened, narrowed or torn blood vessels in the eyes, resulting in vision loss.
Hypertension can lead to weakened and narrowed blood vessels in your kidneys. If this occurs, your kidneys might not work properly, leading to chronic renal failure.
Long-term complications of hypertension.
An abnormal dilatation in the wall of a blood vessel. This occurs when there is a weakness in the vessel wall. Aneurysms can be fatal if they rupture.
A blood vessel carrying blood saturated with oxygen from the heart to the body's tissues.
The fundamental unit of life; the simplest living unit that can exist, grow, and reproduce independently. The human body is composed of trillions of cells of many kinds.
An artery that supplies blood to the heart muscle.
The prognosis for hypertension is generally good if it is detected early and managed effectively. If hypertension is left untreated it can lead to many serious, yet potentially preventable, medical conditions.
A healthy lifestyle is recommended to help prevent you developing hypertension. This could involve eating healthy foods, exercising regularly, reducing stress, maintaining a healthy weight, quitting smoking and reducing your alcohol and salt intake. It is recommended that you have your blood pressure checked regularly by your doctor to ensure you do not have hypertension.