Understanding Hypertension: Causes, Symptoms, and Management

What is Hypertension?

Hypertension, commonly known as high blood pressure, is a condition characterized by persistently high blood pressure in the arteries. Blood pressure is the force exerted by blood against the walls of blood vessels (arteries) as it is pumped by the heart. The Joint National Committee 7 (JNC7) defines normal blood pressure as a systolic BP of less than 120 mmHg and a diastolic BP of less than 80 mmHg. Hypertension is defined as a systolic BP level of 140 mmHg or higher and/or a diastolic BP level of 90 mmHg or higher.

The grey area falling between 120-139 mmHg systolic BP and 80-89 mmHg diastolic BP is defined as "prehypertension". Although prehypertension is not a medical condition in itself, prehypertensive subjects are at increased risk of developing hypertension. Hypertension is often asymptomatic in its early stages, and people may not be aware of their condition until a severe medical crisis occurs, such as a stroke or chronic kidney disease[8–10].

Factors Associated with Hypertension

Several factors can predispose individuals to hypertension. These factors vary from country to country and even between urban and rural regions of the same place. Some of the most common risk factors include:

• Age: Hypertension is more prevalent in older adults.
• Gender: Men are more likely to develop hypertension than women.
• Education level: Illiterate subjects are more likely to have hypertension, while primary educated subjects are more likely to have prehypertension.
• Socioeconomic status: Study subjects from both lower and upper socioeconomic status were almost equal victims of hypertension.
• Tobacco use: Tobacco use is a risk factor for developing hypertension.
• Alcohol use: Although alcohol use was not significantly associated with hypertension status, the rate of hypertension was higher among subjects who consumed alcohol.
• Physical activity: Being married and a government servant were found to be risk factors for both hypertension and prehypertension.

Symptoms and Complications of Hypertension

While many people with hypertension remain asymptomatic, some may experience symptoms such as:

• Early morning headaches
• Nosebleeds
• Irregular heart rhythms
• Vision changes
• Buzzing in the ears
• Fatigue
• Nausea
• Vomiting
• Confusion
• Anxiety
• Chest pain
• Muscle tremors
• Persistent chest pain (angina)
• Heart attacks
• Heart failure
• Irregular heartbeat, which can lead to sudden death
• Strokes, caused by blockages or bursting of arteries that supply blood and oxygen to the brain
• Kidney damage and kidney failure.

Prevention and Management of Hypertension

Preventing and managing hypertension involves reducing modifiable risk factors, such as:

• Unhealthy diets, including excessive salt consumption, a diet high in saturated fat and trans fats, and low intake of fruits and vegetables
• Physical inactivity
• Consumption of tobacco and alcohol
• Being overweight or obese

In addition to lifestyle changes, pharmacological therapy can be very effective in lowering blood pressure and preventing complications of hypertension. First-line antihypertensive medications include angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers, dihydropyridine calcium channel blockers, and thiazide diuretics. Regular monitoring of blood pressure and consultation with healthcare professionals are essential for managing hypertension and associated medical conditions.