hypertension

Hypertension
What is hypertension
Causes
Lifestyle factors
Medications
Complications, bad effects
Natural remeddies for hypertension

What is hypertension HTN

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Hypertension (high blood pressure) is an elevation of blood pressure to a level that is a risk to the patient. There are two readings for blood pressure, systolic and diastolic. When the heart beats it pushes blood out into the arteries which are elastic: they balloon out a bit and gradually squeeze the blood downstream to the small vesels. As they squeeze the blood downstream the pressure falls. So the highest pressure (systolic) is at the time of the heartbeat. The lowest pressure (diastolic) is just before the next heartbeat when the arteries have almost finished squeezing. The traditional normal reading is 120 systolic over 80 diastolic, 120/80. However you may be quite healthy at 130/70 or 105/65. Normal has a wide range.
Hypertension HTN is generally accepted as a systolic BP =>140 and diastolic => 90. Risk for CVD (cardiovascular disease) starts at 115/75 so perhaps we should make that the figure to aim for. CVD risk doubles for every 20/10 increase above 115/95. A person with a BP of 135/95 is at double the risk for CVD of one whose BP is 115/75.

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Causes of hypertension
Most people who have blood pressure problems do not have an obvious cause so it is termed primary or idiopathic.
Some people have hypertension secondary (secondary hypertension) to another disease. Kidney problems head this list but there are many other causes ranging from abnormal blood vessels to disorders of hormones, and tumours that produce hormones.
While the cause may be unknown there are many associated conditions. It is race related, has genetic traits and is associated with lifestyle factors such as obesity, diet and exercise.

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Lifestyle factors

Lower your BP 3mm and you reduce your risk of stroke 8% and your risk of heart attack 5%.

Obesity. Lose 2 lb, lower systolic 1 point, diastolic 1/2 a point.
Maintaining weight loss is difficult but studies have shown that when a doctor or health practitioner takes the time to counsel the patient on weight loss, it is much more successful.
Exercise: BP is lowered for 22 hours after an endurance exercise program.
The higher your starting BP, the greater an effect exercise has on lowering your BP.
Exercise 5 days a week at a moderate pace has shown sustained reduction in hypertension, and a decreased risk of dying from cardiovascular causes.
Diabetes and hyperlipidemia (cholesterol) are also helped by this regime. Forty min. on an exercise cycle is equivalent to 8 units of insulin in many diabeteics: good cholesterol is raised by exercise: triglycerides are burned during prolonged exercise.
To find out what is "moderate" for you requires a stress (treadmill or bicycle ergometer) test, best done by your health practitioner who knows your meds etc. but it can be done saftely at a health facility by a trained exercise physiologist or kinesiologist in low risk, healthy people. If you are already taking BP medication you must consult your doctor before starting an exercise program as some BP meds combine with exercise to lower the blood pressure too much, causing fainting.
Exercise also helps with weight loss. The body is smart: it uses the energy in your food to the best advantage: if you are a regular exerciser, it stores extra energy a energy molecules (free glycogen, fatty acids etc.) in the muscles and liver. If you do not exercise, it stores excess food energy as fat. This is a good survival strategy, as there have always been periods of starvation in our history. Starvation persists today in some parts of the world. Our ancestors ate well when food was available, then they were forced to diet during winter and spring until the first harvests came in.
How much you exercise determines whether the body stores fat or uses it. You can control your metabolism.

Salt and potassium (sodium and potassium) Lower BP by 4.4/2.5 by increasing potassium
Traditionally doctors have counselled patients to reduce salt (sodium) to help hypertension. Now we know that increasing potassium is important too. An increase in potassium 1.9 g per day lowers systolic blood pressure by 4.4 mm and diastolic by 2.5 mm in high BP patients and by 1.8 and 1.0 mm in patients with normal BP.

DASH The DASH diet is designed to achieve the weight loss and other dietary changes needed to help control BP. Dietary Approach to Stop Hypertension.
http://www.nhlbi.nih.gov/health/public/heart/hbp/dash/index.htm

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Medications
The five main types of HTN medications are

diuretics (water pills)
ACE-I, ACE inhibitors, angiotensin converting enzyme inhibitors
ARB, angiotensin 11 receptor antagonists
CCB long acting calcium channel blockers
(Beta-blockers) No longer first line in Britain, still accepted in US: talk with your GP about risk of diabetes.

Any of these can be used as first line therapy, and can be used in combination if there is not a good enough response to the first medication
MORE ON MEDICATIONS (opens new page)

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Complications of hypertension.
Hypertension causes heart attacks and strokes.
Kidney disease is related to hypertension. Kidney disease also causes hypertension. Malignant hypertension is where hypertension causes kidney disease which worsens the hypertension etc. in a viscious circle.
Erectile dysfunction (ED) can result from hypertension and can be associated with hypertension meds.
Eye problems and blindness. The small arteries in the eye are affected by hypertension causing haemorrhages and other damage causing problems with vision.
Hardeningof the arteries (atherosclerosis) is aggravated by hypertension. Cholesterol is laid down in arteries more easily if the artery is under pressure from hypertension. This is particularly bad where arteries split at a Y junction causing turbulence such as to the brain (the carotids) and in the pelvis to the legs (iliac arteries). Just after the Y juction there is often a thickened area called plaque which can block the arteries to the brain or legs. High blood pressure and cholesterol cause partial or total blockage of the arteries. In the case of the legs this causes claudication which is a cramping of the leg muscles on walking or climbing a slope: and gangrene when the blockage is total and tissue dies. In the case of the neck arteries leading to the brain this causes strokes or mini-strokes (TIA, transient ischaemic attack.)