Hypertension or High blood pressure is a chronic condition in which high forces are applied to arterial walls to the extent that it can damage vital organs and result in increase the risk of serious conditions.

There are no typical symptoms for high blood pressure. It can run secretly to cause life-threatening complications, such as heart attack and stroke. Blood pressure is measured through specific machine and the normal result considered to be less than 120/80 mm Hg.

Prescribed medications and lifestyle changes are necessary and effective ways to treat hypertension. Physical activity, healthy diet and loosing excessive weight are helpful steps on the road of hypertension prevention.

Hypertension (HTN) or High blood pressure (HBP) is a common, dangerous condition in which the force of the blood against your artery walls is high to a level that it may causes organ damage and results in increased morbidity and mortality.

There are two main types of hypertension based on their Etiology:

• Essential (primary) hypertension: a high blood pressure with unknown cause. This type accounts for most cases of hypertension;
• Secondary hypertension: appears suddenly and is more severe than primary hypertension. It is caused by an underlying condition or disease, including:
  • Obstructive sleep apnea;
  • Kidney disease;
  • Adrenal gland tumors.
  • Underactive thyroid gland (Hypothyroidism);
  • Certain congenital defects in blood vessels, like Coarctation of the aorta;
  • Some medications, like birth control pills, decongestants and non-steroidal anti-inflammatory drugs;
  • illicit drugs, such as cocaine and amphetamines;
  • Alcohol abuse or prolonged Alcohol drinking.

• Prehypertension: When blood pressure is between 120/80 and 139/89 mmHg, the chance to develop hypertension is greater;
• Having Diabetes: 6 out of 10 people who have diabetes also have high blood pressure;
• Obesity: linked to abnormal cholesterol levels that elevates the risk of hypertension;
• Sedentary life style: inactivity can cause weight gain and higher hear rate, both which can lead to high blood pressure;
• Alcohol drinking: alcohol affects the liver and can lead to cardiovascular conditions as high blood pressure;
• Smoking: It can damage the heart and blood vessels, narrow the arteries, thus increasing blood pressure;
• High sodium intake: Too much sodium in the diet can cause water retention, which increases blood pressure;
• Low potassium intake: Potassium play a major role in balancing the amount of sodium and heart health. It is found in bananas, potatoes and beans;
• Family History: Genetic factors have some impact in hypertension among family members. They may also share environmental factors that increase their risk;
• Vitamin “D” Deficiency: This Vitamin may influence an enzyme produced by kidneys and affects blood pressure through renin-angiotensin system.
• Stress: Severe psychological tension can lead to a temporary increase in blood pressure;
• Certain health problems: some prolonged, untreated conditions also may increase the risk, such as kidney disease and sleep apnea.

When the heart pumps, it creates a force on the walls of the arteries. This pressure depends into 3 factors: heart rate, the ejected blood volume and the resistance to blood flow in the arteries. The more blood heart pumps and the narrower the arteries, the higher your blood pressure. Such increase in these parameters may be due to:

• Sympathetic nervous system stimulation that cause higher resting pulse rate, thus higher cardiac output and blood pressure;
• Impairment is the system that helps regulate blood volume and therefore Blood pressure, which is Renin-angiotensin-aldosterone system;
• Deficiency of a vasodilator such as nitric oxide or excess of a vasoconstrictor like angiotensin and norepinephrine;
• Abnormal Sodium transport across the cell wall because of defected, inhibited Na-K pump or due to increased Na+ permeability.

Hypertension is called the "silent killer" because it is often asymptomatic and many people do not know they have it until discovered suddenly or complication happened. Rarely, high blood pressure can cause symptoms like headache, vomiting, shortness of breath or nosebleeds, but these aren't specific and usually don't noticed until blood pressure has reached a severe, risky level.

The only way to makes sure of having hypertension or not is measuring blood pressure with a tool called sphygmomanometer. Blood pressure test measuring two numbers:

• Systolic pressure (the top number): recorded when the heart ventricles contract to eject blood into the arteries;
• Diastolic pressure (the bottom number): recorded between beats when the ventricles are relaxed.

For instant, If the result was 115 systolic and 75 diastolic, then it is said "115 over 75" or written "115/75 mmHg". The measurements and their interpretation will fall into the following general categories:

Resting and relaxing is needed to accurate measurement. Suitable cuff size also is important to achieve relative result. A doctor then will diagnose hypertension in these cases:

• Right away if blood pressure is higher than 200/120 mmHg;
• After two visits over a short period with Blood pressure higher than 180/110 mmHg;
• After three visits with blood pressure higher than 160/100 mmHg;
• After five visits with blood pressure higher than 140/90 mmHg.

In November, 2017, The American college of cardiology and the American heart association had updated the guidelines for the classification of hypertension. The new guidelines are based on dedicated work from 2003 that includes 21 health professionals from 11 organization who reviewed more than 900 study in the field. Hypertension had been defined as having systolic or diastolic blood pressure equal or more than 130 or 80 MM Hg, respectively. The main categories for blood pressure based on an average of at least two in-office measures are:

• Normal: Systolic less than 120 mm Hg and diastolic less than 80;
• Elevated: Systolic between 120-129 and diastolic less than 80;
• Stage 1: Systolic between 130-139 or diastolic between 80-89;
• Stage 2: Systolic equal or more than 140 or diastolic at least 90 mm Hg;
• Hypertensive crisis: Systolic over 180 and/or diastolic over 120.

In addition to measuring blood pressure, the doctor takes medical history and assesses the risk factors. Tests may also be done include:

• Lipid profile that shows cholesterol levels;
• Echocardiogram or Electrocardiogram to check Heart disease;
• Kidney Function test (KFT) for renal health condition.

Adherence to treatment plan for high blood pressure is very important because it can prevent or delay complications and help having a good quality of life. The combination of medications and the healthy habits helps control and lower blood pressure. Treatment could further include dealing with underlying conditions.

• Medications: Several types and classifications of drugs are uses to control hypertension. Many people take two or more medicines based on doctor prescription. These include:
  • Diuretics: Flush excess sodium and water from the body, which reduces the volume of blood. Examples: Hydrochlorothiazide, Chlorthalidone and Furosemide;
  • Angiotensin-Converting Enzyme (ACE) Inhibitors: blocks the formation of Angiotensin-II; a hormone that narrows blood vessels. It could be beneficial for kidney patients under supervision. Examples: Lisinopril, Benazepril and Captopril;
  • Calcium Channel Blockers: help blood vessels to relax throw keeping calcium from entering the muscle cells of heart and blood vessels. Examples: Amlodipine, Diltiazem. Grapefruit may interact with these medication by increasing their levels in the blood;
  • Beta Blockers: decrease heart rate and force of contraction, thus less blood is pumped through your blood vessels. Examples: Acebutolol and Atenolol;
  • Alpha Blockers: Relax certain muscles and help maintaining of small blood vessels opened. This allows blood to flow more freely. Examples: Doxazosin, Prazosin and Terazosin;
  • Alpha-Beta Blockers: they work as both blockers mentioned above to decrease blood pressure. Examples: Carvedilol and Labetolol hydrochloride.

Taking prescribed medication is crucial to control hypertension. Patients must take medications exactly as directed by health care provider and should never skip days. They have to make sure refilling their medicines before running out. Some people develop irresponsive high blood pressure to prescribed medications. This needs intensive treatment plan that can include a different set of blood pressure medications or other special treatments.

• Healthy eating: According to American Heart Association, people who have hypertension should reduce their total sodium intake to be less than 1500 mailgram per day. This include curbing added salt, limiting processed foods and reading labels to check sodium content. Eating heart healthy foods may also help controlling the condition and mitigating its complications. Such foods are: Whole grains, fruits, vegetables, Legumes and Fish high in omega-3 fatty acids like salmon. In contrast, patients are advised to avoid eating large amount of red meat, sugary foods and beverages also palm and coconut oils.
• Exercising regularly: Routine physical activity can assist in decreasing high blood pressure and reduce the risk for other health problems. It is recommended to talk with health care provider before starting a new exercise regimen In order to determine the suitable kinds and duration of exercise to be safe and effective. Everyone should try to participate in moderate-intensity aerobic exercise, like brisk walking, at least 150 minutes per week, or high-intensity aerobic exercise such as playing football, for 75 minutes a week. Setting many Sessions each for at least 10 minutes and spread them throughout the week.
• shedding excessive weight: Loosing just 3 to 5 percent of person’s weight can lower his/her risk for many health problems or support in controlling it. More weight loss, more improvement in blood pressure readings and lipid profile.
• Managing Stress: Learning how to relax and cope with troubles can improve physical and emotional health which can lower high blood pressure. This can be achieved by some techniques, like Meditating, yoga and listening to something peaceful.
• Ongoing Care: Tracking blood pressure is vital. Regular checking and medical follow-ups can aid in setting and modifying treatment plan to be more relevant. If any complication has noticed, the available interventions will go on.

When blood pressure stays high over time, it can damage the body and cause complications. Some common of them are:

• Stroke: take place when blood flow to a portion of the brain is blocked. Hypertension considered the single most important risk factor for this life-threatening condition;
• Heart Attack: a section of heart muscle doesn’t get enough oxygen by suddenly blocked artery. Hypertension fastens hardening of the coronal arteries and the buildup of plaques that result in this serious disease;
• Aneurysm: an abnormal bulging in the wall of an artery develops for years without signs or symptoms until bursting or enlarging to press on nearby body organs or vessels. The condition can cause deadly bleeding;
• Chronic Kidney Disease: When blood vessels narrow and weaken in the kidneys, blood supply for them is decreased. This can lead to kidney damage and renal failure;
• Cognitive Changes: Over time, high blood pressure can affect cognitive abilities manifested by memory loss, difficulty finding words, and losing focus during conversations;
• Eye problems: vision is hurt by thickened, narrowed or torn eye blood vessels that may burst to cause visual changes or even blindness;
• Heart Failure: Prolong working of the heart against high forces can its construction and function. Here, the heart can’t pump enough blood to meet the body’s needs;
• Peripheral Artery Disease: hypertension increase the risk of plaque formation in leg arteries, which could block them and affects blood flow in the legs;
• Metabolic syndrome. It is a cluster of disorders, including abdominal fat accumulation; high triglycerides; low high-density lipoprotein (HDL); high blood pressure; and high insulin levels.

Healthy lifestyle habits mentioned above can help prevent or delay high blood pressure from developing. In cases of approaching to hypertension (systolic pressure 120-139 or Diastolic 80-89), the person need to take care and focus on commitment and follow-up to avoid progressing of the condition.

Screening tests are good for anticipating hypertension. Healthy and normal blood pressure Persons are advised to get blood pressure readings at least every two years starting at age 18. But measuring yearly if age 40 or older, or even 18-39 years with a high risk of high blood pressure as in prehypertension stage.

Even high blood pressure is a chronic condition, most of the time it can be controlled with prescribed medications and lifestyle changes. The morbidity and mortality of hypertension depend on the intensity of end-organ dysfunction and the degree to which blood pressure is controlled subsequently.

Globally, World Health Organization estimates the number of people with uncontrolled hypertension to 1 billion. The overall prevalence of high blood pressure in adults aged 25 and over was around 40% in 2008. Worldwide, high blood pressure nearly causes 7.5 million deaths every year, accounts for about 12.8% of the total of all deaths.

Blood pressure tends to rise with age. As a result, more elderly people have this condition. Women have about the same chances of men to develop high blood pressure at some point of their lives. Statistics show Black people develop high blood pressure more often than whites, Hispanics, Asians, Pacific Islanders, or American Indians.

Hypertension is a leading cause of stroke and ischemic heart disease that ranked the top two killers worldwide. Death from these problems is proportional to the elevation in blood pressure. According to World Heart Federation, high blood pressure causes about half of ischemic strokes around the world, which happens as a result of blockage in an artery that supplies the brain.