What is blood pressure?
In our daily lives, the term “blood pressure” is not unfamiliar. To know what blood pressure is, we must know its physiology. Arteries are the vessels which distribute the blood in the whole body from the heart to brain and other body organs. For the blood to circulate properly, an adequate amount of pressure is required, which is maintained by arteries or blood vessels.
What is Systolic Blood Pressure?
Systolic Blood Pressure is the pressure of blood during contraction of the heart, resulting in pumping-out of blood to the body through vessels (arteries).
What is Diastolic Blood Pressure?
Diastolic Blood Pressure is the pressure of blood during relaxation of heart muscles during alternating beats.
In our day and night routines, fluctuations in the pressure of blood are natural. However, if these fluctuation results in increased blood pressure even on rest, then it becomes complex and is termed as “hypertension.”
Pathophysiology of hypertension:
Hypertension is chronically increased blood pressure, which is the consequence of an increase in cardiac output (amount of blood pumped out per minute) and SVR- systemic vascular resistance (resistance of vessels against blood flow).
In the younger population, CO (cardiac output) is elevated while in the elderly population, there is an elevation in vascular stiffness and systemic vascular resistance. Both these factors increase the load on the left ventricle of the heart, leading to left ventricular diastolic dysfunction and left ventricular hypertrophy.
Prevalence of hypertension:
In a British survey, 63.7% of the population was presenting with elevated blood pressure and 54.5% of the population was medically diagnosed and aware of their hypertension. While 58.9% of them were taking anti-hypertensive medications to manage it.
Worldwide, about every 1 in 4 people have a complaint of hypertension. It has been estimated that by 2025, hypertension will be affecting more than 1.5 billion people.
According to a report from the Global Burden of Disease, elevated blood pressure accounted for more than 10.7 million deaths.
Stages of hypertension:
According to Joint National Committee VI Guideline, stages of hypertension are described as:
- Systolic – less than 120 mmHg
- Diastolic – less than 80 mmHg
- Systolic – between 120 to 129 mmHg
- Diastolic – between 80 to 84 mmHg
Hypertension – stage 1:
- Systolic – between 140 to 159 mmHg
- Diastolic – between 90 to 99 mmHg
Hypertension – stage 2:
- Systolic – between 160 to 79 mmHg
- Diastolic – between 100 to 109 mmHg
Hypertension – stage 3:
- Systolic – more than 180 mmHg
- Diastolic – more than 110 mmHg
Risk factors of Hypertension:
According to literature, there are two types of a risk factor for hypertension:
- Modifiable risk factors
- Unmodifiable risk factors
Modifiable Risk Factors:
Modifiable risk factors refer to factors which can be changed and modified into less threatening risks. Following are the risk factors which can be controlled to prevent hypertension:
- Diabetes mellitus
- Obesity and body weight
- Smoking habits
- Cholesterol levels
- LVH (left vessel hypertrophy)
- Alcohol consumption
- Sedentary lifestyle/lack of physical functioning and activity
- Excess intake of dietary salt
- Stress and mental health
- Socioeconomic status
Unmodifiable Risk factors:
Refers to factors which aren’t under voluntary control to change them. Unmodifiable risk factors for hypertension are:
- Family History (genetic composition)
Self-monitoring for blood pressure:
To prevent hypertension and to immediately treat it, self-monitoring is vital.
According to The British and Irish Hypertension Society, patients who self-monitor can lower their values by a 2.5mmHg in both systolic and diastolic blood pressures. That’s why it is recommended for patients to put an intense focus of taking blood pressure measures now and then.
Elevated Blood Pressure and its possible complications
Treatment of Hypertension:
According to different studies and literature, there are two ways to manage hypertension:
- Drug therapy
- Lifestyle modification
Drug therapy includes:
- Beta-blockers (atenolol)
- ACE inhibitors (Angiotensin-converting Enzyme Inhibitors)
- Calcium channel blockers
- Natriuretic peptides
- Adrenergic inhibitors (central)
- α1-Adrenergic blockers
- Angiotensin II receptor blockers (Losartan)
Measures that lower levels of blood pressure:
- Reduced intake of saturated fats
- Increased consumption of fresh vegetables and fruits
- Increased physical activity and regular exercise
- Reduction in consumption of alcohol
- Less intake of dietary salt
- Obesity reduction/ body weight reduction
Measures that decrease the risks of cardiovascular diseases related to hypertension:
- Cessation of smoking
- Increased consumption of fish or fish-oils
- Intake of mono-unsaturated or poly-unsaturated fats rather than saturated fats
- Less total consumption of fats
Statin and aspirin therapies:
Hypertension increases the risk of getting Coronary Artery Disease, Myocardial Infarction & stroke. Using low doses of Aspirin has shown to be effective for these conditions. Statin therapies are effective when eliminating the risk of Atherosclerosis.
Hypertension is the leading cause of deaths worldwide. Hypertension is a disease of complex complications involving multiple body systems and damaging multiple body organs. It has affected about one billion population worldwide and has been estimated to affect more than 1.5 billion people after some years. Earlier identification and adequate management of hypertension can reduce its deteriorating effects and minimize its risk factors.
Regular blood pressure is also essential for swift blood circulation to the body’s organs and cells. The power of the blood onto the walls of the blood vessels is called blood pressure. Blood pressure has been measured both as the center contracts, which can be called systole, also because it hastens, which can be called diastole.
If you are concerned about your Blood Pressure or would like to know more information please contact your local Imaan Pharmacist here.