Hypertension

Hypertension is another name for high blood pressure. It can lead to severe complications and increases
the risk of heart disease, stroke, and death.

Blood pressure is the force exerted by the blood against the walls of the blood vessels. The pressure
depends on the work being done by the heart and the resistance of the blood vessels.

Hypertension and heart disease are global health concerns. The World Health Organization (WHO)
suggests that the growth of the processed food industry has impacted the amount of salt in diets
worldwide, and that this plays a role in hypertension.

Hypertension is a major contributor to a greater cardiovascular and renal disease burden among blacks
than whites.1 The racial disparities are greatest in younger adults and decline with advancing age.2 The
article in this issue of the Journal of the American Heart Association (JAHA) by Thomas et al,3
“Cumulative Incidence of Hypertension by 55 Years of Age in Blacks and Whites: the CARDIA Study,”
highlights large racial disparities in incident hypertension between young black and white adults and has
important implications for reducing disparities in prevalent hypertension and cardiovascular and renal
complications in younger black adults.

This commentary will address 4 points related to the current report by Thomas et al3:

1 . High absolute risk of hypertension, defined by systolic blood pressure (BP) 130 mm Hg and/or
diastolic( BP) 80 mm Hg or treatment for hypertension.

2 . Relative and absolute risk of stage 1 hypertension (130–139/85–89 mm Hg) for clinical cardiovascular
disease (CVD) in blacks.

3 . Benefits of lifestyle intervention for prevention of hypertension and CVD.

4 . Rationale for pharmacotherapy of stage 1 hypertension in blacks.

Causes

The heart is a muscle that pumps blood around the body.It pumps blood with low oxygen levels toward
the lungs, which replenish oxygen supplies.The heart then pumps oxygen-rich blood around the body to
supply the muscles and cells. This pumping action creates pressure.If a person has high blood pressure, it
means that the walls of the arteries are constantly under too much force.It is possible to divide the
causes of high blood pressure into two categories:Essential high blood pressure: This type of high blood
pressure has no established cause.Secondary high blood pressure: Another health problem is causing
increased blood pressure.Even though essential high blood pressure has no identifiable cause, strong
evidence links specific factors to the risk of developing this condition.

The exact causes of high blood pressure are not known, but several things may play a role, including:

Smoking

Being overweight or obese

Lack of physical activity

Too much salt in the diet

Too much alcohol consumption (more than 1 to 2 drinks per day)

Stress

Older age

Genetics

Family history of high blood pressure

Chronic kidney disease

Adrenal and thyroid disorders

Sleep apnea

Symptoms

Most people with high blood pressure have no signs or symptoms, even if blood pressure readings reach
dangerously high levels.

A few people with high blood pressure may have headaches, shortness of breath or nosebleeds, but
these signs and symptoms aren't specific and usually don't occur until high blood pressure has reached a
severe or life-threatening stage.

Risk factors

High blood pressure has many risk factors, including:

Age. The risk of high blood pressure increases as you age. Until about age 64, high blood pressure is
more common in men. Women are more likely to develop high blood pressure after age 65.

Race. High blood pressure is particularly common among people of African heritage, often developing at
an earlier age than it does in whites. Serious complications, such as stroke, heart attack and kidney
failure, also are more common in people of African heritage.

Family history. High blood pressure tends to run in families.

Being overweight or obese. The more you weigh the more blood you need to supply oxygen and
nutrients to your tissues. As the volume of blood circulated through your blood vessels increases, so
does the pressure on your artery walls.

Not being physically active. People who are inactive tend to have higher heart rates. The higher your
heart rate, the harder your heart must work with each contraction and the stronger the force on your
arteries. Lack of physical activity also increases the risk of being overweight.

Using tobacco. Not only does smoking or chewing tobacco immediately raise your blood pressure
temporarily, but the chemicals in tobacco can damage the lining of your artery walls. This can cause your
arteries to narrow and increase your risk of heart disease. Secondhand smoke also can increase your
heart disease risk.

Too much salt (sodium) in your diet. Too much sodium in your diet can cause your body to retain fluid,
which increases blood pressure.

Too little potassium in your diet. Potassium helps balance the amount of sodium in your cells. If you
don't get enough potassium in your diet or retain enough potassium, you may accumulate too much
sodium in your blood.

Drinking too much alcohol. Over time, heavy drinking can damage your heart. Having more than one
drink a day for women and more than two drinks a day for men may affect your blood pressure.

If you drink alcohol, do so in moderation. For healthy adults, that means up to one drink a day for
women and two drinks a day for men. One drink equals 12 ounces of beer, 5 ounces of wine or 1.5
ounces of 80-proof liquor.

Stress. High levels of stress can lead to a temporary increase in blood pressure. If you try to relax by
eating more, using tobacco or drinking alcohol, you may only increase problems with high blood
pressure.

Certain chronic conditions. Certain chronic conditions also may increase your risk of high blood pressure,
such as kidney disease, diabetes and sleep apnea.

Sometimes pregnancy contributes to high blood pressure, as well.

Treatment

Treatment for high blood pressure depends on several factors, such as severity and the associated risks
of developing cardiovascular disease or stroke.

The doctor will recommend different treatments as blood pressure increases:

Slightly elevated: The doctor may suggest some lifestyle changes for people with slightly elevated blood
pressure who have a lower risk of developing cardiovascular disease.

Moderately high: If blood pressure is reasonably high, and the doctor believes that the risk of developing
cardiovascular disease during the next 10 years is above 20 percent, they will probably prescribe
medication and recommend certain lifestyle changes.

Severe: If blood pressure levels reach 180/120 mm Hg or above, this is a hypertensive crisis. An
immediate change to the type or dosage of medication may be necessary.

Conclusion

Hypertension is a very important disorder in aged people and is associated with higher risk of
cardiovascular morbidity and mortality. The fact of reducing blood pressure values decreases the risk for
cardiac death as well as neurological, metabolic, and musculoskeletal system sequelae in aged people.