Journal of Health and Medicine

What is Hypertension?


Hypertension does not mean you are suffering from nerves, stress or tension, as the name seems to imply, although many are tense, up-tight individuals. This is the doctor’s medical term which simply means elevated blood pressure.

We all have a certain level of blood pressure. If we didn’t the blood would not be able to circulate around the system. It is a simple, measurable quantity. In recent years, we have discovered that readings that are above normal carry certain risks. In some individuals these may be serious.

It is now much appreciated by doctors that sensible, regular treatment is extremely effective in reducing the risks of hypertension. Or, as the “British Medical Journal” thoughtfully put it recently: “Certainly in mild hypertension (the most common kind), the blood pressure can readily be reduced.”

Blood pressure readings are a measure of the pressure of the blood in the arteries. When the heart pumps, blood surges into the great arteries, firstly the aorta leading from the heart, and then into the smaller branches. This is called the systolic pressure.

In the momentary lull between successive beats, the pressure naturally falls. This lower reading is referred to as the diastolic pressure. In recent years, doctors have recognized that the diastolic reading is the trouble maker. If this is persistently raised, trouble could be in store.

The reason is that each time the heart beats it must force the blood into the arteries against a raised resistance. This simply means that the heart must work harder with each beat. Not much in itself, but when you consider this happens 70 times a minute, day in day out, year in year out, then the increased amount of work the heart is expected to perform becomes gigantic. It is hardly surprising then, that the heart, like the rest of the body, gets prematurely tired and may weaken relatively early in life.

Nobody is sure what causes high blood pressure. Some claim the tendency is inherited. Others believe premature thickening of the vessel walls makes them less elastic, unable to stretch and shrink with each heart beat as new surges of blood are pumped in.

But whatever the cause, and we may not know for decades yet, the fact is that hypertension is one of the well-recognized risks in causing premature heart attacks. It also plays an important part in producing CVAs, cerebrovascular accidents – or strokes, in simple language.

Particularly with advancing years, some blood vessels tend to develop weak spots, just as the water pipes in your home corrode and develop weak spots here and there. With persistently high pressure in these pipes, it becomes inevitable that sooner or later the weak spot will simply give way. When this occurs in blood vessels, blood surges out into surrounding tissues.

If this happens to be in a vital part of the brain it can rapidly destroy a very large area of brain tissue. That’s how sudden strokes develop.

More commonly, small CVAs occur. These may cause odd symptoms in certain areas. For example, the lips may become tingly or numb on one side of the face, or the fingers tingle. Or an arm, or hand may become temporarily weak. Many variations can occur. But these are certainly danger signs, and often they are followed Рmaybe months or even years later Рby more serious strokes.

Just how hypertension produces premature heart attacks is not very clear. But it is certainly well established. It is even more risky if associated with the other trouble spots, such as smoking, overweight, high cholesterol and triglyceride levels (these are the fats conveyed via the blood stream), lack of exercise, stress, diabetes.

Also, a family history of high blood pressure and heart disorders is not exactly ideal either. This makes it all the more important for anyone with any of these “risk factors” to have a blood pressure check. You should also make positive efforts to reduce your blood pressure if it happens to be above normal.

The big trap about hypertension is that tens of thousands of people are walking around totally unaware of the fact they are blood pressure victims.

“I feel okay.” “The doctors says my blood pressure is up, but I don’t feel ill.” “How could I possibly have anything wrong with me. I never get headaches.” These are some of the answers when a person is newly diagnosed. Hypertension is sometimes called the silent killer.

“Laymen and many doctors regard headache as the prime symptom of hypertension,” the “British Medical Journal” said in a leading article not long ago. “Yet relatively few headaches are hypertensive in origin.” The Journal went on to say that many develop headaches once they know they have elevated blood pressure, “but then it is often associated with features of anxiety.” In short, they worry themselves into a headache once they have been told their diagnosis!

Blood pressure is probably one of the most common, serious, symptomless, undiagnosed diseases in the community. Large numbers of people suffer from this disorder, but are completely unaware of the fact. It is often discovered by chance, probably during a routine check for something else, or for a life insurance policy examination.

Its diagnosis invariably comes as a surprise to the patient. The significance is that it can adversely affect other parts of the body. Left untreated, it can gradually worsen, producing a serious set of symptoms.

Of course, many “hypertensives” have been incorrectly diagnosed too. This is a trap in the other direction. Racing against time to an appointment at the doctor’s surgery, probably in heavy traffic, with a thudding heart, will invariably push blood pressure up.

So, false readings are often obtained if the doctor wraps his sphygmomanometer (the blood pressure measuring device) around your upper arm as soon as you arrive.

However, most doctors will refrain from starting treatment until several readings have been taken over a period of a few weeks. The diastolic (base) pressure reading is the one to take most notice of, ideally taken after rest and with minimum mental or physical activity.

A few alcohol drinks can also push the reading up precipitously. Overweight is bad news, and will tend to elevate blood pressure, and keep it there. We have discovered that the quickest drug-free way of reducing pressure is to have an overweight patient lose a few kilos. The effects are often dramatic.

Treatment of hypertension has come a long, long way in the past decade. Being so common, it has attracted an enormous amount of interest among doctors and drug manufacturers and researchers. Today, therapy has really revolutionized the disorder. Nearly everyone with hypertension can be satisfactorily treated.

Gone are the days when patients were drugged with the barbiturates and other sedatives which did little good and made the person often feel worse than ever. First line of attack today is often use of the so-called diuretics, commonly called fluid pills. These tend to increase the amount of urine passed. But they also have a direct effect on the blood vessel walls, it is claimed. In turn, this helps reduce elevated pressure readings.

Because the diuretics as a family of drugs tend to wash out potassium from the system, it is often necessary to take artificial potassium as a separate medication, or use a form of medication which will prevent potassium loss. This is called potassium supplemental or potassium sparing therapy.

The most significant individual form of treatment over the past decade has been the advent of the beta-blocker family of drugs. These originally came to prominence to help check angina – a form of heart pain – and heart beat irregularities.

But it soon became apparent that the drugs were effective in lowering high blood pressure. There are many different brands of these drugs available. Not long ago the “British Medical Journal” summed up the drug routines by saying: “The best treatment of hypertension is a drug regimen which produces no symptoms. The newer beta-blocking drugs come close to this ideal.”

In recent years medical hypnotherapy has been tried with considerable success. It is often effective intense, highly strung individuals. Many doctors now carry out hypnotherapy, which is the fancy name for simple relaxation techniques. Be cautioned – make certain you seek advice from a qualified doctor if you’re interested in this form of treatment.

One final point of advice: when on treatment, despite the way you feel, keep on keeping on. Do not stop treatment because you feel all right. This is the major trap.

Leave a Comment