23 March, 2024

Hypertension: 9 Basic Things Everyone Should Know

Introduction:
An increase in blood pressure (BP) beyond what is considered normal is called Hypertension. Hypertension is one of the most common diseases and can affect almost every organ of the human body. Hypertension is increasingly being diagnosed at a much younger age now, and far more people report poorly controlled blood pressure even on multiple medications. Here I outline a few basic aspects of BP/Hypertension that everyone should be familiar with.

The basics of blood pressure can be found here.

Hypertension typically stays for life
It is possible to control BP just by lifestyle and behavioural modifications in some cases, but that shouldn’t make someone believe that they don’t have ‘Hypertension’ anymore. Few patients stop their medications or fail to keep up with healthy habits once their blood pressure gets under control. This can be a risky practice since BP will likely rise in almost all such cases, and to dangerous levels in certain individuals.

BP is intricately related to daily salt intake
A low-salt diet is a key to Hypertension management, and high salt intake remains one of the most common causes of sub-optimal BP control. Healthy subjects who don’t have Hypertension should avoid excess salt consumption, and people with diagnosed Hypertension should avoid it altogether. The scientific recommendation of fewer than 2 grams of salt daily is effective but difficult to achieve. It’s important to note that non-white salts have a similar effect on BP and should also be avoided. Substitutes like lemon or salt-free vinegar can be a reasonable substitute.

Medicines for Hypertension don’t cause addiction
There is a widespread concern that BP medicines themselves cause addiction and once you get on, you can’t get off. BP medicines do not ‘cure’ hypertension. Rather, the medicines lead to temporary structural or biochemical changes in the human body, which in turn reduces the BP. Once the medicines are stopped for some reason, the human body reverses these changes back to its previous state associated with high BP.

BP medicines are very safe
Commonly used drugs for Hypertension have been extensively studied in humans for their safety and efficacy. These medicines rarely cause a major side effect in an otherwise healthy individual. The benefit-to-risk ratio of such medicines exceedingly favours their long-term clinical use.

People may have Hypertension for years and may not know about it
While extremely high blood pressure (sBP >180-200) can cause acute heart attack, stroke (paralysis), kidney injury, eye injury etc., moderately elevated blood pressure may not produce any overt symptoms. Most people lead a normal life while elevated BP continues to injure a body’s organs in the background. It’s only after years when organs are injured to a threshold that symptoms start showing up. Lucky people report to the hospital/doctors before a permanent injury. In such cases, intricate BP control may reverse organ dysfunction. If not addressed in time, permanent multi-organ damage may occur.

Hypertension is a dynamic condition
Blood pressure fluctuations occur even among people who have been taking medicines for Hypertension religiously. Such fluctuations can be due to changes in the body’s homeostasis mechanisms or the progression of the disease itself. It is of paramount importance for people with Hypertension to check their BP regularly at home, and follow up with their doctors periodically to address any changes from previous.

Yoga is very helpful
In fact, any form of meditation or calming exercises helps to reduce blood pressure. However, one must understand that such modalities are complementary, not supplementary.

Management approach to Hypertension needs to be comprehensive
Simply doing one thing and ignoring others is destined to give a sub-optimal result. Listed below are components of ‘comprehensive’ care:
(a) Low salt diet
(b) Regular exercise
(c) Stress management: Yoga, meditation, recreational activities, socialising etc.
(d) Good sleep hygiene
(e) Active weight management: Aim for a BMI of 18-25
(f) Medicines aimed at bringing down the blood pressure to its goal
(g) Address medical conditions that aggravate blood pressure: Obstructive Sleep Apnea, Thyroid issues etc.
(h) Evaluate for secondary causes of high BP: There is a long list for this. A professional opinion of a cardiologist is advisable.
(i) Avoid medicines that precipitate high blood pressure: Common ones are painkillers, nasal drops/sprays etc.

Blood pressure reading at home often is more reliable than that of a doctor’s visit
This has to do with the human body’s physiology. Our body is programmed to increase the blood pressure or heart rate at times of stress or anxiety. White Coat Hypertension is when a person’s BP is elevated only during a doctor’s visit. While physiologically, blood pressure taken at home is more reliable, often the technique may not be optimal, giving rise to faulty readings. Best practices to ensure optimal home blood pressure recording are listed here.

I am sure I didn’t answer all your questions on this topic. Feel free to message me with your queries, and I will be happy to answer them.

Medical disclaimer: The information on this site is not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images and information, contained on or available through this website is for general information purposes only. You are encouraged to confirm any information obtained from or through this website with other sources and review all information regarding any medical condition or treatment with your physician. NEVER DISREGARD PROFESSIONAL MEDICAL ADVICE OR DELAY SEEKING MEDICAL TREATMENT BECAUSE OF SOMETHING YOU HAVE READ OR ACCESSED THROUGH THIS WEBSITE.