High Blood Pressure - The Silent Killer

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What is High Blood Pressure?

High Blood Pressure, or Hypertension, is a condition where the person's blood pressure is persistently elevated beyond what is medically considered normal level. Normal blood pressure has a wide range from person to person. When taking blood pressure, there are two sets of figures noted by the physician, the systolic and the diastolic pressure, expressed in Millimeters of Mercury as systolic pressure over the diastolic pressure, like 120/80.

What is systolic and diastolic blood pressure?

The systolic pressure is the force of the flow of blood as it travels inside and through the arterial pipe, while the diastolic pressure is the force exerted by the blood against (perpendicular to) the inner wall of the artery.

What is the normal blood pressure?

A systolic pressure of 100 to 140, over a diastolic pressure of 60 to 90 are the normal sets of figures. For instance, blood pressure of 100/60 to 140/90 is the range of normal. The diastolic pressure (the second figure) is most important in determining if a person has hypertension or not. If the systolic is higher than 140 and the diastolic pressure is higher than 90 on at least three separate office visits, then the diagnosis of hypertension applies. So, a blood pressure of 130/92, taken as described above, is considered hypertension (though mild). The older the patient is, the higher the diastolic pressure, and the higher the diastolic is, the more severe the hypertension is.

How does one know if he/she has high blood pressure?

Obviously by having the blood pressure taken, preferably by an experienced nurse or a physician. Other factors and conditions in the patient will be considered by the physician before making a diagnosis of Hypertension.

Once a hypertensive always a hypertensive?

Basically, yes, once you are diagnosed to have high blood pressure, you are always a hypertensive, even if your pressure is "lowered to normal level" and well-controlled by

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medication. Once a hypertensive always a hypertensive, the reason why high blood pressure requires medication for life to maintain a normal blood pressure.

What is "White-Coat" Hypertension?

"White-Coat" Hypertension is a condition where the patient's blood pressure goes up when he/she goes to visit the doctor. Somehow the White Lab Coat of the physician taking the blood pressure seems to jack up anxiety and the adrenalin level in the waiting patient, leading to a rise in the blood pressure of this patient, but only temporarily if the patient is really not a hypertensive. And when a nurse takes the blood pressure, it is back down to normal.

What are the signs or symptoms of hypertension?

Not all persons with high blood pressure have symptoms. As a matter of fact, many of them do not have symptoms, especially the mild to moderate hypertensives. This is why it is called the "silent killer." Some simply develop a stroke or a heart attack, before learning they have hypertension. Classically, though, some of the symptoms might include headaches, feeling of "wanting to explode," being short-tempered, of being flushed; and nervousness, irritability, impatience, etc.

What is Primary and Secondary Hypertension?

Primary Hypertension, also called Essential Hypertension, is one where the cause is not known. Heredity is implicated in its etiology but there are other probable causes that medical science still does not fully understand. Todate, we still do not know what causes high blood pressure. Secondary Hypertension is high blood pressure caused by certain conditions or diseases, like bilateral kidney disease, pheochromocytoma (tumor of adrenal gland), hyperthyroidism, etc., or ingestion of contraceptives or excessive alcohol intake. The most common high blood pressure condition is the Primary or Essential Hypertension.

How common is high blood pressure?

About 20% or 50 million of the population of the United States have high blood pressure (systolic higher than 140 and diastolic higher than 90 mm. Hg). Hypertension occurs more in black than in white Americans. This writer does not have statistics on the prevalence of hypertension in the Philippines. In a northern province of Japan, inhabitants consume the highest amount of salt per capita, and the incident of hypertension in that area is the highest in the country. Since we Filipinos love to eat salty food, I would not be

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surprised if the incidence of high blood pressure in the Philippines is at least like that of the United States, about 20% of the population.

Does ingesting salty food really aggravate high blood pressure?

Yes, because when one eats salty food, water is retrained in the body, increasing the volume of total body fluids, which leads to elevation of blood pressure, especially among hypertensive persons. There is another mechanism, a chemical one, that goes into effect when the person with high blood pressure ingests salt or salty food, aggravating the high blood pressure. This is why physicians strongly recommend a low-salt diet as an essential part of the treatment strategy for patients with high blood pressure.

Are the so-called Salt Substitutes better?

Salt substitutes are Potassium, and not Sodium. It is the Sodium in the regular table salt that is harmful to hypertensives and to persons with heart disease. Potassium is medically acceptable for these patients, Potassium salt tastes a bit bitter.

Do we really need to eat salt?

No, unless the person has lost an abnormal amount of Sodium from severe diarrhea, dehydration, or other illnesses that lower the serum sodium level in the person. In these cases, sodium chloride ingestion, or even intravenous infusion of sodium chloride might be needed. There is really no need to start shaking the salt shaker, because the fruits, vegetables, fish, meat, etc. that Mother Nature has given us all contain the "perfect" amount of sodium already. Adding salt to our food, even before we even taste it, is just a bad habit that many of us have developed over the years. Indeed, it is best to be on a low-salt diet, especially as we grow older than 30.

What else is bad for a person with high blood pressure?

Smoking, lack of exercise, eating eggs and red meats (pork, beef, etc.), stress, lack of rest and relaxation, are some of the aggravating factors in a patient with hypertension.

Page Four High Blood Pressure Is hypertension curable?

No, there is no cure for high blood pressure. The only exception to this are conditions or tumors in the adrenal glands (located on top of the kidneys), where the high blood pressure ceases after surgery. The commonest high blood pressure condition---called Essential Hypertension or Primary Hypertension---is not curable. It is controllable with medications.

Can a person with high blood pressure live normally?

Yes, with current day treatment, a person with high blood pressure who is under effective management with pills, low-salt and low-fat diet, exercise and no smoking, can live a normal life. As long as the treatment is taken daily, and as long as the blood pressure is controlled well, the person could even have a normal life span. With several medications available today in the physician's armamentarium against hypertension, persons with high blood pressure nowadays, who are compliant with the treatment, can be as "healthy" as the next person who does not have high blood pressure. However, there are some persons with the so-called malignant hypertension, who are resistant to the conventional treatment. These are the ones whose blood pressure is not well-controlled and these inidviduals are prone to develop complications of hypertension.

How often should the blood pressure be checked?

It depends. If the blood pressure is erratic or hard to control, like when the patient is starting on a new medication for hypertension, the blood pressure should be taken once a day until the medication is adjusted and the blood pressure is basically controlled. If the blood pressure is within normal limits (as described above), as a response to treatment, the medications should be continued for life, and the blood pressure could be taken once a week. If it is really stable at the normal range, then it could be done once every two weeks or once a month. It is important to continue taking medications daily or regularly (as prescribed by the physician) for life, even if the blood pressure is well-controlled and now normal. What is keeping it "normal" is the medication! So, do not stop, unless ordered by your physician.

©2003Raoul R. Diez, M.A.O.D.