The cardiac cycle

 The sequence of one heartbeat ending to the beginning of another is known as the
cardiac cycle.
 The heart consists of two pumps that work together where both sides of the heart
relax and contract with one another.
 Systole is the repetition in contractions of the heart chambers.
 Diastole is the relaxation of the heart chambers.
 Blood moves through the circulatory system from regions of high pressure to low
pressure
 There are three stages to the cardiac cycle; atrial systole, ventricular systole and
diastole.
 Atrial systole is where the atria within the heart contract and tops up the ventricles
that are already filled with blood.
 Ventricular systole is where the ventricles chambers contract and forces the blood up
and out of the heart and into the arteries.
 Diastole is where all four chambers in the heart relax and re-fill with blood.
 SAN causes the atria to contract and the AVN causes a delay before the ventricles
contract.

Stages of the cardiac cycle

All the events that come and play within the heart come together to become the
cardiac cycle. The cardiac cycle is a series of contractions that ensure blood is flowing
in the correct direction.

The cycle is broken down into three stages:

• Cardiac Diastole – the entire heart is relaxed
• Atrial Systole, also known as Ventricular Diastole
• Ventricular Systole, also known as Atrial Diastole

Cardiac Diastole
In cardiac diastole the entire heart is relaxed. Both the atria and ventricles are relaxed,
and the blood enters at low pressure through the veins, the pulmonary vein, and the
vena cava into the atria. As the blood flows in the atria the blood pressure begins to
increase causing the AV valves to become opened allowing for the blood to enter the
ventricles.

Atrial Systole
This is where the atria contracts when they are around 50% empty. This ensures all the
blood is emptied from the atria and enters the ventricles. This causes the pressure
within the ventricles to slightly increase shutting the AV valves, to prevent the
backflow of blood back to the atria.
Ventricular Systole
The next stage is ventricular systole, where the ventricles contract from the bottom of
the heart also known as the apex of the heart and upwards. Now the pressure further
increases in the ventricles above the pressure within the arteries (pulmonary arteries
and aorta). Due to the pressure change, blood can flow out through the semilunar
valves and allows for the blood to leave.

Actions of the valves and pressure changes

Pressure changes – The pressure graph

Mammals have a double circulatory system; blood is kept within the blood vessels
allowing the pressure within them to be maintained and regulated. Figure 2 illustrates
the pressure changes that occur within the heart during one cardiac cycle.
 Pressure changes in the left side of the heart
 The atrial pressure shown in Figure 2 (yellow line) has the least changes in
the pressure. The pressure is always relatively low due to the thin walls of the
atrium and therefore, cannot create a force to increase the pressure. The atria
fill up with blood that leads to a slight increase in blood however, there is drop
again when the left atrioventricular (AV) valve opens allowing some of the
blood to enter the ventricles.
 The ventricular pressure (green line) begins low at first, but then undergoes
a huge pressure change during ventricular systole since the ventricles fill with
blood as the atria contracts. This shuts the left AV valve and the pressure rises
dramatically due to the ventricles thick muscular walls. As the pressure arises
the aorta blood is passed through the semilunar valves and enters the aorta.
Pressure then falls as the ventricles empty, and the walls relax.
 The pressure in the aorta remains high to begin (shown with the red line)
 It is important to remember the key time when the valves open and when
they close; the AV valve closes when the ventricular pressure exceeds the atrial
pressure, indicated on Figure 2. The AV valve will only open again when the
ventricular pressure is below the atrial pressure.
 Looking above on the top part of the graph shows when the semilunar
valve opens and closes. The semilunar valve will open when the ventricular
pressure exceeds above the aortic pressure and the semilunar valve will close
when the ventricles pressure would be below the pressure within the aortic
artery.
 The sounds of a heartbeat “lub” and “dub” are made by the sounds of the valves
snapping shut (below).

Coordination and regulation of the cardiac cycle

For the heart to function effectively, there must be a fine control and balance of events
that take place during the cardiac cycle described above.
Heart tissue is myogenic which means it would initiate its own contraction
allowing the heart to contract without needing to be connected to the body.
If the cardiac muscle was left to contract by itself this could bring some problems to
the heart. Since the atria contract faster than the ventricles this could lead to
fibrillation hence there is a need for a way to control the cardiac cycle.

In the heart, there are two nodes that are responsible to keep the cardiac cycle running
correctly. A heartbeat starts off at the region of tissue called the sinoatrial node
(SAN) which is located above the right atrium. The SAN acts as the hearts pacemaker
and ensures the heart is beating at a constant regular rate. This is achieved by the SAN
giving out regular electrical signals spread throughout the heart and spreads
throughout the atrial muscles that causes the atria to contract (atrial systole). This is
what starts the contraction of the atria.

The second node is known as the atrioventricular node (AVN) which is located near
the AV valve. The role of the AVN is to pass the electrical signal to the middle of the
heart also known as the septum. There is also a delay in the electrical pulse at the
AVN (between the atria and ventricles contracting) which allows the atria to fully
empty before the ventricles control. The electrical pulse next passes the signal into
extremely insulated fibres called the Bundle of His. The insulation of these fibres
ensures the electrical signal cannot escape.

The Bundle of His carries the electrical signal to the apex, bottom of the heart. At the
bottom of the heart the Bundle of His splits into two. The non-insulated fibres called
Purkinje fibres spread up the walls of the ventricles and cause the ventricles to
contract from the bottom of the heart to cause the blood to be forced out from the
ventricles, out of the semilunar valves and towards the aorta and pulmonary artery.
Electrocardiograms (ECG)
An electrocardiogram (ECG) is a medical device that measures the electrical pulse
of the heart. Since the heart undergoes a series of electrical changes related to the
waves of excitation, sensors that are connected to a monitor can detect these electrical
signals. The ECG produces a trace of electrical activity shown below.
Doctors can use the ECG trace to examine the patient’s electrical activity within the
heart and understand better the status of the patient’s health.
A normal healthy ECG trace shows what is known as the “PQRST shape”.

 Wave P is the stage that corresponds to atrial systole, excitation, and

contraction of the atria.
 Ventricular systole forms the “QRS” complex.
 The start of ventricular diastole corresponds to the “T” wave.
Below, Figure 6 shows the ECG from a healthy patient, a patient suffering from a
heart attack and one patient suffering from fibrillation. Fibrillation already mentioned
above is where the atria and ventricles contract and relax in an irregular manner
causing strenuous stress to the heart that leads to death if not treated immediately
(Figure 6c).

Haemoglobin Adaptations & Bohr Shift

Haemoglobin is an indispensable protein found in red blood cells responsible for transporting
oxygen throughout the body. The protein's adaptations and intricate mechanisms, particularly
in foetal and adult stages, contribute significantly to ensuring efficient oxygen delivery.
Furthermore, phenomena like the Bohr Shift play an essential role in tailoring oxygen
delivery according to the metabolic needs of tissues. Let's dive deeper into these
complexities.

Foetal Haemoglobin (HbF)

 Structural Differences:
 HbF differs structurally from adult haemoglobin. While both have two alpha
chains, HbF includes two gamma chains, as opposed to the two beta chains in
adult haemoglobin.
 This structural difference contributes to the higher affinity of HbF for oxygen.
 Transition to HbA: After birth, the concentration of HbF gradually decreases, and by
about six months of age, HbA becomes the predominant form of haemoglobin.
Foetal haemoglobin

 The haemoglobin of a developing foetus has a higher affinity for oxygen than adult
haemoglobin
 This is vital as it allows a foetus to obtain oxygen from its mother's blood at the placenta
o Fetal haemoglobin can bind to oxygen at low pO2
o At this low pO2 the mother's haemoglobin is dissociating with oxygen
 On a dissociation curve graph, the curve for foetal heamoglobin shifts to the left of that for
adult haemoglobin
o This means that at any given partial pressure of oxygen, foetal haemoglobin has a
higher percentage saturation than adult haemoglobin
 After birth, a baby begins to produce adult haemoglobin which gradually replaces foetal
haemoglobin

o This is important for the easy release of oxygen in the respiring tissues of a more
metabolically active individual
Adult Haemoglobin (HbA)

 Cooperative Binding of Oxygen:

 Hemoglobin's tetrameric structure allows each of its four subunits to bind to
one oxygen molecule.
 The binding of the first oxygen molecule induces a change in the
haemoglobin's shape, increasing the protein's affinity for further oxygen
molecules. This results in the progressive "cooperative binding" of additional
oxygen molecules.
 Allosteric Binding of Carbon Dioxide:
 In areas of the body where carbon dioxide concentration is elevated,
haemoglobin can bind to it, though not at the same binding sites as oxygen.
This binding affects haemoglobin's structure and reduces its affinity for
oxygen.
 This allosteric effect means that in areas where tissues are producing more
carbon dioxide (due to increased metabolic activity), oxygen delivery is
enhanced.

Bohr Shift

 The Underlying Mechanism:

 As the concentration of carbon dioxide rises in actively respiring tissues, it
results in a decrease in pH (increase in acidity). This change in pH affects the
shape and function of haemoglobin, leading to reduced oxygen affinity.
 This phenomenon, where an increased carbon dioxide concentration leads to
augmented oxygen release, is termed the Bohr Shift.
 Beneficial Implications:
  Actively respiring tissues, such as muscles during intense exercise, produce
increased amounts of carbon dioxide. These tissues require more oxygen to
support their metabolic needs.
 The Bohr Shift ensures that these tissues receive a higher amount of oxygen
precisely when they need it, improving tissue function and efficiency.
 Impact on Oxygen Dissociation Curve:
 The Bohr Shift manifests as a rightward shift of the oxygen dissociation curve
in the presence of elevated carbon dioxide levels.

Oxygen Dissociation Curve

 The Significance of the S-Shape:
 Hemoglobin's oxygen binding is represented by an S-shaped or sigmoidal
curve.
 At lower oxygen concentrations (like in peripheral tissues), the curve is
relatively flat. This indicates a reduced tendency of haemoglobin to bind
oxygen, ensuring that the tissues receive the oxygen they require.
 Conversely, in areas with high oxygen concentrations, such as the lungs, the
curve becomes steeper, illustrating that haemoglobin readily absorbs oxygen.
 Adaptability to Varying Conditions:
 The S-shape is not just a biological quirk; it's a vital feature. The initial flatter
portion of the curve ensures tissues receive adequate oxygen, even if blood
oxygen levels drop slightly.
 Meanwhile, the steep portion guarantees that haemoglobin becomes saturated
with oxygen when in the oxygen-rich environment of the lungs.
 This adaptability means that in various situations, be it during vigorous
exercise or at rest, haemoglobin can adjust its oxygen-binding properties to
suit the body's needs.
The Oxygen Dissociation Curve
 The oxygen dissociation curve shows the rate at which oxygen associates, and also
dissociates, with haemoglobin at different partial pressures of oxygen (pO2)

o Partial pressure of oxygen refers to the pressure exerted by oxygen within a

mixture of gases; it is a measure of oxygen concentration
o Haemoglobin is referred to as being saturated when all of its oxygen binding
sites are taken up with oxygen; so when it contains four oxygen molecules
 The ease with which haemoglobin binds and dissociates with oxygen can be described
as its affinity for oxygen
o When haemoglobin has a high affinity it binds easily and dissociates slowly
o When haemoglobin has a low affinity for oxygen it binds
slowly and dissociates easily
 In other liquids, such as water, we would expect oxygen to becomes associated with
water, or to dissolve, at a constant rate, providing a straight line on a graph, but with
haemoglobin oxygen binds at different rates as the pO2 changes; hence the
resulting curve
o It can be said that haemoglobin's affinity for oxygen changes at different
partial pressures of oxygen
Explaining the shape of the curve

 The curved shape of the oxygen dissociation curve for haemoglobin can be explained as
follows
 o Due to the shape of the haemoglobin molecule it is difficult for the first oxygen
molecule to bind to haemoglobin; this means that binding of the first oxygen occurs
slowly, explaining the relatively shallow curve at the bottom left corner of the graph
o After the first oxygen molecule binds to haemoglobin, the haemoglobin protein
changes shape, or conformation, making it easier for the next oxygen molecules to
bind; this speeds up binding of the remaining oxygen molecules and explains
the steeper part of the curve in the middle of the graph
 The shape change of haemoglobin leading to easier oxygen binding is known
as cooperative binding
o As the haemoglobin molecule approaches saturation it takes longer for the fourth
oxygen molecule to bind due to the shortage of remaining binding sites, explaining
the levelling off of the curve in the top right corner of the graph

Interpreting the curve

 When the curve is read from left to right, it provides information about the rate at which
haemoglobin binds to oxygen at different partial pressures of oxygen
o At low pO2, in the bottom left corner of the graph, oxygen binds slowly to
haemoglobin; this means that haemoglobin cannot pick up oxygen and become
saturated as blood passes through the body's oxygen-depleted tissues
 Haemoglobin has a low affinity for oxygen at low pO2, so saturation
percentage is low
o At medium pO2, in the central region of the graph, oxygen binds more easily to
haemoglobin and saturation increases quickly; at this point on the graph a small
increase in pO2 causes a large increase in haemoglobin saturation
o At high pO2, in the top right corner of the graph, oxygen binds easily to
haemoglobin; this means that haemoglobin can pick up oxygen and become saturated
as blood passes through the lungs
 Haemoglobin has a high affinity for oxygen at high pO2, so saturation
percentage is high
 Note that at this point on the graph increasing the pO2 by a large amount
only has a small effect on the percentage saturation of haemoglobin; this
is because most oxygen binding sites on haemoglobin are already occupied
 When read from right to left, the curve provides information about the rate at which
haemoglobin dissociates with oxygen at different partial pressures of oxygen
o In the lungs, where pO2 is high, there is very little dissociation of oxygen from
haemoglobin
o At medium pO2, oxygen dissociates readily from haemoglobin, as shown by
the steep region of the curve; this region corresponds with the partial pressures of
oxygen present in the respiring tissues of the body, so ready release of oxygen is
important for cellular respiration
 At this point on the graph a small decrease in pO2 causes a large decrease
in percentage saturation of haemoglobin, leading to easy release of plenty
of oxygen to the cells
o At low pO2 dissociation slows again; there are few oxygen molecules left on the
binding sites, and the release of the final oxygen molecule becomes more difficult, in
a similar way to the slow binding of the first oxygen molecule

Foetal haemoglobin

 The haemoglobin of a developing foetus has a higher affinity for oxygen than adult
haemoglobin
 This is vital as it allows a foetus to obtain oxygen from its mother's blood at the placenta
o Fetal haemoglobin can bind to oxygen at low pO2
 o At this low pO2 the mother's haemoglobin is dissociating with oxygen
 On a dissociation curve graph, the curve for foetal heamoglobin shifts to the left of that for
adult haemoglobin
o This means that at any given partial pressure of oxygen, foetal haemoglobin has a
higher percentage saturation than adult haemoglobin
 After birth, a baby begins to produce adult haemoglobin which gradually replaces foetal
haemoglobin

o This is important for the easy release of oxygen in the respiring tissues of a more
metabolically active individual

Different types of haemoglobin

 Haemoglobin is a quaternary protein, made up of four globin polypeptides and four haem
groups
 The structure of haem is identical in all types of haemoglobin
 The globin chains however can differ substantially between species
o The globin polypeptides determine the precise properties of haemoglobin
 There are a wide range of haemoglobin types that exist
o They vary in their oxygen-binding properties
o They bind to and release oxygen in different conditions
 Environmental factors can have a major impact on the evolution of haemoglobin within a
species

Effects of altitude

 The partial pressure of oxygen is lower at higher altitudes

 Species living at high altitudes have haemoglobin that is adapted to these conditions
 For example, llamas have haemoglobin that binds very readily to oxygen
  This is beneficial as it allows them to obtain a sufficient level of oxygen saturation in their
blood when the partial pressure of oxygen in the air is low

Exam Tip
You may be shown the oxygen dissociation curves of different types of haemoglobin and
asked to explain how they are adapted to the environment the animal is living in. Remember
that the curve furthest to the left represents the haemoglobin with the highest affinity for
oxygen.

Transport of Oxygen

Haemoglobin
 The haemoglobins are a group of chemically similar molecules found in many different organisms.

The Structure of Haemoglobin

 Haemoglobin is a water soluble gobular protein that has a quaternary structure. This means that it
consists of more than one polypeptide chain.

 The structure of Haemoglobin consist of four polypeptide chains. Two chains are ⍺-polypeptides (alpha)
and two chains are β-polypeptides (beta).

 Each of the polypeptide chains are associated with a haem group. Each haem group contains
an Fe2+ ion which can combine with an oxygen molecule (O 2).

 Each haemoglobin molecule can therefore carry four oxygen molecules.

  Fetal haemoglobin has a different affinity for oxygen, compared to adult haemoglobin. This is to allow
the foetus to survive at a low partial pressure.

 Fetal haemoglobin needs to be very good at absorbing oxygen. By the time oxygen reaches the placenta, the
oxygen saturation of the blood has decreased.

 β-polypeptides (beta) chains are uncommon. Instead, the haemoglobin molecule is made up of two ⍺-
polypeptide (alpha) chains and two γ-polypeptide chains (gamma).

Role of Haemoglobin
 Haemoglobin is found in red blood cells (erythrocytes). Haemoglobin allows red blood cells to transport
oxygen from the lungs to all other parts of the body.

 When haemoglobin combines with oxygen, oxyhaemoglobin is formed.

The Transport of Oxygen By Haemoglobin

 The association (or loading) of oxygen is the process by which haemoglobin binds with oxygen. In
humans, oxygen association occurs in the lungs.

 After oxygen association, the red blood cells transport the oxygen. Oxygen is transported from the lungs to
the rest of the body.

 The dissociation (or unloading) of oxygen is the process by which oxygen is released from
haemoglobin. In humans, oxygen dissociation occurs at cells which require oxygen, where haemoglobin
returns to the lungs in order to bind to oxygen again.

 Affinity is the degree to which one substance combines with another. Haemoglobin has
different affinities for oxygen molecules under different conditions.

 When oxygen concentration is high, haemoglobin has a high affinity for oxygen. This means that it will
readily associate with oxygen and will dissociate with it less easily.

 When oxygen concentration is low, haemoglobin has a low affinity for oxygen. This means that it will
readily dissociate with oxygen and will associate with it less easily.

 Haemoglobin changes its affinity for oxygen by changing its shape when in the presence of certain
substances. For example, in high carbon dioxide (CO2) concentration, haemoglobin has a low affinity for
oxygen, whereas in low CO 2 concentration, haemoglobin has a high affinity for oxygen.

 Having changing affinities for oxygen means that oxygen is only associated/dissociated where
necessary. This makes haemoglobin efficient at transporting oxygen because oxygen is readily associated at
the gas exchange surface (the lungs) and readily dissociated at the tissues which need it.

Oxyhaemoglobin Dissociation Curves

 The partial pressure of oxygen is a measure of oxygen concentration. Partial pressure is measured
in kilopascal (kPa).
  The greater the concentration of dissolved oxygen in a cell, the greater the partial pressure.

 Haemoglobin has different affinities for oxygen depending on its partial pressure. Haemoglobin will
readily associate more tightly with oxygen if the partial pressure of oxygen is high and will readily dissociate
with oxygen if the the partial pressure of oxygen is low. These two processes are known as loading and
unloading.

 The process of respiration uses up oxygen. This decreases partial pressure, in turn decreasing affinity of
oxygen for haemoglobin. As a result, oxygen gets released to respiring tissues where needed.

 Oxyhaemoglobin dissociation curves are S-shaped. They show the relationship between the partial pressure
of oxygen and the saturation of haemoglobin with oxygen.

 Saturation can have an effect on affinity.

1. Gradient of the curve is initially shallow. This is because the shape of haemoglobin makes it hard for the
first oxygen molecule to bind to one of the four sites. This explains why haemoglobin has a low affinity for
oxygen at low partial pressure of oxygen.
2. Gradient of the curve steepens as the second and third oxygen molecules bind. The binding of the first
oxygen molecule causes the structure of the haemoglobin to change, and this change in shape makes it easier
for the second and third oxygen molecules to bind.
3. Gradient of the curve flattens and levels off. Although it should be easier for the fourth oxygen molecule to
bind to haemoglobin, it is actually harder because three out of four binding sites are occupied. This makes it
less likely that an oxygen molecule will find a site to bind to.

The Effects of Carbon Dioxide Concentration

 Haemoglobin has a lower affinity for oxygen at higher partial pressures (concentrations) of carbon
dioxide, causing oxygen to be released. This is known as the Bohr effect and explains why haemoglobin has
different affinities at different areas in the body.
  Dissolved carbon dioxide is acidic. When carbon dioxide is present, it lowers the pH of the area and causes
the haemoglobin to change shape.

 Respiring cells produce carbon dioxide, and this increases the partial pressure of carbon
dioxide. This reduces the affinity of haemoglobin for oxygen, and as there is also a low partial pressure
of oxygen at the respiring cells, oxygen is dissociated from haemoglobin.

 At the gas-exchange surface (the lungs), the partial pressure of carbon dioxide is low because here it is
removed from the organism. This increases the affinity of haemoglobin for oxygen, and as there is also
a high partial pressure of oxygen in the lungs, oxygen is readily associated to haemoglobin.

 The Bohr effect refers to shifts to the oxyhaemoglobin dissociation curve. An increase in partial pressure
of carbon dioxide will shift the S-curve to the right, whereas a decrease in partial pressure of carbon
dioxide shifts the curve to the left.

Haemoglobin in Different Organisms

 Different species have different types of haemoglobin. These haemoglobins have different oxygen transport
properties which are adapted to the environment of each animal.

 Species living in environments with low oxygen concentrations will have haemoglobin with a higher
affinity for oxygen. Their oxygen dissociation curve would be to the left of a human’s.

 Species living in environments with high oxygen concentrations and that are also very active will have
haemoglobin with a lower affinity for oxygen. Their oxygen dissociation curve would be to the right of a
human’s.
Transport of Carbon Dioxide
Myoglobin

 Myoglobin is a substances that can act as another respiratory pigment. As

it is found in muscle, it does not travel in the blood.

 It has more of an affinity for oxygen than haemoglobin. Because of this, it

only releases oxygen at a very low partial pressure.

 Myoglobin only has one polypeptide chain and is often found in animals
living in aerobic mud.

 Its function is to act as a store of oxygen. This acts to prevent aerobic

respiration occurring. The process is outlined below:

1. Carbon dioxide diffuses into erythrocytes from the tissues

2. The carbon dioxide then reacts with water, producing carbonic acid. This reaction is
catalysed by carbonic anhydrase, an enzyme in the cell.

o
 Carbonic acid ionises into H+ and HCO3–

o
 Haemoglobin combines with H+ ions to
form haemoglobinic acid (very weak)


 o
 Carbonic acid ions diffuse into blood plasma where it is
able to be transported to the lungs

o
 Chlorine ions diffuse into the red blood cell from the
plasma, counteracting the build up of positive charge
from the H+ ions. This is called the chloride shift.

o
 This whole process reverses once the blood reaches the
lungs.

o
 Whilst most of the CO2 in the blood is carried this way,
a small amount can be combined with haemoglobin to
be carried as carbaminohaemoglobin.

Differenc

ween Systolic and Diastolic Blood Pressure

Blood Pressure
Blood pressure is a serious health problem which affects nearly 40 to 50 per cent of the total
population.

Blood is a fluid connective tissue which is carried to all parts of our body with the help
of arteries. It plays a key factor in providing blood (thus oxygen and energy) to organs.
Blood pressure is the force of blood against the arteries. An individual should maintain a
normal blood pressure from 90 – 120 / 60 – 80 mm Hg. Blood pressure is given by two
numbers, with one above or before the other – 120/80.120 – This is called systolic pressure
and 80 – This is called diastolic pressure.

Also Read: Blood pressure symptoms

Types of Blood Pressure

 Systolic Blood Pressure.
The normal range of systolic blood pressure should be 90 – 120 mm Hg.

 Diastolic Blood Pressure.

The normal range of diastolic blood pressure should be 60 – 80 mm Hg.

Both Diastolic and Systolic are derived from the Greek word. Diastolic meaning drawing
apart and Systolic meaning a drawing together.
Differences Between Systolic and Diastolic Blood Pressure
Here is the differenced between systolic and diastolic blood pressure.

Hypertension
Hypertension or high blood pressure is a serious health problem which currently affects
nearly 1 billion people worldwide. According to the recent analysis by the World Health
Organisation (WHO), this statistic might rise to around 1.57 billion by the year 2025.
Blood is the fluid connective tissue, carried to all parts of our body in blood vessels called
arteries. The arteries play a key role in providing blood (thus oxygen and energy) to all
organs of the body.

Blood pressure is the force of blood against the arteries. Around 75 million people are
affected by high blood pressure in the US and more are at risk of dying from related
cardiovascular disease. In the year 2017-2018, about one-third of all individuals above the
age range of 20 have high blood pressure assessments and most are under antihypertensive
medications.

What is Hypertension?
Abnormally high blood pressure and a combination of high psychological stress are known as
Hypertension. These patients suffering from this disorder will have their blood pressure
reading greater than 140 over 90 mm.

Hypertension is diagnosed by measuring blood pressure. The Systolic pressure would be the
first readings viz. a pressure by which the heart pumps blood through the body, and second
readings would be the Diastolic pressure, meaning a pressure at which the heart relaxes and
refills the blood.

Types of Hypertension
When people talk about hypertension, they are usually referring to one of the two types,
namely:
  Primary hypertension
 Secondary hypertension

Primary hypertension is also known as essential hypertension. This is the most prevalent form
of hypertension and it has no identifiable cause.

Secondary hypertension is caused by an underlying disease or even medication. Thyroid

dysfunction, sleep apnea and diabetes have been linked to secondary hypertension. Chemicals
such as amphetamines, antidepressants and even caffeine can lead to hypertension.

Causes of Hypertension
Acute stress and unfavourable environmental factors are the main factors for increasing blood
pressure in normal and healthy individuals. The increasing rate of the prevailing condition is
mostly blamed on the lifestyle and dietary factors such as inactive habits, high diet sodium
content from processed fatty foods, tobacco and alcohol use.

Symptoms of Hypertension
High blood pressure is itself asymptomatic, that means there is no indication or any clear
symptoms. This is the reason why high blood pressure is also referred to as ‘the silent killer’
since it could cause damage to the Cardiovascular system.

High blood pressure could also create problems in certain organs. A prolonged illness may
lead to complications such as arteriosclerosis, where the production of plaques narrows the
blood vessels.

A systolic blood pressure readings of 180 mmHg or above and a diastolic blood pressure
readings of 110 mmHg or above could indicate the signs of hypertensive crisis that requires
immediate medical attention.

Diagnosis of Hypertension
The process of diagnosis is usually carried out by measuring the patient’s blood pressure
using a sphygmomanometer. At least 3 different elevated readings are required to diagnose
this condition. This examination along with additional tests help to identify the causes of high
blood pressure and any other complications.

Additional diagnosis might include

 1. Kidney ultrasound imaging,
2. Urine tests,
3. Blood tests
4. Electrocardiogram (or) ECG Test.

Treatment and Precautions

 Weight loss treatment programs like diet and exercise are recommended as high blood pressure
and obesity are related to each other.
 Having a well-balanced diet including whole grains, fruits, vegetables and low-fat dairy products.
 Avoid foods that have high amounts of LDL cholesterol (low-density lipoprotein).
 Reduce intake of sodium in the diet.
 Increase the intake of calcium and vitamin D.

Hypertension can turn quite serious if left unchecked. However, it could be easily lowered or
controlled by regular exercise. Following a strict, low sodium diet supplemented with foods
rich in potassium and calcium is crucial. Eat more low-fat protein sources, whole grains,
plenty of fruits and vegetables.