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What Is Hypertension?
By Annabel Cruz
If your blood pressure reading is consistently over J 60/90 mmHg, you will be told that yon have hypertension, but, generally speaking, the lower your blood pressure, the better. If your pressure is between 140/90 and 160/90 mmHg, then you may be diagnosed as having ''borderline' hypertension.
Blood pressure readings are a remarkably accurate predictor of life expectancy: the higher the pressure the greater the risk. Even people whose blood pressures are average for the population has a slightly greater risk of heart disease than people with lower than average levels. For this reason, it has been extremely difficult to find a simple working definition of hypertension.
Perhaps the most sensible view is to define it as that level of blood pressure where treatment with anti-hypertensive drugs does more good than harm', because there is no such thing as drug treatment that does not have some potential side-effects. It your blood pressure is found to be more than 160/90 mmHg, and if you have several different risks factors to heart disease, such as high cholesterol, being a smoker and a family tendency to heart disease, then treating your is likely to be very worthwhile.
On the other hand, for some young people with only very marginally raised blood pressure, and no other risk factors for heart disease, the value of blood pressure-lowering drugs is very small and cling treatment may therefore be held back. It is, however, crucial that such people are re-cheeked at intervals of roughly about six months.
Hypertension has been called the 'silent killer' because it usually causes no symptoms until a late stage of the disease. Contrary to what many people believe, it is not possible to feel your own blood pressure. The only way to find out whether your blood pressure is raised is to have it measured with a blood pressure machine As hypertension causes no symptoms until complications begin to show themselves, about half of all individuals who have it remain unaware that they have a problem.
WHY HYPERTENSION MATTERS
Blood vessels are like rubber tubes that carry blood constantly to wherever it is needed. Arteries, which carry blood out of the heart, have to withstand the great pressures with which the blood is pumped out. If the blood pressure is higher than usual over many years, as in untreated hypertension, the vessels become damaged. The lining of the arteries can become roughened and thickened, and this eventually causes them to narrow and become less flexible, or elastic, than previously. This is known as arteriosclerosis.
If an artery becomes too narrow, blood cannot get through properly, and the part of the body that relies on that artery for its blood supply is starved of blood and the all-important oxygen that
it carries. As the artery narrows there is an increased tendency to develop blood clots (thrombosis), which may cause total blockage of the artery so that the part of the body that it serves dies. II the heart or the brain is affected, the dead area is called an infarct.
OTHER RISK FACTORS
High blood pressure over many years can cause all these problems, and the whole point of measuring blood pressure regularly, and treating it effectively if it is high, is to prevent these complications. However, you arc more likely to develop these complications if you smoke and if you have untreated high blood cholesterol levels. The reason is that cigarette smoking damages blood vessels in much the same way as high blood pressure, making the artery itself narrower and its lining thick and rough.
High cholesterol can cause fatty deposits, called atheroma, in the lining of the artery to develop more rapidly than normal, which also helps to narrow the arteries. It is not possible for your level of serum cholesterol to be too low, and treatment to lower cholesterol saves lives.
Another common risk factor that can also contribute to narrowing of the arteries, known as cardiovascular disease, is diabetes (diabetes mellitus), which affects four to five per cent of the white population and 10-15 per cent of the south Asian and Afro-Caribbean population in the UK. High glucose levels in the blood damage arteries in a similar way to high blood pressure.
But it would not do to paint too gloomy a picture. The whole point of having your blood pressure checked is that, if you are found to have hypertension, it is possible to treat it effectively and so bring your risk of heart disease and strokes back down to normal. It does not matter particularly how severe the hypertension was in the first place. What is really important is how well your blood pressure is controlled over the ensuing years.
It is better to have had severe hypertension that has been well treated than to have slightly raised blood pressure that remains untreated or neglected.
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