Hypertension, also known as high blood pressure, is a condition in which the force of blood against the walls of the arteries is consistently too high. This can damage the blood vessels and lead to an increased risk of heart disease, stroke, and other health problems. Hypertension is a silent killer because in many cases, it may not show symptoms. Hypertension is typically diagnosed through regular blood pressure screenings and can be treated with lifestyle changes, medication, and/or other medical interventions.

What causes high blood pressure?

Hypertension, or high blood pressure, can be caused by a variety of factors including genetics, obesity, smoking, excessive alcohol consumption, stress, and an unhealthy diet high in salt and low in potassium. It can also be a side effect of certain medications or a symptom of underlying medical conditions such as kidney disease or sleep apnea.

Why is high blood pressure dangerous?

Hypertension, or high blood pressure, is dangerous because it can lead to serious health problems such as heart disease, stroke, and kidney disease.

When blood pressure is consistently high, it puts extra stress on the blood vessels and organs, including the heart. Over time, this can cause the blood vessels to become damaged and narrowed, increasing the risk for heart attack and stroke. Hypertension can also cause the heart to enlarge, making it less efficient, and can lead to heart failure.

High blood pressure can also damage the kidneys, which are responsible for filtering waste products from the blood. If the kidneys become damaged, they may not function properly, leading to kidney failure.

In addition, hypertension can also cause damage to the eyes, leading to vision loss, and can increase the risk of developing dementia.

It’s important to have hypertension diagnosed and treated early to avoid these potential health complications.

Types of Hypertension

There are two main types of hypertension: primary (essential) hypertension and secondary hypertension

• Primary hypertension – is the most common type of hypertension and is caused by a variety of factors including genetics, obesity, smoking, excessive alcohol consumption, stress, and an unhealthy diet high in salt and low in potassium. It develops gradually over time and typically has no identifiable cause.
• Secondary hypertension – is not very common and is mostly a result of certain medical conditions or due to some medications. Some examples of underlying medical conditions that can cause secondary hypertension include kidney disease, sleep apnea, and adrenal gland tumors. Medications that can cause secondary hypertension include birth control pills, decongestants, and non-steroidal anti-inflammatory drugs (NSAIDs).

Blood Pressure Medications

There are several classes of antihypertensive medications available. These include:

1. Diuretics: Also known as “water pills,” diuretics help to lower blood pressure by removing excess salt and water from the body. Example – furosemide (Lasix), hydrochlorothiazide (Microzide)
2. ACE inhibitors: These medications work by blocking the action of a chemical called ACE, which helps to reduce the fluid retention, relax the blood vessels and lower blood pressure. Examples – captopril (Capoten), lisinopril (Prinivil, Zestril). Note, they end with ‘pril’
3. ARBs: ARBs block the action of a different chemical called angiotensin II, which also helps to relax the blood vessels and lower blood pressure by reducing fluid retention and blood volume. Example – losartan (Cozaar), valsartan (Diovan). Note they end with ‘sartan’
4. Beta-blockers: These medications work by slowing the heart rate and relaxing the blood vessels, which in turn lowers blood pressure. Examples – atenolol (Tenormin), metoprolol (Lopressor). Note they end with ‘lol’
5. Calcium channel blockers: These medications help to relax the blood vessels and lower blood pressure by blocking the movement of calcium into the cells of the heart and blood vessels. Examples – amlodipine (Norvasc), diltiazem (Cardizem). Note they mostly end with ‘dipine’
6. Alpha-blockers: These medications work by reducing the activity of sympathetic nervous system, relaxing the muscles in the walls of blood vessels, which leads to the dilation of blood vessels and a decrease in blood pressure. Example – doxazosin (Cardura), prazosin (Minipress). Note, they end with ‘zosin’
7. Aldosterone antagonists: These medications help to lower blood pressure by blocking the action of a hormone called aldosterone, which helps to regulate salt and water balance in the body. Examples – eplerenone (Inspra), spironolactone (Aldactone)
8. Renin-inhibitors: These medications work by inhibiting the action of the enzyme renin, which is involved in the regulation of blood pressure. Example – Aliskiren (Tekturna)
9. Vasodilators: There are a class of medications that help to widen or dilate blood vessels, which leads to a decrease in blood pressure. They work by relaxing the smooth muscle cells in the walls of blood vessels, which allows blood to flow more easily and with less resistance. Some examples of vasodilators include Minoxidil, Nitric oxide donors, Hydralazine

Source: American Heart Association

These medications are often prescribed in combination to achieve optimal blood pressure control. It’s important to note that not all medications work for all patients, so your doctor will work with you to determine the best treatment plan for you

Lifestyle Changes – Diet and Exercise tips for reducing blood pressure

Lifestyle changes can be very effective in controlling hypertension and reducing the risk of related health problems. If done in the right manner, it can even help you in reducing the medications. Any such change in medications, if required, is to be assessed and be advised by your doctor only. DO NOT self-medicate or change the medicine dosages by yourself. Here are some lifestyle changes that may help you achieve that goal

1. Reduce Sodium: Most of us, in our usual diet, are consuming nearly 3 gms of sodium per day – double the recommended levels. Reduce the sodium intake to below 1.5 grams per day and you may notice a 3 – 5 mm Hg reduction in blood pressure readings
2. Include Potassium: The more potassium you eat, the more sodium you lose through urine! the average potassium intake is 1.7 grams a day in a normal Indian diet, while the recommendation is 4.5 to 4.7 grams a day. Increase your potassium intake to 3.5 – 4.5 grams a day and you may notice another 4 – 5 mm Hg reduction in blood pressure. Raisins, banana, beans, lentils, avocados etc are all rich in potassium
3. Magnesium Intake – Include food rich in magnesium as it can help bring down blood pressure. Pumpkin seeds, almonds, spinach etc are all rich in Mg (Refer – Article)
4. Omega 3 fatty acids – Omega 3 fatty acids are anti-inflammatory and can help in reducing the cholesterol levels in the blood. It may also help in reducing blood pressure by 2-3 mm Hg, if combined with a balanced diet. (Refer – Article)
5. Eating a healthy diet: This includes eating plenty of fruits, vegetables, and whole grains, and limiting your intake of salt, saturated fats, and added sugars.
6. Maintaining a healthy weight: Being overweight or obese can increase the risk of developing hypertension. Weight loss can help regulate blood pressure by decreasing the amount of work the heart has to do to pump blood throughout the body. Remember – the higher the weight and body mass, there is more area to which the heart has to pump. Our heart hence needs to be pumping at higher pressure which leads to hypertension. Losing weight can reduce the pressure on the blood vessels and decrease the workload on the heart, ultimately leading to lower blood pressure. Additionally, weight loss can improve the overall functioning of the cardiovascular system, which can also lead to a reduction in blood pressure. If the BMI is more than 30, the risk for cardiovascular diseases is nearly double! It is estimated that, for every kg of weight loss in a healthy manner, the systolic pressure falls by nearly 1 mm Hg. Therefore by losing 10 kg of body fat, you may be able to bring down your blood pressure by 8 – 10 mm Hg. Read more here – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5038894/
7. Exercising regularly: Regular physical activity can help to lower blood pressure and improve overall heart health. For a beginner, 30 minutes of moderate-intensity exercises, 5 days a week is a good start. As you become regular with exercises, gradually increase the time to 60 mins, for 5 days a week. Regular exercises can help bring down blood pressure by 2-5 mm Hg
8. Quitting smoking: Smoking can damage the blood vessels and increase the risk of hypertension and other health problems.
9. Limiting alcohol consumption: Drinking too much alcohol can raise blood pressure and increase the risk of hypertension and other health problems. Stopping alcohol entirely may bring down the blood pressure by 2-5 mm Hg
10. Managing stress and sleep: Stress can raise blood pressure, so it’s important to find ways to manage stress in your life, such as through meditation, yoga, or other relaxation techniques. Lack of sleep is yet another reason for elevated blood pressure

Regularly checking your blood pressure at home can help you to monitor your progress and make any necessary adjustments to your lifestyle or treatment plan. It’s important to note that these lifestyle changes work best in conjunction with medication, and it’s always important to discuss them with your doctor or a healthcare professional before making any significant changes in your lifestyle.

Most of the lifestyle changes mentioned above work very much similar and parallel to the medications mentioned above. Watch the below video to know more

DASH diet to reduce BP

The DASH diet is a dietary pattern that stands for “Dietary Approaches to Stop Hypertension.” It is a diet that is rich in fruits, vegetables, whole grains, and low-fat dairy products and is low in saturated and total fat. The DASH diet also includes moderate amounts of lean meats, fish, poultry, and nuts, and is low in sugar-sweetened foods and beverages, red meats, and added fats. The diet is designed to lower blood pressure and improve heart health by emphasizing the consumption of nutrient-dense foods that are high in potassium, magnesium, calcium, and fibre, and low in sodium. The DASH diet is also a low-sodium diet and has been shown to reduce the risk of heart disease, stroke, and other health problems.

Hypertension – Difference between BP medicine and lifestyle intervention

Also Read: Cholesterol – LDL Vs HDL

Sodium – The villain

Doctors advise patients with high blood pressure to keep their salt intake minimal. The real villain here is the sodium in the salt. Sodium is an essential mineral that helps to regulate the balance of fluids in the body, including the amount of fluid in the blood vessels. When there is too much sodium in the diet, it can lead to an increase in blood volume, which in turn can cause an increase in blood pressure. It is important to note that, sodium comes from many other foods and not just through salt.

Many processed and tinned foods and restaurant meals are high in sodium content. Here are some examples of foods that are typically high in sodium:

1. Canned soups, broths, and stews
2. Frozen dinners and pizzas
3. Deli meats, bacon, and hot dogs
4. Processed cheeses and cheese spreads
5. Salted snack foods such as crackers, chips, and popcorn
6. Pickles, olives, and relish
7. Soy sauce, barbecue sauce, and other high-sodium condiments
8. Cured or smoked fish and meats
9. Frozen breaded foods such as chicken nuggets, fish sticks, and mozzarella sticks
10. Fast food items such as burgers, fries, and chicken sandwiches

When the body absorbs too much salt, the extra water in the bloodstream causes the blood vessels to become constricted, which raises blood pressure. The harder the heart has to work to pump blood through constricted vessels, the higher the blood pressure. Over time, high blood pressure can damage the blood vessels and increase the risk of serious health problems such as heart disease, stroke, and kidney disease.

Limiting your intake of sodium can help to lower blood pressure, and it’s one of the key lifestyle changes that can be helpful in controlling hypertension. The American Heart Association recommends keeping the sodium intake below 2,300 milligrams (mg) a day (i.e 2.3 gm per day). The ideal limit will be to keep it below 1.5 gm per day if you are already hypertensive or on medications. It is worthwhile to note that one teaspoon of table salt has nearly 3 grams of sodium.

It’s important to read nutrition labels to check the sodium content of food products. A good rule of thumb is to try to choose products that have less than 140 mg of sodium per serving. Also, using herbs, spices and lemon juice can be a great way to add flavour to your food without adding much sodium.

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