Author Dalia Ghoneim December 2009
Hypertension, whether someone you know has been diagnosed with it, or you dealt with someone complaining from it, but have you ever wondered how many cases are diagnosed with hypertension? What are its symptoms? How can I diagnose it myself?
High blood pressure affects approximately one in three adults according to The American Heart Association. That means that in the United States alone it affects around 73 million people. Also the stereotypic thinking that high blood pressure affects adults only has changed as it was found that hypertension is estimated to affect about two million American teens and children, and the Journal of the American Medical Association reports that many are under-diagnosed.
From the previous numbers we can say that hypertension is clearly a major public health problem
Usually the term hypertension is co-related in our minds with the exposure to stress or excessive emotional tension, although tension and stress can temporarily increase blood pressure, that’s not the true meaning of hypertension.
Hypertension is a chronic medical condition in which the blood pressure is elevated; this means that there is tension in the arteries carrying blood from the heart to different tissues in the body.
Normal blood pressure is approximately 120 mmHg systolic and 80 mmHg diastolic and it’s usually written as 120/80. The systolic blood pressure corresponds to the pressure in the arteries as the heart contracts and pumps blood forward into the arteries and the diastolic pressure represents the pressure in the arteries as the heart relaxes after the contraction.
The diastolic pressure reflects the lowest pressure to which the arteries are exposed. Any rise above these figures is considered as a stage of hypertension, except in the case of people older than 50 years, hypertension is considered to be present when the blood pressure is consistently above 140/90.
Increase in blood pressure has been recently classified into prehypertension, hypertension (stages 1, stage 2) and isolated systolic hypertension, which commonly occurs among the elderly.
| Systolic mmHg | Diastolic mmHg | |
| Prehypertension | 120–139 | 80–89 |
| Stage 1 | 140–159 | 90–99 |
| Stage 2 | ≥160 | ≥100 |
| Isolated systolic hypertension | ≥140 | <90 |
But what causes hypertension?!!! Unfortunately in most of the cases, almost 90-95% no medical cause can be found to explain the increase in blood pressure; this is defined as primary or essential hypertension. Sometimes raised blood pressure is a due to an underlying cause such as kidney disease or tumors (adrenal adenoma or pheochromocytoma), it is then called secondary hypertension.
Although up till now not a specific cause of hypertension has been known, several risk factors that increase the incidence of the disease as sedentary lifestyle, obesity (more than 85% of cases occur in those with a body mass index greater than 25), large salt intake, alcohol intake and vitamin D deficiency.
The most known risk factors is aging, as getting older in age already causes constriction of the arteries hence causing increase in the blood pressure. It is also known that hypertension is highly heritable and having family history increases the risk of developing hypertension.
It’s important to mention that untreated and persistent hypertension is one of the risk factors for strokes, heart attacks, heart failure and arterial aneurysm, and is a leading cause of chronic renal failure. These complications of hypertension are often referred to as end-organ damage because damage to these organs is the end result of chronic high blood pressure
Even moderate elevation of arterial blood pressure leads to shortened life expectancy. In short it is estimated that cardiovascular disease risk doubles for each increment of 20/10 mmHg. At severely high blood pressure, defined as mean arterial pressure which is 50% or more above average, a person can expect to live no more than a few years unless appropriately treated.
For these reasons, the diagnosis of high blood pressure is significantly important as when it is diagnosed efforts are made to normalize blood pressure and prevent complications. This causes an alarm in society, due to the fact that high blood pressure usually is undiagnosed. Mainly a mild to moderate increase in blood pressure is usually undetected by the patients themselves as it is symptomatic. Even in cases of higher elevation of the blood pressure the patient will normally complain just form a slight headache, confusion, visual disturbances, and nausea and vomiting (hypertensive encephalopathy).
All of these symptoms can go by undetected or misdiagnosed, hence putting patients in the greater risk of hypertension and not being properly treated.
Due to these facts it’s probably essential to perform health screening programs and mandatory blood pressure recording in adults attending any health clinic. Once detected, patients with hypertension should preferably be followed up in specialized clinics run by medical personnel involved in hypertension treatment. Patient education is indispensable for proper screening of the disease and regular checkup is always required to maintain the blood pressure within the appropriate levels.
According to the most recent studies it seems that hypertension is emerging as an important public health problem in the UAE. As it is known the prevalence of hypertension varies from country to country according to age, gender, race, body-weight and dietary habits. An understanding of the extent, severity and nature of hypertension in a population is essential for the appropriate application of detection, investigation, therapy and follow-up programs of hypertension in the UAE in order to prevent the related complications. Patient education is a crucial factor when trying to control and prevent more cases of hypertension.
Identification and treatment of hypertension must become as important as control of infectious diseases and maternal and child health care. Indeed, prevention initiatives and measures taken for the treatment of hypertension should be implemented through the available community-based health-care clinics managed by the Ministry of Health. Such endeavors must be carefully inte-grated with the efforts of individual clinicians and other healthcare providers.
The society must fully understand the dangers of hypertension and become more aware that it is a serious disease and should not be taken lightly.
Article Written by Dalia Ghoneim for Biomed Middle East