Hypertension, High Blood Pressure

High blood pressure, also called as hypertension, is a very common condition found all over the world. In the United Kingdom, more than 25 percent population has high BP. Ironically the affected individuals do not realise it due to the absence of any visible symptoms.

What is High Blood Pressure?

High blood pressure (BP) is defined as a condition when the force with which the blood flows through the arteries is consistently high. 

Normal blood pressure consists of the systolic pressure, the pressure exerted by the heartbeat to pump the blood, and diastolic pressure, the reduced pressure when the heart rests between the beats. The normal BP is 120/80 mm Hg.

BP becomes high due to either more blood volume being pumped by the heart or high resistance in the blood vessels, which may occur due to cholesterol accumulation. This reduces the work efficiency of the heart as well as the vessels over a period of time. If it persists, it may lead to serious health problems, such as heart disease.

Symptoms of High Blood Pressure

A person can have high BP for years without manifestation of any visible symptoms, even if there is heart and blood vessel damage. However, high BP can be easily detected by getting the blood pressure checked.

Sometimes severely high BP may result in headaches or nose bleeding.

Causes of High Blood Pressure

Based on the causes, there are two types of high BP:

• Primary - Most people develop high BP without any underlying condition. This is termed as primary hypertension and develops over many years.
• Secondary - It is sudden with higher BP and caused by an underlying condition. Several conditions that lead to secondary hypertension include obstructive sleep apnea, kidney problems, adrenal gland tumors, thyroid problems, birth defects (congenital) in blood vessels, illegal drugs (such as cocaine and amphetamines), and certain medications (such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers, and some prescription drugs).

Risk factors

There are many factors that may increase the risk of high BP:

• Age - The risk of high BP increases with age.
• Race - Blacks are at a higher risk of developing high BP than the whites.
• Family history - An individual with family history has a higher risk of high BP.
• Obesity – An overweight individual has high BP since more blood needs to be pumped to all the tissues.
• Physically inactive - Lack of physical activity increases the risk of being overweight and high BP.
• Smoking - Smoking causes an instant increase in the BP.
• Salt - Too much salt (sodium) in the diet increases BP due to more fluid retention.
• Potassium – Potassium deficiency may result in sodium accumulation, which may cause high BP.
• Vitamin D - Vitamin D deficiency may affect an enzyme that affects the BP.
• Alcohol – Too much drinking for many years may damage the heart.
• Stress - High levels of stress can lead to a temporary increase in BP.
• Pregnancy - Sometimes pregnancy contributes to high BP.

Complications in the Future

The excessive pressure on the artery walls caused by persistent, uncontrolled high BP can damage the blood vessels as well as the body organs, resulting in serious complications:

• Heart attack - High BP may damage the tissues in the arteries causing tears, which further get clogged by cholesterol giving rise to plaques and causing atherosclerosis. This can lead to insufficient blood supply to the heart or the brain resulting in a heart attack, stroke or other complications.
• Aneurysm - Increased BP can cause the blood vessels to weaken and form an abnormal bulge, called aneurysm. If an aneurysm ruptures, it can result in death.
• Heart failure – The heart muscle thickens in order to pump more blood against the higher pressure in the vessels. Eventually, it is unable to pump enough blood to meet body's needs, which can lead to heart failure.
• Kidney Problems – The damaged blood vessels in the kidneys hamper normal functioning.
• Vision Problems - Narrowed or torn blood vessels in the eyes may result in vision loss.
• Metabolic syndrome – High BP may affect the normal metabolism, resulting in various conditions such as high triglycerides, low high-density lipoprotein (HDL) cholesterol, and high insulin levels. This may further cause diabetes, heart disease and stroke.
• Memory Loss - Uncontrolled high BP may also affect the ability to think, focus and learn.

Children and high blood pressure

Although high BP is more common in adults, children are also at risk. High BP in children may be due to problems in the kidney or heart. However, the majority of children are affected due to poor lifestyle habits, such as an unhealthy diet, obesity and physical inactivity.

It is very important for the new generation to adopt a healthy diet, lose excess weight, and get regular physical activity.

How to manage High BP?

In addition to the medications, lifestyle changes significantly help to control and prevent high BP:

• Healthy foods – A healthy diet, called the Dietary Approaches to Stop Hypertension (DASH) diet, should be adopted that stresses the intake of fruits, vegetables, low-fat dairy foods, whole grains, poultry, and fish. Sufficient potassium should be included in the diet to avoid fluid retention. Saturated fats should be avoided to prevent obesity.
• Less salt – Sodium should be taken in low amounts (1,500mg/day) by individuals who are 51 years old or more, or suffering from hypertension, diabetes or chronic kidney disease.
• Manage weight – Overweight individuals should aim to lose weight to control high BP.
• Physical activity - Regular physical activity is essential to reduce weight, BP as well as stress.
• Limit alcohol – Alcohol should be consumed in moderation.
• Quit smoking - Tobacco injures the walls of the blood vessels and speeds the hardening of the arteries.
• Manage stress – Stress could be reduced by muscle relaxation, deep breathing, meditation, regular physical activity, and sufficient sleep.
• Monitor blood pressure – BP could be monitored at home for keeping a regular check and see any effects of medication. It could also help to alert about any potential complications.

Supplements for High BP

In addition to diet and exercise, several supplements may also help in reducing BP. However, some supplements may interact with medications to cause symptoms such as increased bleeding. Therefore, doctor’s advice is needed before taking any supplements for BP treatment.

Supplements that reduce BP include:

Minerals

Potassium helps in lowering the BP by balancing the levels of sodium in the body, which increases the BP by causing fluid retention. Additionally, potassium relaxes the walls of the blood vessels, which further helps in reducing the blood pressure. The amount of potassium recommended for an adult is 4700 mg/day. It is found naturally in foods (such as banana, apricots and sweet potatoes) but supplements may be needed if an individual is taking a diuretic medication for high BP, which causes potassium excretion in the urine.

Magnesium relaxes the blood vessels and helps in transporting calcium and potassium. It has been shown to improve blood flow and reduce BP in adults. The recommended amount of magnesium in the diet should be 300-400 mg/day.

Calcium helps the vessels to constrict and expand in an efficient way. Also, it helps in nerve signal transmission and proper cell functions. It also balances the sodium levels, lowering the BP. The recommended daily intake for those managing hypertension would be between 1000mg and 1200 mg/day.

Omega-3 fatty acids

Omega 3 fatty acids are found in fatty fish, fish oil supplements or flaxseed. They have been shown to significantly reduce triglycerides and lower blood pressure.

Folic acid

Folic Acid, found in foods such as green leafy vegetables and citrus fruits, has been shown to reduce high BP. The recommended amount is 400 micrograms/day.

Beetroot

Nitrates and potassium in the beetroot extract are believed to maintain normal BP. Nitrates are converted by the body into nitric oxide, which relaxes the blood vessels and reduces the BP.

Fibre

Dietary fibre can be taken in the form of psyllium husk and wheat bran (outer covering). It makes one feel full and thus helps in reducing weight. Dietary fibre has been shown to lower cholesterol in overweight individuals. Studies have also shown the use of psyllium in lowering risk of heart disease.

Nitrates

Several supplements increase nitric oxide and widen blood vessels, resulting in reduced BP. These supplements include cocoa, L-arginine and garlic.

Cocoa reduces the risk of cardiovascular disease. It contains flavanols that increase nitric oxide production, which promotes vessel flexibility and reduces blood pressure.

L-arginine, an amino acid found in nuts, fish, soy etc., may help patients with heart disease and clogged arteries since it relaxes the blood vessels and lowers BP. However, more studies are needed to confirm the long-term effect of arginine in heart disease. Doctor’s advice is needed before taking arginine supplements as it may interact with medications.

Garlic was shown to significantly reduce the blood pressure, with the reduction being comparable to that obtained with drugs. This reduction has been associated with the production of hydrogen sulphide and the presence of allicin, which relaxes the blood vessels.

Green Coffee Bean

Studies have shown that chlorogenic acid (CGA) in green coffee bean decreases BP by reducing the amount of blood being forcefully pushed into the system.

Although high BP is a common and serious condition, it can be controlled and prevented. In addition to medications and lifestyle changes, the supplements offer numerous benefits for controlling high BP.

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