Hypertension or high blood pressure, this particular condition is like a very smart and stealthy thief of someone’s good health. It comes silently in our body and creates a havoc in our life. To understand this condition let assume that this body of ours is like a band or orchestra, where each person is playing each organ in harmony, now just think what will happen if one instrument will be played very loudly and others will look like drowning out, which will destroy the harmony of the music. So this example roughly shows us the idea about how hypertension or high blood pressure can destroy the harmony of our life.
Imagine there is a network of highways, where goods are being transported but because of some disturbance on highways or say more vehicle will generate more traffic on road and it can cause discomfort to the society. In hypertension this is the scenario which happens, so bloodstream is our highway where blood transports oxygen to every part of our body. So the blood pressure is the pressure of force which is generated by our blood when it travels through our veins and arteries. So if this pressure rises above the normal value, we call it as hypertension.
What is Hypertension?
Hypertension or high blood pressure is very common condition but it’s one of the most misunderstood conditions too. It is currently affecting billions of people worldwide. When hypertension occurs, the pressure of the blood travelling through arteries is also elevated, which stress outs our heart and blood vessels.
Who does Hypertension affect?
So high blood pressure is not a discriminatory condition, it is affecting every one, no matter what is your age, gender or background. There are so many factors which can influence the condition like genetics, age, diet or lifestyles.
Understanding the numbers.
So when you go to consult the doctor about whether you have hypertension or not, they simple takes your arm and one cuff will be tied around your arm and will be inflated properly enough to occlude the flow of arteries. They do this via using a device called sphygmomanometer, which consists of inflatable cuff which is connected to a pressure gauge which is in simple term column of mercury. Now the cuff’s pressure is enough to cross the systolic pressure and so doctor will do auscultation above your elbow area where one artery called brachial artery is present which will present no sound because there is fully obstruction of the blood flow.
Now the doctor will decrease the amount of pressure or deflated the cuff slowly which auscultating the artery. So when the pressure is decreased where it matches the diastolic pressure the sound will also decrease. So in simple words when doctor inflates the cuff there will be one point where the sound will be generated and when he deflates the cuff slowly the sound will disappear at one point.
So the point where there is a generation of sound is called systolic pressure and the point where sound disappears called diastolic pressure.
Now when you go to consult the doctor, he will do the same procedure and tell you two numbers, the upper or top number suggests the systolic pressure which is there because of the blood pumping and heartbeat. And the lower or bottom number suggest the diastolic pressure which is there when heart takes rest between beats.
Pathophysiology
If someone has to make it very easier to understand, let’s do it by an example. Let’s imagine there is any highway which is always busy with traffic in which there are many vehicles transporting foods, goods, etc. now if this highway gets blocked or obstructed due to debris which causes traffic jams, similarly happens in hypertension.
So in here, there is a system called renin-angiotensin-aldosterone system, this system is responsible for regulate the blood volume, balance the electrolytes and systemic vascular resistance. So when there is low blood volume or pressure, renin-angiotensin-aldosterone system gets activated which produces angiotensin II which a hormone responsible for constricting the blood vessels which results in high blood pressure.
So now let’s talk about kidney because it also plays important role in hypertension, so kidney’s main function is to do filtration, because of which there is balance in electrolytes and fluids. Now if kidney gets hyperactive it may start retaining water and salt which will activate the RAAS and in the end there will be high blood pressure.
There is one other factor too, called endothelial dysfunction. So inner lining of the blood vessels is affected with inflammation and stress which results in lining destruction. Because of which there will be high resistance in blood vessels, resulting in high blood pressure.
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Causes:
The exact cause of high blood pressure is still elusive, there many factors which is responsible for the causing the condition. Still there is one major character who plays a important role which is life style choices. Additionally, if there are also some genetic factors, family history and other conditions like kidney dysfunction.
Risk:
As we have talked earlier, hypertension can affect anyone regardless of their age, gender, etc. there are some factors which have capability to increase hypertension such as overweight, family history, diabetes, high cholesterol, excessive alcohol consumption, smoking and chronic stress.
Signs and symptoms
So hypertension is called silent killer because it does not show any kind of signs or symptoms in early stages. But if there is there is elevation in blood pressure one might show signs and symptoms like headaches, chest pain, short breath, blurry vision and dizziness or lightheadedness.
Investigations
Blood pressure measurement :
Using a sphygmomanometer one can measure the blood pressure. This is the cornerstone of the diagnostic investigations.
Laboratory test:
Tests like kidney function test, cholesterol levels, lipid profiling, fasting and random blood sugar analysis, sodium, potassium, electrolyte imbalances, urine analysis and uric acid analysis helps greatly in assessing underlying conditions which may have cause hypertension.
Diagnosis:
So normally, a doctor can easily identify if there is presence of hypertension only by measuring the blood pressure.