Hypertension - Dr Shashank Jain

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 Hypertension

Hypertension, high blood pressure.

• A common disorder, often without symptoms, marked by high blood pressure persistently exceeding 140/90. 

Facts about Hypertension

• Defined as blood pressure, persistently exceeding 140/90 mm of mercury (mm.Hg).

• Most commonly detected on routine check ups, as it has no symptoms for initial several years of onset, until it becomes severe and life threatening.

• Hypertension is a multi system disorder, as uncontrolled, long standing high blood pressure  can effect various organs and systems causing  'End Organ Damage'. The typical examples are:

Examples of end organ damage due to hypertension.

1. Angina and Heart attacks.

2. Stroke and paralysis.

3. Eye damage (Retinopathy or retinal damage) causing blindness.

4. Kidney damage and failure. (Nephropathy)

5. Nerve damage. (Neuropathies). 

Factors effecting long term outcome of disease

• Failure to detect it in initial stages, often leads to irreversible complications , resulting in decreased life expectancy and quality of life. 

• Hypertension has underlying causes, aggravating factors, associated illnesses and high risk factors.

• 'Superficial treatment' of hypertension without proper assessment of cause, and associated  risk factors ,can not achieve long term goals of minimizing complications and increasing life expectancy.

• Several anti hypertensive drugs are available ,which can all control high blood pressure ,but choosing the most appropriate for a particular patient is most crucial. Certain anti hypertensive can thus favorably or  un favorably effect other coexisting illnesses and may have additional beneficial, or harm full effect on various parameters like: blood sodium levels, serum cholesterol levels etc.

• Certain anti hypertensive drugs may have additional beneficial effects on coexisting diseases like Diabetes and Angina and thus become,  'The Drug Of Choice' in these patients.

Management of a patient of Hypertension requires:

• Early diagnosis and quick ,vigorous treatment.

Steps in management 

1. Detection of 'High Risk Groups'.

2. Early diagnosis and prompt treatment.

3. Constant monitoring of blood pressure.

4. Thorough clinical examination by doctor.

5. Assessment of cause, risks  and aggravating factors.

6. Detection of coexisting illnesses.

7. Assessment of 'End Organ Damage'.  (complications of Hypertension).

8. Appropriate investigations to detect cause, associated risk factors, coexisting diseases, and to detect 'End Organ Damage'.

9. Ensuring regular medicine intake by the patient by proper education.

10. 'Life Style Modification ' including healthy eating habits, stress on physical exercises, avoiding smoking and alcohol intake.