Dr.Sushil Kumar Sharma
Every year 17th May is dedicated to World Hypertension Day (WHD). This is an initiative of the World Hypertension League (WHL), an umbrella organization of 85 national hypertension societies and leagues.
Hypertension is one of the leading causes of the global burden of disease. One in three adults worldwide has high blood pressure .The proportion increase with age from 1 in 10 people in their 20s and 30s to 5 in 10 people in their 50s. Approximately 7.6 million deaths (13 -15% of the Total) and 92 million disability – adjusted life worldwide were attributable to high blood pressure in 2001. Hypertension doubles the risk of cardiovascular diseases, including coronary heart disease (CHD), Congestive heart failure ( CHF), ischemic and hemorrhagic stroke, renal failure , and peripheral arterial disease. It often is associated with additional cardiovascular disease risk factors, and the risk of cardiovascular disease increases with the total burden of risk factors. Although antihypertensive therapy clearly reduces the risk of cardiovascular and renal disease, large segments of the hypertensive population are either untreated or in adequately treated.
BLOOD PRESSURE CLASSIFICATION
Blood pressure Classification
SYSTOLIC, mmhg DIASTOLIC, mmhg
Normal < 120 And < 80
Prehypertension 120 -139 Or 80 – 89
Stage 1 Hypertension 140 -159 Or 90 -99
Stage 2 hypertension > 160 Or > 100
Isolated Systolic Hypertension > 140 And < 90
Depending on methods of patient ascertainment , 80 – 95% of the hypertensives patients are diagnosed as having ” essential ” hypertension. In the remaining 5 – 20 % of hypertensives patients, a specific underlying disorder causing the elevation of blood pressure . In individuals with ” seconmdary ” hypertension , a specific mechanism for the blood pressure elevation is often more apparent.
Secondary Causes of Systolic and Diastolic Hypertension are :- Renal, Renovascular , Adrenal, Aortic Coarctation, Obstructive Sleep Apnea, Preeclampsia/eclampsia, Neurogenic , Miscellaneous endocrine and Medications.
Signs and Symptoms :-
High blood pressure is called the silent killer because it often does not produce any signs or symptoms to some patients. Patient may have headache, dizziness or epistaxis, palpitation, muscle cramps, giddiness, burning of eyes, distended neck veins, insomnia, neck pain & vertigo. But some patients have high blood pressure for years without knowing it. Sign and symptoms typically don’t occur until high blood pressure has advanced to a higher possibility of life threatening-stage.
Hazards of High Blood Pressure
Hypertensives patients have stiffer arteries, and arteriosclerotic patients may have particularly high systolic blood pressure and wide pulse pressure as a conquences of decreased vascular compliance due to structure changes in the vascular wall. Recent evidence suggests that arterial stiffness has independent predictive value of cardiovascular events.Clinically , a number of devices are available to evaluate arterial stiffness or compliance, including ultrasound and magnetic resonance imaging (MRI).
Prevention
High blood pressure is preventable and treatable. The old adage, ‘Prevention is better than cure’ is especially true for high blood pressure.
Weight Reduction : Attain and maintain BMI < 25kg/m2
Dietary salt Reduction < 6g Nacl /d
Adapt DASH – type dietary plan Diet rich in fruits , vegetables, and low – fat diary products with reduced content of saturated and total fat.
Moderated alcohol consumption For those who drink alcohol, consume < 2drinks/day in men and <1 drink/day in women
Physicial activity : Regular aerobic activity , e.g., brisk walking for 30 min/day.
The ultimate goal of World Hypertension Day observation is to give awareness of the consequences of Hypertension to the General Population, so that we can prevent, heart attack, heart failure, stroke, kidney failure, retinal haemorrhage and atherosclerosis. Hypertension though a huge burden could easily be tackled with conscious steps such as regular Bp check ups ,following the instructions given by doctor and not stoping the medicines without consulting the doctor.
(The author is HoD Cardiogoly)
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