Hypertension : Classification, Symptom, Cause, Diagnosis, Medication, And Prevention

Hypertension (High Blood Pressure) is a long term medical condition in which the blood pressure in the arteries is persistenly elevated.It usually does not cause symptoms.Normal blood pressure at rest is within the range of 100 - 140 millimeters mercury (mmHg) systolic and the range of  60 - 90 millimeters mercury (mmHg) diastolic.For adults, hypertension is present if the resting blood pressure persistenly at or above 140/90 mmHg.Hypertension can cause headache, failure to thrive, blurred vision, nosebleeds, and facial paralysis in older infant and children.

There are two measurements of blood pressure :

• The Systolic Pressure occurs when the left ventricle is most contracted.
• The Diastolic Pressure occurs when the left ventricle is most relaxed prior to the next contraction.

Hypertension (HT) can be classified into two :

• Primary Hypertension is high pressure without obvious underlying cause.
• Secondary Hypertension is hypertension due to an identifiable cause, such as chronic kidney disease, kidney arteries, an endocrine disorder.

The Signs and Symptoms of Hypertension

• Headache at the back of the head and in the morning
• Lightheadedness
• Vertigo
• Buzzing or hissing in the ears (Tinnitus)
• Altered vision or fainting episodes
• Anxiety
• Fatigue
• Dizziness
• Blood spot in the eyes
• Facial flushing
• Shortness breath

The Causes of Primary Hypertension

• Family history of hypertension
• High salt intake
• Obesity
• Stress
• Depression
• Lack of exercise
• Caffeine consumption
• Vitamin D deficiency
• Maternal smoking
• Low birth weight
• Lack of breastfeeding

The Causes of Secondary Hypertension

• Obesity
• Coarctation of the aorta
• Pregnancy
• Sleep apnea
• The consumption of liquorice excessively
• Herbal remedies
• Certain prescription medicines, and certain medications such as birth control pills, cold remedies, decongestants
• Illegal drugs, such as cocaine, amphetamines.
• Arsenic exposure through drinking water
• Alcohol abuse or chronic alcohol use

Diagnosis

Hypertension is diagnosed on the basis of a high blood pressure persistenly.Typical tests are performed :

• Kidney system uses tests, such as microscopic urinalysis, protein in the urine, BUN and/or creatinine.
• Endocrine system uses tests, including serum sodium, potassium, calcium, TSH.
• Metabolic system uses tests, such as  fasting blood glucose, HDL, LDL, and total cholesterol, triglycerides.
• The other can be used tests , such as hematocrit, electrocardiogram, and chest radiograph.

The clasification of blood pressure for adult

I. Normal 

• Systolic   : 90 - 119 mmHg
• Diastolic : 60  -   79 mmHg

II. High Normal (Prehypertension)

• Systolic   : 120 - 139 mmHg
• Diastolic :   80 -  89  mmHg

III. Stage I Hypertension

• Systolic   : 140 - 159 mmHg
• Diastolic :   90 -  99  mmHg

IV. Stage II Hypertension

• Systolic   : 160 - 179 mmHg
• Diastolic :  100 - 109  mmHg

V. Stage III Hypertension (Hypertensive Emergency)

• Systolic   : 180 mmHg or over
• Diastolic :  110 mmHg or over

VI. Isolated systolic Hypertension

• Systolic   : 140 mmHg or over
• Diastolic :  90 mmHg or over

Medications for Hypertension (High Blood Pressure)

1. Beta Blockers are to reduce the workload on the heart and open blood vessels, causing the heart to beat slower and with less force.

Beta Blockers include :

• Acebutolol (Sectral)
• Atenolol (Tenormin)

2. Thiazide Diuretecs act on the kidneys to help the body in eliminating sodium and water and reducing blood volume.

Thiazide Diuretics include :

• Hydrochlorothiazide (Microzide)
• Chlorthalidone

3. Angiotensin-converting Enzyme (ACE) Inhibitors help in relaxing blood vessels by blocking the formation of a natural chemical that narrows blood vessels.

These medications include :

• Benazepril (Lotensin)
• Lisinopril (Zestril)
• Captopril (Capoten)

4. Angiotensin II Receptor Blockers (ARBs) help in relaxing blood vessels by blocking the action, not the formation, of a natural chemical that narrows blood vessels.

These medications include :

• Losartan (Cozaar)
• Candesartan (Atacand)

5. Calcium Channel Blockers help in relaxing the muscle of blood vessels.

These medications include :

• Amlodipine (Norvasc)
• Diltiazem (Cardizem)
• Tiazac

6. Renin inhibitors are to slow down the production of renin, an enzyme produced by kidneys that starts a chain of chemical steps that increase blood pressure.

Renin inhibitors include :

• Aliskiren (Tekturna)

Additional Medications for treating Hypertension

1. Alpha Blockers reduces nerve impulses to blood vessels.

Alpha Blockers include :

• Prazosin (Minipress)
• Dosazosin (Cardura)

2. Alpha-Beta Blockers slow the heartbeat to refuce the amount of blood that must be pumped through vessels.

Alpha-Beta Blockers include :

• Labetalol (Trandate)
• Carvedilol (Coreg)

3. Central-Acting Agents prevent brain from signaling nervous system to increase the heart rate and narrow the blood vessels.

Central -Acting Agents include :

• Clonidine (Catapres, Kapvay)
• Guanfacine (Intuniv, Tenex)
• Methyldopa

4. Vasodilators prevent the muscles from tightening and arteries from narrowing.

Vasodilators include ;

• Hydralazine
• Minoxidil

5. Aldosterone Antagonists block the effect of a natural chemical that can lead to salt and fluid retention, which can contribute to high blood pressure.

These medications include :

• Spironolactone (Aldactone)
• Eplerenone (Inspra)

Primary Prevention of Hypertension

• Maintaining normal body weight for adult.
• Reducing dietary sodium intake to 2, 4 g of sodium per day.
• Limiting alcohol consumption to no more than two units per day in women and three units per day in men.
• Consuming a diet rich in fruit and vegetables at least five portions per day.
• Enganging in regular aerobic physical activity.