Hypertension - the “blood pressure” problem

1. Hypertension - the “blood pressure” problem After having seen thousands of patients in clinical practice we can say that there is a lot of confusion regarding hypertension (high blood pressure). We would attempt to simplify the subject and provide some guidance on the common queries.

2. Why monitor Blood Pressure? Second, only to smoking (which results in high blood pressure), hypertension is a leading cause of heart disease (heart attack) and stroke (paralysis). In the modern world, hypertension is among the leading causes of suffering, illness, and death. It is often designated a “silent killer” as it does not produce symptoms and often goes undetected. This fact makes the monitoring of blood pressure a critical step in health management. Regular BP monitoring may help detect heart and kidney issues early and reduce the incidence and severity of strokes.

3. How do we define hypertension? In 2017, the American Heart Association made some changes to the definition of hypertension. Currently, normal BP is defined as being less than 120/80. Note: A high reading in either of the numbers is enough to diagnose. Blood pressure should be taken with the correct techniques and an average of at least two readings must be taken. Hypertension (Stage I) is defined as a BP of more than 130/80 Hypertension (Stage II) is defined as BP more than 140/90

4. Who is at risk? Advancing age (after 40yrs), male sex, and family history of hypertension are essential non-modifiable risk factors. These may not be changed but do serve to make the individual more vigilant regarding their BP control. Other causes that can and should be addressed proactively are called modifiable risk factors: Lifestyle choices - Poor diet (high carb, low fiber, high sodium, sweets and soft drinks, processed food, fast food), lack of physical activity, excessive alcohol consumption & smoking.

5. Stress - Chronic stress, poor sleep habits, poor family support, demanding professional life, anxiety & burnout. Chronic conditions - Obesity, diabetes, thyroid problems, poor cholesterol profile, psychiatric illnesses, and addictions, and some medications. What to do if you have Hypertension? It is important for the individual to understand these risk factors and start addressing them as soon as possible. It is necessary to integrate healthy practices such as exercise, yoga, weight control, taking breaks and vacations, and stress & time management into your life. A “health comes first” approach to life may be adopted.

6. Hypertension Stage I (BP more than 130/80) - This requires the individual to be cautious and monitor their BP regularly. There should be a thorough evaluation of the risk factors mentioned above. If multiple risk factors are present or any other condition is found along then a consultation may be warranted. Your doctor may also advise some laboratory investigations. Medications specifically for Blood Pressure are generally not recommended but the presence of diabetes, a poor cholesterol profile, presence of strong family history may influence the decision. Other conditions may also be investigated and addressed appropriately. Lifestyle modifications are vital, stress should be managed and sleep quality has to be improved. In many cases, a psychiatric evaluation is also considered if anxiety, depression, or sleep issues are impairing the quality of life of the individual. Hypertension (Stage II) (BP more than 140/90) - This requires all the above-mentioned approaches along with an active treatment specifically targeted at reducing BP. Your doctor may prescribe a set of lab investigations and may also advise for a detailed cardiac checkup including ECG, TMT & Holter Monitoring. Medications are advised in most cases for BP control and even for associated conditions such as diabetes, thyroid problems & cholesterol control. Your doctor may also advise intensive BP monitoring twice or thrice a day (at home or at the Hospital) for a week or two to adjust the medications as per need. Associated conditions must be proactively investigated and treated. Thus, it may require the individual to consult different specialists to find the right combination of treatments.

7. Conclusion Managing hypertension requires a collaborative approach involving different specialists and individual commitment to a healthier lifestyle. By addressing risk factors, monitoring blood pressure, and following medical guidance, individuals can take control of their health and reduce the risks associated with hypertension. Remember, early detection, timely interventions, and consistent efforts towards a healthy lifestyle can make a significant difference in managing hypertension and promoting overall well-being.