Hypertension (High BP): Causes, Symptoms, Diagnosis, and Treatment

Title: Hypertension: Causes, Symptoms, Diagnosis, and Treatment

Introduction to Hypertension

Hypertension, also known as high blood pressure, is one of the most common chronic medical conditions worldwide. It occurs when the force of blood against artery walls is consistently too high, causing serious health problems, including heart disease, stroke, and kidney failure.

According to the World Health Organization (WHO), nearly 1.28 billion adults aged 30–79 years have hypertension, and two-thirds live in low- and middle-income countries. Unfortunately, many individuals are unaware they have high blood pressure due to its silent nature, earning it the nickname “the silent killer.”

In this article, we will explore the key aspects of hypertension: its causes, symptoms, diagnosis, and treatment, along with preventive measures and lifestyle tips to control blood pressure naturally.

What is Hypertension?

Blood pressure is measured in millimeters of mercury (mm Hg) and is recorded as two numbers:

Systolic pressure (top number): Pressure in the arteries when the heart beats.

Diastolic pressure (bottom number): Pressure in the arteries when the heart rests between beats.

Hypertension Classification (American Heart Association):

Category Systolic (mm Hg) Diastolic (mm Hg)

Normal <120 <80
Elevated 120–129 <80
Stage 1 Hypertension 130–139 80–89
Stage 2 Hypertension ≥140 ≥90
Hypertensive Crisis >180 >120

Causes of Hypertension

Hypertension can be classified as:

1. Primary (Essential) Hypertension

Most common type (90–95% cases)

Develops gradually over time

No identifiable cause but associated with:

Genetics

Aging

Sedentary lifestyle

Obesity

High sodium intake

Stress

Smoking and alcohol consumption

2. Secondary Hypertension

Caused by underlying medical conditions or medications

Develops suddenly and leads to higher BP than primary hypertension

Common causes include:

Kidney disease

Adrenal gland tumors

Thyroid disorders

Obstructive sleep apnea

Certain medications (e.g., birth control pills, NSAIDs, decongestants)

Risk Factors for Hypertension

Age: Risk increases with age

Family history: Genetic predisposition

Obesity: Excess weight increases pressure on artery walls

Lack of physical activity

Tobacco use

Excessive alcohol consumption

High-sodium, low-potassium diet

Chronic stress

Diabetes and metabolic syndrome

Symptoms of Hypertension

Most people with mild to moderate hypertension do not experience symptoms. However, when blood pressure reaches dangerously high levels, the following symptoms may appear:

Common Signs and Symptoms:

Severe headache

Blurred vision

Dizziness

Chest pain

Shortness of breath

Nausea or vomiting

Fatigue or confusion

Nosebleeds

Irregular heartbeat

Important Note: These symptoms may also indicate a hypertensive crisis, which requires immediate medical attention.

Diagnosis of Hypertension

Early detection is essential to prevent hypertension-related complications. Diagnosis involves:

1. Blood Pressure Monitoring

Use of a sphygmomanometer

Readings taken on multiple occasions

Ambulatory BP monitoring may be used for 24-hour evaluation

2. Physical Examination

Review of medical history and risk factors

Checking for signs of heart, kidney, or eye damage

3. Laboratory Tests

Urinalysis: Check for kidney problems

Blood tests: Measure cholesterol, blood sugar, creatinine, electrolytes

Electrocardiogram (ECG): Evaluate heart function

Echocardiogram: Assess for structural heart changes

Eye exam: Detect damage to blood vessels in the retina

Complications of Uncontrolled Hypertension

Prolonged high blood pressure can damage vital organs and lead to serious complications, such as:

Heart disease (heart attack, heart failure)

Stroke

Kidney damage or failure

Aneurysm

Vision loss (hypertensive retinopathy)

Cognitive decline and dementia

Treatment of Hypertension

Treatment aims to lower blood pressure and reduce the risk of complications. It involves lifestyle changes, medications, and regular monitoring.

1. Lifestyle Modifications

These are the first-line approach, especially for Stage 1 hypertension.

a. Healthy Diet (DASH Diet)

Rich in fruits, vegetables, whole grains, low-fat dairy

Low in saturated fats, sodium, and added sugars

Limit sodium intake to <1500 mg/day

b. Regular Physical Activity

At least 30 minutes/day of moderate aerobic exercise (walking, cycling, swimming)

Improves heart health and helps manage weight

c. Weight Loss

Even a small reduction in weight can significantly reduce BP

d. Limit Alcohol Intake

Men: ≤2 drinks/day; Women: ≤1 drink/day

e. Quit Smoking

Improves overall cardiovascular health

f. Manage Stress

Relaxation techniques: yoga, meditation, deep breathing

2. Medications for Hypertension

When lifestyle changes are not enough, doctors may prescribe:

Drug Class Examples Mechanism

Diuretics Hydrochlorothiazide Remove excess salt and water
ACE Inhibitors Enalapril, Lisinopril Relax blood vessels
ARBs Losartan, Valsartan Block angiotensin receptors
Calcium Channel Blockers Amlodipine Prevent calcium from entering heart cells,
Beta-blockers Metoprolol, Atenolol Reduce heart rate and cardiac output
Alpha-blockers Doxazosin Reduce arterial resistance

Note: Medication should only be taken under the supervision of a healthcare provider.

3. Monitoring and Follow-Up

Self-monitoring at home

Regular check-ups with your physician

Adjust treatment as needed

Prevention of Hypertension

While some risk factors like genetics or age cannot be controlled, others can be managed effectively.

Prevention Tips:

Maintain a healthy weight

Eat a balanced, low-sodium diet

Exercise regularly

Avoid smoking and limit alcohol

Manage stress effectively

Monitor blood pressure regularly

Get adequate sleep

Hypertension in Special Populations

1. Hypertension in Pregnancy

Known as gestational hypertension or pre-eclampsia

Requires close monitoring to avoid complications for both mother and baby

2. Hypertension in Children and Adolescents

Increasing due to rising obesity rates

Should be monitored and managed with pediatric guidance

3. Resistant Hypertension

Blood pressure remains high despite the use of 3+ medications

May require evaluation for secondary causes or specialist referral

Natural Remedies for High Blood Pressure

Though not a replacement for medication, certain natural remedies can complement treatment:

Garlic supplements: May help lower BP

Omega-3 fatty acids: Found in fatty fish and flaxseeds

Potassium-rich foods: Bananas, oranges, sweet potatoes

Herbal teas: Hibiscus tea has shown BP-lowering effects.

CoQ10: Antioxidant that supports heart health

Always consult a doctor before starting supplements.

Conclusion

Hypertension is a serious yet manageable condition. With early detection, proper lifestyle changes, and medication when necessary, most people with high blood pressure can lead long, healthy lives.

Controlling hypertension requires a holistic approach that includes a healthy diet, physical activity, stress management, and regular monitoring. Public awareness and education are key to reducing the global burden of high blood pressure.

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I hope that you liked this article.
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Writer: Vandita Singh, Lucknow (GS India Nursing Group)

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