Complications of Hypertension

Topic Highlights

● Blood pressure is the force of blood pushing against the walls of the blood vessels.

● Blood pressure persistently above 140/90 mmHg is termed as hypertension.

● Hypertension is recognized as a 'silent killer' and is a leading cause of morbidity and mortality.

● It affects different organs of the body, leading to a variety of complications.

● This presentation focuses on the complications of increased blood pressure, a discussion of its definition, and how to measure and diagnose blood pressure.

● It also explains how blood pressure can be controlled through lifestyle modifications and medications.

Transcript

Hypertension or high blood pressure is a common condition that can damage important organs of the body and lead to death, if left untreated. Hypertension produces symptoms only in the advanced stages and often is not given serious attention. In spite of medical and scientific progress in understanding and eradicating many diseases conditions like hypertension still continue to be a major health concern.

Blood pressure (BP) is the pressure created in the blood vessels, particularly the arteries, by the blood pushing against the walls of the vessels. Blood pressure is measured in terms of millimeters of mercury (mmHg). It has two values, systolic and diastolic pressure. The optimal recommended systolic pressure is less than or equal to 120 mmHg and the diastolic pressure is less than or equal to 80 mmHg. It is expressed as 120/80 (120 over 80).

The body maintains the blood pressure at a constant level through a complex system of controls like the sympathetic nervous system and the renin'angiotensin aldosterone system (RAAS). Any disturbance in these control mechanisms result in a rise or fall of blood pressure.

Blood pressure varies during the course of the day. It is usually high in the morning due to physical activities, and lower in the evening. Blood pressure is also low during the early morning hours and at rest. Blood pressure also fluctuates due to some normal physiological conditions like fear, anxiety and excitement.

If the blood pressure remains constantly over 140/90 mmHg, it is diagnosed as hypertension. When the blood pressure reading is higher than 120/80 mmHg on at least three visits to the doctor, the patient may be recommended for blood and urine examination, ECG and an X-ray of the chest to rule out other conditions that can bring about an elevation in blood pressure.

Normally, hypertension does not produce any symptoms and hence is called a 'silent killer.' The commonly observed symptoms include generalized headache, dizziness, or bleeding from the nose. Other symptoms exhibited include weakness, tiredness, increased urination, cramps, palpitation, and irregular heartbeats. Most of the time, hypertension is discovered in an individual during a routine follow-up or while being treated for other ailments.

Hypertension affects many organs chiefly due to damage of blood vessels and muscles as a result of increased pressure, which overtime can be life-threatening.

A commonly arising complication of high BP in the heart is atherosclerosis, a condition in which blood vessels are blocked by high cholestrol deposits thereby reducing or completely stopping the blood flow through them.

High blood pressure makes the heart work harder than normal, increasing the risk of injury to the heart and arteries. A heart forced to work harder for a long perod time tends to weaken or enlarge, leading to congestive heart failure. Overtime, an outward bulge may develop in the heart, causing aneurysm.

Hypertension can also cause a reduced blood flow to the brain or a bleeding of the blood vessels. These conditions lead to stroke. Reduced blood flow also results in a reduced supply of oxygen and nutrients to the brain, where it is possible for bleeding to lead to the compression of the brain, causing nervous abnormalities or even death. The degree of damage depends on where and how much blood flow to the brain is affected.

Hypertension is a major cause of kidney disease and kidney failure. Increased pressure damages the blood vessels and filters in the kidneys, affecting waste removal from the body. Glomerulonephritis, inflammation of the filtering portion of the kidney, is another commonly observed complication.

Hypertension affects the retina, which is the light capturing portion of the eye, resulting in hypertensive retinopathy. As the disease progresses it impairs vision. In severe cases, the optic nerves or macula may be permanently damaged, leading to near total or complete blindness.

Men with hypertension are more prone to sexual dysfunction, for example erectile dysfunction. Hypertension is also known to affect the bones. Calcium excretion in urine increases due to high blood pressure, leading to a loss of bone mineral density and increasing the risk for fractures, particularly in elderly women. In severe cases, the diastolic pressure (i.e., the lower number) exceeds 140 mmHg and is termed as malignant hypertension. This condition requires immediate hospitalization and care to reduce BP, and prevent brain hemorrhage.

A patient with hypertension is advised to make changes in diet and lifestyle as a first step to control blood pressure. People with obesity should lose weight and maintain a reduced salt and fat diet. Moderate daily exercise is recommended. Those with hypertension should also reduce alcohol consumption and quit smoking. They should also learn to manage stress levels and take prescribed medications on time.