Blood pressure (BP) is defined as the pressure exerted by blood on to the wall of blood vessels. The normal blood pressure is 120/60mmHg where numerator value stands for systolic blood pressure and denominator for diastolic blood pressure. However under any circumstances when the BP reading goes beyond 140/90 mmHg, a condition called as high blood pressure or more technically hypertension prevails. High blood pressure is the leading cause of death in today’s society.
Another name assigned for hypertension is ‘Silent Killer’, because this disease may grow silently into your bod y without showing any signs or symptoms. HBP is of two types- primary or essential hypertension and secondary hypertension. Primary hypertension is the condition where the exact cause of hypertension is not known and in secondary hypertension, the blood pressure rises due to the other disease condition present in body. Having high blood pressure increases your chances of stroke and heart attack and it also affects certain vital organs of body like kidney, lungs, brain etc.
In order to achieve the proper treatment we first have to learn how high blood pressure affects other diseases? And what could be the possible consequences of having high blood pressure?
High Blood Pressure Effect on heart
Heart is the one who pumps blood and arteries caries it to different parts of body. The organs in your body need oxygen for proper functioning, and this demand of oxygen is fulfilled by circulating system. The supply of oxygen to organ may decrease during condition of high blood pressure. This decline in blood supply may invite certain heart disease like stroke, heart attack, heart failure and congestive heart diseases.
Arteries as you all know is made up of muscles and flexible tissues which stretch when blood flows through them. However this elastic nature may get impaired during hypertension. Let us discuss in step wise manner the effect of hypertension on arteries
- Blood vessels weakens – During condition of high blood pressure, heart pumps the blood faster. Therefore more the blood pressure, more the arteries gets stretched over. This overstretching creates weak places in the arteries which may get rupture. The condition like aneurysm and heart attack may occur when blood vessels rupture.
- Scarring off vascular tissue – Overstretching may produce some scars on the walls of blood vessels. These scars may cause deposition of debris like cholesterol, fats and blood cells.
- Formation of blood clot – The deposited blood forms clot or plaque in blood vessel. This narrows or sometimes blocks blood flow which may lead to heart attack or strokes.
- Increase in plaque growth – The formation of plaque decreases the blood supply or sometimes may even cut it off. Under such situation, heart has to pump harder in order to circulate blood to rest of our body. Sometimes plaques break and move to different parts of body, deposits there and finally blood supply to that organ decreases.
- Organ/tissue damage – As the supply of blood is blocked, the tissues may not able to get sufficient amount of oxygen. This will result in tissue damage.
The effect on arteries leads to further heart problems. The heart diseases which are caused by increase in BP are mentioned below:
1. CORONARY ARTERY DISEASE (CAD) – We have discussed that scars in the artery may cause deposition of fats, cholesterol and blood cell and forms plaques. Plaques lead to narrowing, swelling and hardening of arteries and eventually blood flowing through the artery declines. The condition of formation of plaque is known as atherosclerosis and coronary artery disease is the term assign to condition when one or more plaques are formed in blood vessels due to atherosclerosis. Beta blockers and angiotensin converting enzyme (ACE) are recommended for the treatment of CAD.
2. ANGINA – Angina is a condition where people suffer from chest pain usually at the left side specifically during exercise or stress. This is because, while exercising heart muscles needs more blood supply, which is actually low when there is build-up of plaques in arteries. However pain diminishes after resting for few minutes. Beta blockers are mainly prescribed in case of angina. Calcium channel blockers (CCB) are also useful but it should be avoided if you had heart attack and also suffered from heart failure.
3. HEART ATTACK – Heart attack is described as a permanent damage to heart muscles caused by decrease in blood supply to heart. Sometimes the clot formed in the artery may be so large that it completely blocks the artery, as a result the portion of heart muscles relying on the supply of blood from arteries is damaged and slowly starts dyeing. This permanent damage to the heart muscles leads to heart attack or myocardial infarction. Heart attack is more fatal and often accompanied by nausea, headache, sweating and sense of impending doom.
4. STROKE – Stroke is a condition in which the blood supply to brain is interrupted or blocked. Brain is the vital organ and it needs the maximum supply of oxygen and even if the supply is blocked for few minutes, may cause serious complication. As the brain controls most of the action of our body, stroke may have impact on vision, memory or language and even paralysis can occur. The blood supply may be blocked either by clot formation i.e. ischaemic stroke or bursting of vessels- Haemorrhagic stroke.
High blood pressure increases the chances of having stroke. About 87% of stroke is ischaemic stroke which are due to the clot blood vessels that blocks blood supply to heart. 13% of stroke s is haemorrhagic stroke, which results in rupturing of blood vessels in or near brain. HBP makes the arterial wall too weak and they get rupture easily. The best remedy for reducing risk of stroke is the treatment of HBP.
Warning signs of stroke –
- Sudden numbness or weakness of face, arm or leg, especially on one side of the body.
- Sudden confusion, trouble speaking or understanding.
- Impairment in vision.
- Sudden severe headache without any significant cause.
- Sudden trouble walking, dizziness, loss of balance or coordination.
5. HEART FAILURE – Heart failure is term used for heart when it is not able to supply blood to the body. Heart failure may affect the entire circulatory system. As HBP results in clogged arteries, heart failure may develop. Narrowed arteries hamper the smooth flow of blood and ultimately pressure on heart increases to force blood through the arteries. Heart failure causes the build-up of extra fluid in body and also leads in generation in irregular heartbeat. The possibility of heart failure and portion of heart affected can be recognised by the area of fluid build-up and problems caused by it. If your left side of heart is affected most of the blood is build up in lungs and you may suffer from cough or breathlessness when lying down.
If right side of heart is affected, fluid builds up in body and causes swollen ankles, feet and legs. In both cases you may get tired easily or feel weak.
ACE inhibitor and angiotensin II receptor blocker drug are mainly recommended for the treatment of heart failure. Even beta blockers are helpful in treatment of heart failure.
Older people are at greater risk of having heart attack or stroke. Drug recommended for them are diuretics and ACE inhibitor. Remember not to take calcium channel blocker when you are prescribes with thiazide diuretics.
High Blood Pressure and Diabetes
Chances of cardiovascular is 2-3 times more in people having both high blood pressure and diabetes. Under such situation you have to 3 parameters in normal level- blood pressure, blood sugar level and cholesterol level. Cholesterol level should be less than 5mmol/litre, BP below 130/80mmHg and glycosylated haemoglobin below 5%.
High Blood Pressure and Kidneys
HBP is the leading cause of kidney disease. Kidney is supplied with rich network of arteries and blood from this artery is supplied to nephron, a component of kidney that filters blood. HBP causes arteries around kidney to narrow, harden and weak, as a result blood supply to nephron decreases. Finally kidney loses its ability to filter blood and control of hormone, salt and fluid in body.
Impairment in kidney function also affects renin angiotensin system, which is the body owns mechanism to regulate blood pressure. Kidney disease is also more likely to develop if you are suffering from diabetes. In case of chronic renal failure, dialysis is the recommended treatment. Also the intake of ACE inhibitor and angiotensin II receptor blocker helps in controlling high blood pressure and therefore reducing chances of heart failure.
Cholesterol and High Blood Pressure
90% of people with high blood pressure always has lipid abnormality. Both of this can lead to increases chances of cardiovascular disease.
Statins are widely used for control of cholesterol level. They work by blocking the enzyme cholesterol synthase which are responsible in manufacturing of cholesterol. It helps in reducing both LDL and VLDL level. Drugs coming under statins are pravastatin, atorvastatin, cerivastatin, fluvastain and simvastatin. Statin produces some side effects like muscle pain, fever, weakness, headache and liver damage. Statins also reduce the chances of heart attack and stroke. More effective and quick action will be observed if both the BP and cholesterol level are properly controlled.
Rheumatoid arthritis or gout results in joint pain. Hypertensive patient who are also suffering from gout should definitely take care of the medicament used for relieving joint pain. Mostly non-steroidal anti-inflammatory drug are used for the treatment of gout. But the main drawback of NSAIDS drugs is that it tends to increase the blood pressure by 5-6mmHg which is roughly the same as reduction produces by antihypertensive drug. NSAIDS even leads to salt retention. Ibuprofen, an NSAID, is mostly recommended under such circumstances as t increases BP by only 2mmHg. So before taking NSAIDS consult doctor regarding its effect on blood pressure or any chances of interaction with BP lowering drug.
Steroids is the another class of drug which are recommended for the treatment of gout. But it is associated with various side effects like salt retention and increase in body fluids which can lead to HBP. Long term use of steroids weakens the bone, reduces breathing capacity and immunity. Therefore steroids should be avoided in hypertensive patient. Some of the BP lowering drugs like thiazide diuretics also lead to gout. However this condition can be avoided if you go for low dose of thiazide diuretic.
High Blood Pressure and Impotence
Erectile dysfunction or impotence is caused by many factors like HBP, diabetes or excessive exercise. Some of the medicaments like spironolactone, thiazide diuretic and clonidine even lead to erectile dysfunction. Studies have shown that 75 % suffer from erectile dysfunction at some point of life. Erectile dysfunction may also arise from hypertension. This is because excess of pressure may cause damage to the arteries in penis. Penis is supplied with arteries which get dilated during sexual stimulation to supply more blood into it. Excess pressure may produce tiny scares in to it, which gets healed through natural mechanism. After the healing process, the arteries become thicker to develop resistant to excess blood pressure. These arteries may not be able to fulfil the blood demand to the penis and finally it may cause erectile dysfunction.
Several drugs are available for treatment of erectile dysfunction. BP lowering drugs lowers the BP may by bringing BP to normal level, we can indirectly treat this problem. The next possible way of treating impotence is use of drugs like sildenafil and taldanafil. Avoid use of these drugs if you are prescribed with nitrates for the treatment of angina.