Hypertension

What is hypertension?

Hypertension is the medical term for high blood pressure. A blood pressure between 120 and 129 mm Hg for the top (systolic) number and more than 80 mm Hg (diastolic) for the bottom number is considered elevated. Hypertension is a silent killer; 30% of Ghanaians are reported to have hypertension but are unaware of their diagnosis.

Myths about hypertension

Eating too much salt can cause hypertension. Consumption of too much table salt (Sodium Chloride), stock cubes, packaged spices and flavor enhancers (Monosodium Glutamate) and salt petre (kanwe) is a direct risk factor for developing hypertension.

Hypertension can be cured. Not all types of hypertension can be cured completely- as explained above. Management with medication can however prevent disease progression and other complications.

How is blood pressure measured?

When your heart beats, it creates pressure that pushes blood throughout your circulatory system. Your blood pressure is measured with two numbers, in units of millimeters of mercury (mm Hg). The first (top) number represents the pressure when your blood is pumped from your heart to your arteries. This is called systolic blood pressure. The second (bottom) number represents the pressure when your heart is at rest, between beats. This is called diastolic blood pressure.

Now blood pressure measurements are categorized as follows:

• Normal: systolic less than 120 mm Hg and diastolic less than 80 mm Hg
• Elevated: systolic between 120-129 mm Hg and diastolic less than 80 mm Hg
• Stage 1: systolic between 130-139 mm Hg or diastolic between 80-89 mm Hg
• Stage 2: systolic at least 140 mm Hg or diastolic at least 90 mm Hg

What are the types of hypertension?

Primary hypertension

Primary hypertension is also known as essential hypertension. Most adults with hypertension are in this category. A specific cause isn’t known. A combination of factors typically plays a role in the development of essential hypertension these are:

• Genes: Some people are genetically predisposed to hypertension. This may be from gene mutations or genetic abnormalities inherited from your parents.
• Age: Individuals over 65 years old are more at risk for hypertension.
• Race: Black Africans have a higher incidence of hypertension.
• Living with obesity: Living with obesity can lead to a few cardiac issues, including hypertension.
• High alcohol consumption: Women who habitually have more than one drink per day, and men who have more than two drinks per day, may be at an increased risk for hypertension.
• Living a very sedentary lifestyle: lowered levels of fitness have been connected to hypertension.
• Living with diabetes and/or metabolic syndrome: Individuals diagnosed with either diabetes or metabolic syndrome are at a higher risk of developing hypertension.

Secondary Hypertension

Secondary hypertension is when there’s an identifiable— and potentially reversible— cause of your hypertension. Its more prevalent in younger people. The underlying causes of secondary hypertension include:

• Narrowing of the arteries that supply blood to your kidneys
• Adrenal gland disease
• Side effects of some medications, including birth control pills, diet aids, stimulants, antidepressants, and some over-the-counter medications
• Side effects of excessive herbal medications and concoctions
• Obstructive sleep apnea
• Hormone abnormalities
• Thyroid abnormalities
• Constriction of the aorta
• Diabetes

Resistant hypertension

Resistant hypertension is the name given to high blood pressure that’s difficult to control and requires multiple medications.

Malignant hypertension

Malignant hypertension is the term used to describe high blood pressure that causes damage to your organs. This is an emergency condition. Malignant hypertension is the most severe type, characterized by elevated blood pressure usually at >180 mm Hg systolic or >120-130 mm Hg diastolic, plus damage to multiple organs.

Hypertensive emergency

A hypertensive emergency, also called malignant hypertension, is when your blood pressure suddenly rises above 180/120 and you have symptoms from this sudden increase in blood pressure. These include:

• Chest pain
• Headache
• Shortness of breath
• Dizziness
• Visual changes

This is a life threatening condition, because high blood pressure can cause severe damage to the essential organs which may deem fatal.

Hypertensive urgency

Hypertensive urgency is when your blood pressure is above 180/120, but you have no other symptoms.

White coat hypertension

This term refers to when your blood pressure may go up temporarily simply because you’re in a doctor’s office or another stressful occurrence, like being stuck in traffic or waiting for exam results.

How is hypertension treated?

• Beta-blockers: Beta-blockers make your heart beat slower and with less force. This reduces the amount of blood pumped through your arteries with each beat, which lowers blood pressure. It also blocks certain hormones in your body that can raise your blood pressure.
• Diuretics: High sodium levels and excess fluid in your body can increase blood pressure. Diuretics, also called water pills, help your kidneys remove excess sodium from your body. As the sodium leaves, extra fluid in your bloodstream moves into your urine, which helps lower your blood pressure.
• ACE inhibitors: Angiotensin is a chemical that causes blood vessels and artery walls to tighten and narrow. ACE (angiotensin converting enzyme) inhibitors prevent the body from producing as much of this chemical. This helps blood vessels relax and reduces blood pressure.
• Angiotensin II receptor blockers (ARBs): While ACE inhibitors aim to stop the creation of angiotensin, ARBs block angiotensin from binding with receptors. Without the chemical, blood vessels won’t tighten. That helps relax vessels and lower blood pressure.

Hypertension is a fairly common condition common amongst people in Ghana. Do well to go for regular reviews at the clinic and check your Blood pressure at home, or at a pharmacy or health facility nearby, to have an idea of how well your BP control is.