Hypertension and Complications

Hypertension (HTN ) which is also referred to as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated.

It is a serious medical condition that significantly increases the risks of heart, brain, kidney, and other diseases.

An estimated 1.4 billion people worldwide have hypertension, most (two-thirds) living in low- and middle-income countries.

Fewer than 1 in 5 people with hypertension have the problem under control.

Hypertension is a major cause of premature death worldwide.

Classification of Hypertension

According to the American Heart Association, blood pressure can be classified as

  • Normal less than <120/<80mmHg
  • Prehypertension 120 -129/<80mmHg
  • Stage 1 hypertension 130 – 139/80 – 89mmHg
  • Stage 2 hypertension 140 or higher/90 or higher
  • Stage 3 hypertension – >180 and/or >120mmHg

Risk factors for hypertension

Modifiable risk factors
  1. Unhealthy diets
  • excessive salt consumption
  • a diet high in saturated fat and trans fats
  • low intake of fruits and vegetables
  1. Physical inactivity
  2. Consumption of tobacco and alcohol
  3. Being overweight or obese.
    Non-modifiable risk factors
  • family history of hypertension
  • Age over 65 years
  • Co-existing diseases such as diabetes or kidney disease.

What are the common symptoms of hypertension?

Hypertension is described as a “silent killer”.

Most people with hypertension are unaware of the problem because it may have no warning signs or symptoms. For this reason, it is essential that blood pressure is measured regularly.

When symptoms do occur, they can include

  • early morning headaches
  • nosebleeds
  • irregular heart rhythms
  • visual disturbances
  • buzzing in the ears.

Severe hypertension can cause

  • fatigue
  • nausea
  • vomiting
  • confusion
  • anxiety
  • chest pain
  • muscle tremors

Complications of uncontrolled hypertension

Among other complications, hypertension can cause serious damage to the heart.

Excessive pressure can harden arteries, decreasing the flow of blood and oxygen to the heart. This elevated pressure and reduced blood flow can cause:

  • Chest pain also called angina.
  • Heart attack, which occurs when the blood supply to the heart is blocked and heart muscle cells die from lack of oxygen. The longer the blood flow is blocked, the greater the damage to the heart.
  • Heart failure, which occurs when the heart cannot pump enough blood and oxygen to other vital body organs.
  • Irregular heartbeat which can lead to sudden death.

Other complications include;

  • Stroke
  • Bone loss
  • Visual loss/disturbances
  • Kidney damage leading to kidney failure.
  • Sexual problems
  • Increases chances of developing diabetes
  • Increases risk of dementia and consequent cognitive decline

Management of hypertension

Because hypertension is most times without symptoms, its findings are usually incidental when some other disease condition brings one to the hospital or during medical screening.

Persistently elevated blood pressure measured about 4 hours apart or more confirms the diagnosis of hypertension.

Treatment

It is treated with antihypertensive and lifestyle modification

The use of antihypertensive either as a monotherapy or with drug combinations will depend on the blood pressure and response to treatment. Some people will do well with monotherapy and lifestyle modification while others will require a combination of 2 or more antihypertensives

Reducing the burden of hypertension

Well-controlled blood pressure helps in the prevention of heart attack, stroke, kidney damage, and other complications as mentioned above. Adapting to the below listed preventive measures is very paramount to risk reduction

Prevention

  • Reducing salt intake (to less than 5g daily)
  • Eating more fruit and vegetables
  • Being physically active on a regular basis
  • Avoiding the use of tobacco
  • Reducing alcohol consumption
  • Limiting the intake of foods high in saturated fats
  • Eliminating/reducing trans fats in the diet

Other preventive measures

  • Reducing and managing mental stress
  • Regularly checking blood pressure
  • Treating high blood pressure
  • Managing other medical conditions

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