What else do we need to know about Hypertension?

Introduction

High blood pressure or hypertension is one of the top 10 “Silent Killer” diseases not only here in the Philippines but around the globe. Its pseudo-name is derived from the fact that majority of people having hypertension are unaware that they have it due to its hidden symptoms. What do we need to know about hypertension?

Basic Facts about Hypertension

Statistics in the Philippines revealed that hypertension affected a projected number of 1.13 billion people in year 2015, and including 7.5 million deaths in a year. Philippine Heart Association also disclosed in their conducted survey that hypertension has the highest number among hospital-based population in relation to incidence of cardiovascular diseases, a leading risk factor amid stroke, coronary artery disease and heart failure. If not managed accordingly, it may also lead to diseases aforementioned, adding renal failure in the list.

According to American Heart Association (AHA), blood pressure is defined as “the force of blood pushing against blood vessel walls.” It is measured in millimeters of mercury (mm Hg). High blood pressure (HBP) means “the pressure in your arteries is higher than it should be. Another name for high blood pressure is hypertension.”

As common as it is, blood pressure is inscribed with a fraction number style, example is 110/80 mmHg. The upper or first number is called systolic wherein it measures the “pressure when heart beats.”. The lower or second number is termed as diastolic in which “the heart rests between beats.” Clinical practice guidelines have been established to set a standard to diagnose hypertension. Higher chances of developing hypertension consist of certain modifiable or controlled and non-modifiable or uncontrolled risk factors. 

Modifiable risk factors include cigarette smoking or passive (second-hand) smoking, diabetes, being obese or overweight, high cholesterol, unhealthy diet that involves of more high sodium and low potassium food intake, and sedentary lifestyle. Nonmodifiable risk factors are strong family history of high blood pressure, race/ethnicity, male as a gender and old age (>65 years).

Hypertension can only be diagnosed by regularly checking one’s blood pressure by a health care provider. An average of two or more readings in two or more consecutive visits can appropriately diagnose a high blood pressure. Management of hypertension encompasses a change in the previous lifestyle, particularly reversing one’s modifiable risk factors. Anti-hypertensive drugs such as angiotensin II receptor antagonists and beta blockers that work to control high blood pressure, are usually prescribed as maintenance medications.

New Discoveries about Hypertension 

As previously mentioned, clinical practice guidelines updates and revisions are released by the medical governing authorities to standardize diagnosing a certain disease. Quoting once more from AHA, “Normal blood pressure is below 120/80 mm Hg. If you’re an adult and your systolic pressure is 120 to 129, and your diastolic pressure is less than 80, you have elevated blood pressure. High blood pressure is a systolic pressure of 130 or higher, or a diastolic pressure of 80 or higher, that stays high over time.” To understand briefly, the following list presents the newly grouped blood pressure measurements and indications based on the latest guidelines from the American College of Cardiology (ACC) and American Heart Association (AHA):

• Normal: Less than 120/80 mm Hg;
• Elevated: Systolic between 120-129 and diastolic less than 80;
• Stage 1: Systolic between 130-139 or diastolic between 80-89;
• Stage 2: Systolic at least 140 or diastolic at least 90 mm Hg;
• Hypertensive crisis: Systolic over 180 and/or diastolic over 120, with patients needing prompt changes in medication if there are no other indications of problems, or immediate hospitalization if there are signs of organ damage.

The newest guideline abolished the category of prehypertension, a previously labeled indicator of high blood pressure with a systolic of 130-139. A systolic of 140 was formerly classified as Stage 1 hypertension, but is now categorized to Stage 2 hypertension. Other variations according to the ACC/AHA guidelines are as follows:

• Only prescribing medication for Stage I hypertension if a patient has already had a cardiovascular event such as a heart attack or stroke, or is at high risk of heart attack or stroke based on age, the presence of diabetes mellitus, chronic kidney disease or calculation of atherosclerotic risk (using the same risk calculator used in evaluating high cholesterol).
• Recognizing that many people will need two or more types of medications to control their blood pressure, and that people may take their pills more consistently if multiple medications are combined into a single pill.
• Identifying socioeconomic status and psychosocial stress as risk factors for high blood pressure that should be considered in a patient’s plan of care.

Conclusion

Updating the latest guidelines aim for better detection, prevention, management and treatment of high blood pressure. Intensification of hypertension awareness, promotion of a healthy lifestyle and a commitment in taking antihypertensive drugs as maintenance medications decrease the risk of complications from hypertension. If you are feeling the signs of hypertension, you may contact Mypocketdoctor through their Facebook page and/or chat with their agents on their website www.mypocketdoctor.com. Likewise, you may check the Frequently Asked Questions (FAQs) through this link.

References:

www.manilatimes.net

www.ahajournals.org

www.heart.org

www.acc.org