High blood pressure (Hypertension) is a common problem, particularly as people get older. Getting yourself and your loved ones diagnosed and treated early is an important part of preventing long term problems.
What is normal?
Our body cells need oxygen to function. We breathe oxygen into our lungs. Blood that goes to the lungs absorbs the oxygen. We then need to get this oxygenated blood to the rest of the body. To do this we have an excellent pump (the heart) that pushes blood down the body’s highways (the blood vessels).
The heart has a cycle. First, it relaxes and allows blood from the lungs to fill it: this is called diastole. It then contracts and pushes blood into the blood vessels, increasing their pressure: this is called systole. Everybody has a blood pressure (BP) reading. A BP is expressed as a fraction with two values i.e. the systolic value/ the diastolic value. The systolic value represents the pressure in the blood vessels when the heart is pumping blood into them, it is the higher value. The diastolic value represents the intrinsic pressure in the blood vessel while the heart is relaxed. BP is measured in the unit mmHg.
The ideal BP is 120/80 mmHg. This is a systolic BP of 120mmHg and a diastolic pressure of 80mmHg.
What is hypertension?
Hypertension is when the blood pressure in your blood vessels is too high. There is fluctuation in BPs in people around the ideal blood pressure, this is normal. Doctors diagnose hypertension when:
• your systolic BP is 140mmHg or higher
• your diastolic BP is over 90mmHg or higher
• both your systolic and diastolic BP are too high.
Hypertension can then be separated into three main categories:
1. Primary: this is the most common type. It does not have a known underlying cause. This is not curable and requires long term solutions to control the high BP.
2. Secondary: this is far less common (2% to 10% of all hypertension cases). There is a very specific problem in the body that causes this and it is often curable.
3. Gestational: this is Hypertension that occurs when one is pregnant.
Having an elevated BP is a problem. We are going to look at the problems in three categories:
Immediate problems: Hypertension often does not have any symptoms. This is what makes it so dangerous. It is important for everyone to get their BP checked regularly to ensure that they do not have hypertension.
Later problems: These can include vision loss, kidney damage, erectile dysfunction, fluid build up in the lungs causing shortness of breath, memory loss (vascular dementia), heart attacks, strokes and heart failure
Urgent problems: When you do have symptoms, it generally means that the BP has increased very quickly and to very high levels. This is always an emergency and it is really important to go to the hospital as quickly as you can. These symptoms include severe headache, severe anxiety and shortness of breath.
There are two ways to tackle Hypertension:
• If you are overweight, try and lose some weight. Body Mass Index is a measurement of whether you are at a healthy weight for your height. It is calculated using the formula weight in kg divided by height in metres squared (weight (kg)/ height (m2)
• Regular aerobic physical exercise is important. The ideal amount is 150 minutes per week. This means 30 minutes a day for 5 days.
• It is important to stop smoking.
• Salt holds onto water. If you have excess salt in your body, your body will hold onto more water; thus increasing the blood volume and therefore blood pressure. Try and restrict the amount of salt that you consume.
There are lots of medication options. Often, your doctor will choose a medicine based on how well it works for you, the side effects you are experiencing and any other health problems you may have. This is how the commonly used medicines work:
• Diuretics: These cause the kidneys to excrete more salt and water. This decreases the amount of blood in the body and therefore decreases the blood pressure.
• ACE (Angiotensin-converting enzyme) inhibitors: These block the work of the ACE enzyme. This prevents the production of Angiotensin 2. Normally, Angiotensin 2 causes blood vessels to narrow. By decreasing angiotensin 2, blood vessels are wider, thus decreasing blood pressure
• Angiotensin 2 receptor blockers: These are similar to ACE inhibitors. While these allow Angiotensin 2 to be produced, they stop it from activating the blood vessels to narrow by blocking its receptors. This results in wider blood vessels and decreased blood pressure
• Calcium channel blockers: Muscles need calcium to contract. These decrease the amount of calcium in the heart and the blood vessels. This means that the heart contracts less forcefully and slower. The blood vessel muscle cells contract less and the blood vessels dilate. Overall, there is less pressure in the heart and blood vessels
• Beta Blockers: These decrease the force and speed of heart contraction. This decreases blood pressure.
Hypertension is easily controllable. Let us work together to help protect your heart and its highways. While it may not affect your daily life now, looking after your body is an investment into your future and a way of honoring the body that Allah has blessed you with.
Dear Sister, you are worth it!
Hafiza Husna Moola is a medical student at UCT. Her passion is the marriage of religion and health. She firmly believes that understanding is power. Her column aims to provide insight into common medical conditions and create empowered individuals. When not studying, Husna enjoys baking, haunting bookstores and the great outdoors.