Tuesday, December 18, 2012


High blood pressure (BP) or hypertension is a medical condition in which the blood pressure is chronically elevated. Hypertension is the most important modifiable risk factor for coronary heart disease (CHD), stroke, congestive heart failure (CHF), end-stage renal disease and peripheral vascular disease.
Worldwide, hypertension is seen in about 1 billion people and the prevalence has been estimated to increase by more than 29% by the year 2025. This condition is associated with increased obesity and aging population. Due to the associated morbidity, mortality and economical burden to the society, hypertension remains as a significant public health challenge.
 Classification of high blood pressure 
Hypertension is classified as
  • Primary hypertension and
  • Secondary hypertension.
Primary or essential hypertension which accounts for more than 90% of cases of hypertension is diagnosed in the absence of an identifiable secondary cause.It is more common in adolescents and adults, and has multiple risk factors. Secondary hypertension indicates that the high Blood pressure is a consequence of another condition such as a kidney disease or adrenal disease.
Symptoms of high blood pressure
Although patients with isolated hypertension are usually asymptomatic, occasionally they have symptoms such as
  • Headache (especially pulsating headaches behind the eyes that occur early in the morning)
  • Blurred vision
  • Facial flushing or tinnitus (ringing sound in the ears)
 Causes of high blood pressure
The following are the causes of hypertension as follows
-Increased sympathetic nervous system activity.
-Increased production of sodium-retaining hormones and vasoconstrictors.
-Deficiencies of vasodilators such as prostacyclin and nitric oxide.
-Inappropriate or increased renin secretion, resulting in increased production of angiotensin II and aldosterone.
-Genetic predisposition.
-Chronic kidney disease
-Renovascular disease
-Cushing’s syndrome (hypersecretion of the hormone cortisol)
-Pheochromocytoma (adrenal tumor)
-Drugs such as nonsteroidal antiinflammatory drugs (NSAIDs) and oral contraceptives

Risk factors for high blood pressure
The risk factors associated with increase in the blood pressure include the following:
  • Long-term increased sodium intake
  • Reduced dietary potassium, calcium and magnesium
  • Diabetes mellitus and insulin resistance
  • Excessive alcohol consumption
  • Lack of physical activity
  • Obesity
  • High stress levels
·         Tobacco use is the most common cause of avoidable cardiovascular mortality worldwide  There are now 1.3 billion cigarette smokers, 82 percent in developing countries, and if current practices continue, there will be an estimated one billion tobacco-related deaths during the 21st century. The immediate noxious effects of smoking are related to sympathetic nervous over activity, which increases myocardial oxygen consumption through a rise in blood pressure, heart rate, and myocardial contractility.
·         Chronically, cigarette smoking induces arterial stiffness which may persist for a decade after smoking cessation. The incidence of hypertension is increased among those who smoke 15 or more cigarettes per day, and the coexistence of hypertension and smoking decreases left ventricular function in asymptomatic people .
·         With each cigarette, the blood pressure rises transiently and the pressor effect may be missed if the blood pressure is measured 30 minutes after the last smoke. The transient rise in blood pressure may be most prominent with the first cigarette of the day even in habitual smokers. However, habitual smokers generally have lower blood pressures than nonsmokers as observed in most, but not all , studies. The mild reduction in BP in smokers is related to decreased body weight . Support for this observation is the higher body weight and increased blood pressure among former smokers versus that observed among never-smokers . A vasodilator effect of cotinine, the major metabolite of nicotine, also may contribute to the lower blood pressure.
Pick a date to stop smoking and then stick to it.
Write down your reasons for quitting. Read over the list every day, before and after you quit. Here are some other tips:
  • Write down when you smoke, why you smoke, and what you are doing when you smoke. You will learn what triggers you to smoke.
  • Stop smoking in certain situations (such as during your work break or after dinner) before actually quitting.
  • Make a list of activities you can do instead of smoking. Be ready to do something else when you want to smoke.
  • Ask your doctor about using nicotine gum or patches. Some people find these aids helpful.
  • Talk to your physician who may recommend medications to help combat nicotine craving and also help with information on using nicotine substitutes, such as a patch or gum.

                                     EDUCATE OTHERS

No comments:

Post a Comment