Do You Have Hypertension? A Doctor's Guide to Spotting the Signs, Types

Hypertension puts high pressure over the heart and blood vessels of organs leading to organ damage like heart attack

The force of pressure exerted by the blood flow over the blood vessels is called as Blood pressure or BP in short. Hypertension i.e. Increasing blood pressure puts high pressure over the heart and blood vessels of vital organs leading to organ damages like heart attack and stroke.

As per the latest international guidelines BP over 130/90 in < 60 years of age and 140/90 is >70 years is considered as hypertension requiring medical intervention.

Hypertension is mainly classified as

• Primary Hypertension

• Secondary Hypertension

• Gestational Hypertension

• Other than these White coat Hypertension and Resistant Hypertension are also important subtypes.

Primary Hypertension

This is usually asymptomatic and is diagnosed at random in routine checks. Henceit is highly recommended for patients with family history of hypertension, obesity, diabetes, and smokers to monitor their BP regularly.

How Can Primary Hypertension Be Managed

• Eating a healthy diet low in salt and saturated fats

• Regular exercise

• Maintaining a healthy weight

• Quitting smoking

• Limiting alcohol intake

• Managing stress

• In addition to lifestyle changes, medication may be prescribed to help lower blood pressure.

Secondary Hypertension

Rise in blood pressure secondary to obstructive sleep apneas, intrinsic renal dysfunction or renal vascular dysfunction and adrenal defects is usual sudden and is treated along with treatment of the basic pathology.

To manage secondary hypertension, the underlying condition must be diagnosed and treated. In addition, lifestyle changes such as those recommended for primary hypertension may also be helpful.

It is important to note that hypertension can lead to serious health complications if left untreated, including heart attack, stroke, and kidney disease.

If you have high blood pressure, it is important to work with your healthcare provider to develop a treatment plan that works for you.

Gestational Hypertension

Pregnancy-induced hypertension affects maternal and foetal health.

Pregnancy-safe anti-hypertensive agents and timely delivery under obstetrician supervision is usually the rule. But a significant percentage of patients do require prolonged anti-hypertensive post-delivery.

White Coat Hypertension

This is usually seen with young patients with anxiety and is a condition where a person's blood pressure reading is higher in a healthcare setting than at home.

The phenomenon is believed to be due to anxiety experienced during a clinic visit. It is important to note that white-coat hypertension is a temporary condition and does not lead to long-term health problems.

However, it is still important to monitor blood pressure readings and work with healthcare providers to develop a treatment plan if necessary

Resistant Hypertension

It is one where by definition it requires more than 3 anti-hypertensive drugs to control BP including a diuretic. Usually seen in patients with poor drug compliance, severe obesity and multi-factorial hypertension.

What Are The Causes Of Resistant Hypertension

These factors may vary but can include:

• Poor medication adherence

• Secondary hypertension (caused by an underlying medical condition)

• Obesity

• Sleep apnea

• Chronic kidney disease

• Excessive alcohol consumption

• Certain medications or supplements

To manage resistant hypertension, it is important to identify and address any underlying causes or contributing factors.

This may include lifestyle changes such as weight loss, regular exercise, and a healthy diet low in sodium and saturated fats. In addition, medication adjustments or changes may be necessary to help control blood pressure.

It is important for individuals with resistant hypertension to work closely with their healthcare provider to develop a comprehensive treatment plan.

Regular blood pressure monitoring and medication adjustments may be necessary to effectively manage the condition and reduce the risk of complications such as heart attack, stroke, and kidney disease.

Any increase in blood pressure primarily requires changes in lifestyle with taking adequate rest from physical and mental stress, weight loss, salt restriction followed by regular physical activity.

Anti-hypertensive medications typically are focused on relaxing blood vessels, pouring out more fluid in urine, relaxing heart muscles and reducing body’s sympathetic drive.

The choice of agent depends on patient profile and analysis of different organ functions.

(Dr Natasha Kumrah , MBBS, MD-General Medicine at Ruby Hall Clinic.)