HYPERTENSION

BY,
SHREYA BHANJA CHAUDHURY
ASSISTANT PROFESSOR (ADHOC)
THE NEOTIA UNIVERSITY
Hypertension is a chronic condition of concern due to its role in the causation of coronary heart
disease, stroke and other vascular complications.
It is the commonest cardiovascular disorder, posing a major public . health challenge to
population in socio-economic and epidemiological transition.
HYPERTENSION , also known as high blood pressure ( HBP) is a long term medical condition
in which the blood pressure in the arteries is persistently elevated.
CLASSIFICATION:
Hypertension is divided into primary (essential) and secondary.
Hypertension is classified as "essential" when the causes are generally unknown. Essential
hypertension is the most prevalent form of hypertension accounting for 90 per cent of all cases of
hypertension.
Hypertension is classified as "secondary" when some other disease process or abnormality is
involved in its causation.
Magnitude of the problem:
-Although blood pressure is easily measured, it had taken several
decades to realize that hypertension is a frequent, worldwide health
disorder.
-Hypertension is an "iceberg" disease. It became evident in the early
1970s that only about half of the hypertensive subjects in the general
population of most developed countries were aware of the condition,
only about half of those aware of the problem were being treated, and
only about half of those treated were considered adequately treated.
"Tracking" of blood pressure:
If blood pressure levels of individuals were followed up over a period of years
from early childhood into adult life, then those individuals whose pressures were
initially high in the distribution, would probably continue in the same "track" as
adults. In other words, low blood pressure levels tend to remain low, and high
levels tend to become higher as individuals grow older.
Risk factors for hypertension:
1. Non-modifiable risk factors
(a) AGE : Blood pressure rises with age in both sexes and the rise is greater in those with higher
initial blood pressure.
(b) SEX: Early in life there is little evidence of a difference in blood pressure between the sexes.
However, at adolescence, men display a higher average level. This difference is most evident in
young and middle aged adults. Late in life the difference narrows and the pattern may even be
reversed.
(c) GENETIC FACTORS: There is considerable evidence that blood pressure levels are
determined in part by genetic factors
2. Modifiable risk factors
(a) OBESITY : Epidemiological observations have identified obesity as a risk factor for
hypertension. The greater the weight gain, the greater the risk of high blood pressure. Data also
indicate that when people with high blood pressure lose weight, their blood pressure generally
decreases.
(b) SALT INTAKE : There is an increasing body of evidence to the effect that a high salt intake
(i.e., 7-8 g per day) increases blood pressure proportionately. Low sodium intake has been found
to lower the blood pressure.
Besides sodium, there are other mineral elements such as potassium which are determinants of
blood pressure.
(c) SATURATED FAT : The evidences suggest that saturated fat raises blood pressure as well as
serum cholesterol.
(d) DIETARY FIBRE : Several studies indicate that the risk of CHD and hypertension is
inversely related to the consumption of dietary fibre.
(e) ALCOHOL: High alcohol intake is associated with an increased risk of high blood pressure.
(f) HEART RATE :The heart rate of the hypertensive group is invariably higher.
(g) PHYSICAL ACTIVITY: Physical activity by reducing body weight may have an indirect
effect on blood pressure.
(h) OTHER FACTORS : The commonest present cause of secondary hypertension is oral
contraception, because of the oestrogen component in combined preparations. Other factors such
as noise, vibration, temperature and humidity require further investigation.
PREVENTION OF HYPERTENSION:
(a) NUTRITION- Dietary changes are of paramount importance. These comprise : {i) reduction
of salt intake to an average of not more than 5 g per day {ii) moderate fat intake {iii) the
avoidance of a high alcohol intake
(b) WEIGHT REDUCTION
(c) BEHAVIOURAL CHANGES-Reduction of stress and smoking, modification of personal
life-style, yoga and transcendental meditation could be profitable
(d) HEALTH EDUCATION-The general public require preventive advice on all risk factors and
related health behaviour.
(a) SELF-CARE-The patient is taught self-care, i.e., to take his own blood pressure and keep a
log-book of his readings. By doing so, the burden on the official health services would be
considerably reduced.
(b) EARLY CASE DETECTION
(c) TREATMENT
(d) EXERCISE