What is hypertension?

The term hypertension refers to a state where a person's blood pressure remains at an elevated level at all times. This condition is formally known as arterial hypertension and is popularly called high blood pressure.

There are two types of hypertension - essential (or primary) and secondary. When a patient's chronically elevated blood pressure does not have a specific medical cause that can be identified, it is referred to a essential hypertension. When high blood pressure is caused by other health conditions like tumors of the adrenal gland, kidney disease of other problems, it is called secondary hypertension.

Hypertension is a dangerous condition because it can lead to serious complications. Chronically elevated blood pressure increases the risk of developing heart failure, heart attacks, arterial aneurysm and strokes. Many cases of chronic renal failure have been linked to high blood pressure.

Heightened blood pressure can lead to reduced life expectancy, even if the pressure is only moderately above normal. When the arterial pressures are fifty percent or more above the average levels, it can reduce life expectancy to just a few years. In such cases, the patient can expect to live for long only if he or she is given appropriate treatment.

How is hypertension defined? A person is considered to have hypertension if his systolic blood pressure level is consistently at 140 mmHg or higher and/or his diastolic pressure is always 90 mmHg or more. This is usually represented as 140/90 mmHg.

According to the Mayo Clinic, normal blood pressure is defined as below 120/80 mmHg. They also indicate that the ideal level should be around 115/75 mmHg. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure states that the blood pressure range from 120/80 mmHg to 139/89 mmHg should be considered to as pre-hypertension. This is not hypertension per se, but individuals whose blood pressure reading is in this range should be considered to be at a higher risk of developing hypertension compared to the general population.

Research indicates that patients who have kidney disease or diabetes should be considered to have hypertension if their blood pressure is above 130/80 mmHg.

High blood pressure usually does not show any symptoms. It is often detected only when the patient undergoes a routine medical checkup or has a blood pressure reading taken because of the presence of other diseases. A blood pressure test is the only means of detecting hypertension.

A minority of patients with hypertension complain of dizziness, facial flushing, vision problems or headaches. Some patients may also suffer end-organ damage as a result of hypertension. Patients with accelerated hypertension (also known as malignant hypertension), which is often a late stage in the condition, often complain of the above symptoms. Other symptoms of advanced cases of elevated blood pressure include nausea, vomiting, confusion, lethargy, etc.

It should be remembered that conditions like anxiety or stress are not in themselves causes of high blood pressure, although they can make the condition worse.

It is estimated that about 10% of pregnant women develop hypertension associated with pregnancy. In most cases, it does not cause any serious problems. In some women, however, it can lead to pre-eclampsia, eclampsia or HELLP syndrome - three conditions that develop during pregnancy.

Hypertension is controlled using many different kinds of medication, which are collectively called antihypertensives. Using drugs to bring the condition under control is important because it is estimated that reducing blood pressure by about 6 mmHg will slash the risk of heart disease by up to 20% and the risk of strokes by a full 40%. It also reduces the risks of developing heart failure and other serious conditions.

Along with medication, the doctor will often prescribe lifestyle changes. This can include weight reduction through aerobic exercise, reduction in salt intake (to cut down on sodium), avoiding alcohol and tobacco completely and relaxation therapy such as meditation or yoga.

The right combination of medication and lifestyle modifications will control hypertension in most patients.

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