An overview of Hypertension & it's Prevention:
Dr. Sagardeep Datta
November 22, 2021, 11:06:35
Hypertension is a common medical disorder across the
world which has been growing in intensity with
changing life-styles, evolution of individual and collective world view,
fast changing moral value system and also perhaps rapid changes in climate.
Needless to say that Hyper tension is virtually a universal problem that
creates a host of complications in human health leading to critical diseases
including life-threatening ones . But how this problem is created and how this
should be handled is the hottest topic in any discussion over health and well
being. But the issue has to be seen
with a holistic approach, delving deep into roots and dwelling at
length on the ramifications. The
following article is a modest attempt at this :
Before going to topic proper, let us understand the basics of the Circulatory system. This system deals with the transport of blood and thus various
nutrients and oxygen to every nooks and corner of body .Blood is the red
coloured fluid flowing through heart and blood vessels. Blood is rightly
referred to as liquid Connective tissue.
Blood is composed of two main constituents-Plasma, which is the liquid part of
blood and Cellular elements- Red Blood Cell (RBC), White Blood Cell (WBC),
Platelets. The total Blood volume is 5-6
litres. Blood flows through minute channels or tubes called Blood Vessels-Arteries, Veins,
Pressure or Arterial Blood Pressure (BP) is the lateral (side)
pressure exerted by the flowing column of blood on the wall of arteries. Blood
Pressure (BP) is measured by Sphygmomanometer. Quite often you must have
noticed that while measuring BP, the doctor puts on record two values-the upper
value is called Systolic
Blood Pressure (SBP) which is the maximum pressure generated in the
arteries during Systole (a state of contraction of heart wherein heart pumps
blood to all organs of body) and the lower
value is called Diastolic Blood Pressure(DBP) which is the minimum pressure generated in the
arteries during Diastole(a state of relaxation of heart wherein heart receives
There are many physiological factors which
Age: As age
increases both SBP and DBP increase. With ageing there is thickening of
arteries ( a process called Arteriosclerosis) and there is increase in both SBP
Gender: BP is
higher in men than women at similar ages. After menopause, SBP in women becomes
more than men of same age.
Body Built: It has
been seen in some studies that BP is more in obese persons than lean persons.
Emotions: Excitement, fear, worry increase SBP.
increases by 5-6 mm Hg upto 1 hr after meals.DBP remains same or decreases
falls by 15-30 mm Hg during early hours of sleep. But disturbed sleep causes
increase in SBP.
Diurnal variation: In a
single day, a 5-10 mm Hg variation of SBP is common .Peak values of SBP
recorded during afternoon and lowest values during early hours of morning.
Exercise: After exercise, there is increase in SBP but
the DBP may remain unchanged or slightly decrease after moderate exercise.
Now understanding the definition of Hypertension, we will follow the
Less than 120 mm Hg &
Less than 80 mm Hg
120-129 mm Hg &
Less than 80 mm Hg
130-139 mm Hg or
80-89 mm Hg
More than or equal to 140 mm
More than or equal to 90 mm
While recording BP, two readings
should be taken 5 mins or 30
mins apart and then again next day or 1 week apart. Therefore, two or more than two BP readings
on two or more than two occasions is a must.
Hypertension is a disorder with multiple
genetic and environmental contributions. The most common cause of Hypertension
or Primary Hypertension (90-95%) which means that there is no identifiable
cause of Hypertension. Secondary
Hypertension is the other entity which means Hypertension in the
presence of an identifiable cause such as-
diseases( Chronic Kidney Disease, Acute glomerulonephritis)
causes(Thyroid disturbances- Hyper/Hypothyroid)
intake of steroids, Birth control pills and certain drugs.
can also cause Hypertension.
stress including surgery.
( tumour of Adrenal gland).
ovarian disease in females
laden with cyst).
Coarctation of aorta
(Narrowing of aorta, usually congenital).
Yet another entity is Malignant Hypertension characterised
by severe hypertension with SBP ≥200 mm Hg and DBP ≥120 mm Hg with organ
Risk factors of Hypertension:
Ø Obesity: Greater the weight gain, greater is the risk
of High BP.
Ø Salt intake: High salt intake (7-8
gm/day) increases BP proportionately.
Ø Excess intake of saturated
Ø Excess alcohol consumption:
Ø Sedentary lifestyle:
Studies reveal consistently high BP in black communities than other ethnic
Familial tendencies of Hypotension (Low BP) or Hypertension with SBP are
Effects of Uncontrolled
Hypertension/Untreated Hypertension on various organs:
Ø Heart: Risk of Heart failure ( Heart is unable to pump blood)
Risk of stroke,
Risk of Renal/Kidney
failure increases.(kidney is unable to clear waste products)
Ø Eyes: There is also eye damage (Retina, inner layer
of eye is damaged: Hypertensive retinopathy).
constellation of Hypertension, Obesity, Insulin Resistance
(Insulin which maintains normal blood glucose level is unable to work), Dyslipidemia ( Altered fat levels in body leading
to increased cholesterol level) is called Metabolic Syndrome, which is the modern
Hypertension remains asymptomatic and
undiagnosed for many years so it should be diagnosed at the earliest to prevent
complications subsequently. For this purpose, proper medical care is essential.
Consult with a health care professional at the earliest. Routine BP monitoring is
essential. With the advances in biomedical research, we have plentiful drugs
for managing Hypertension which should be taken religiously if prescribed by a
health care professional.
the emergence of risk factors, the following measures should be adopted:
Ø Weight Reduction is the first and foremost step. Attain and
maintain BMI (Body Mass Index: Weight in Kg÷ Height in meter²):18.5
Ø Dietary salt reduction: To
less than 6 g salt(sodium chloride) per day
Ø DASH diet: Dietary
approaches to stop Hypertension. Consume a diet rich in fruits (≥75 gm), green
leafy vegetables (≥300 gm) and low fat dairy products with a reduced
content of saturated fat and total fat.
Ø According to WHO, the total Fat intake should
be less than 30% per day incase of adult. Saturated fat
should be less than 10% per day. Most
animal fats are saturated. Saturated fat is present in processed foods like
sausages, ice cream, cheese, butter.
intake should be less than 50 gm per day.
Remember excess carbohydrate in the body gets converted to fat.
Ø Intake of PUFA (Poly unsaturated Fatty Acids) should be encouraged in therapeutic
doses. PUFA are seen in vegetable oils like sunflower oil & fish oils.
Omega (ῳ) 3 fatty
acid like linolenic acid (sources include marine fish oil) is also a type of
PUFA and their consumption has shown cardio protection in many studies. However
don’t self medicate. Seeking expert
opinion is of paramount importance.
Ø Protein should account for approximately 10-15% of daily intake. Normal protein requirement
a healthy adult.
Ø Plant derived fiber reduces blood level of cholesterol.
So intake of dietary fiber should be considered. Onion and garlic also reduce
blood cholesterol and triglyceride.
Ø Refrain from smoking at all
cost. Smoking increases the level of LDL (Bad
Ø Avoid Junk foods. They contain Trans
Fatty Acid which has many deleterious effect on heart.
Ø Antioxidants like vitamin E and selenium prevent fat deposition in liver and can be
considered after proper consultation.
Ø Alcohol in moderate quantity can increase HDL
(Good cholesterol) and can dilate blood vessels. For males ≤2 drinks per day. For
females ≤1 drink per day.(1 drink=15 gm ethanol)
Ø Don't take exogenous steroids to enhance muscle mass and
birth control pills without proper consultation with a doctor.
Ø Regular aerobic exercise e.g.
Brisk walking for atleast
30 mins per day is the most effective intervention.
Ø Ensure adequate intake of water. A simple way to remember is 8 glasses of water per day or 2-3 litres of water per day on an average.
Ø A proper 7-8 hrs of sleep
is of utmost importance.
Ø Regular checkup of BP and if needed Lipid profiles.
Ø Regular visit to health care professional.
Ø Compliance to drugs should be ensured if the patient
is on antihypertensives. Don’t stop antihypertensives without consulting a
Ø Don't selfmedicate at any time.
some mind relaxing exercise such as Meditation or Breathing exercise will help
you in keeping a positive mindset.
the Body, Mind & Intellect are our assets. In this era, where there is
competition in all spheres of life, taking care of your body and mind is of
paramount importance inorder to sustain yourself.
Take the first step
towards your health care & you will see the result.