Hypertension, commonly known as high blood pressure, is a prevalent condition that occurs when the pressure in the blood vessels consistently measures at or above 140/90 mmHg. Although often asymptomatic, hypertension can lead to severe health complications if left untreated. Given its silent nature, regular blood pressure monitoring is crucial for early detection and effective management.

Understanding Hypertension

Hypertension is characterized by elevated pressure in the arteries. This pressure is recorded using two numbers: the systolic pressure (the force exerted when the heart beats) and the diastolic pressure (the force when the heart rests between beats). A reading of 140/90 mmHg or higher on two separate occasions confirms a diagnosis of hypertension.

Risk Factors

The risk factors for hypertension are broadly categorized into modifiable and non-modifiable factors. Modifiable risk factors include lifestyle choices such as an unhealthy diet high in salt, saturated fats, and trans fats, insufficient physical activity, tobacco use, and excessive alcohol consumption. Additionally, being overweight or obese significantly increases the risk of developing hypertension.

Non-modifiable risk factors encompass genetic predisposition, age (particularly those over 65), and co-existing health conditions like diabetes and kidney disease. These factors necessitate vigilant monitoring and proactive management to mitigate the risk of hypertension.

Symptoms and Complications

Most individuals with hypertension do not exhibit symptoms, which underscores the importance of regular blood pressure checks. However, extremely high blood pressure, often referred to as a hypertensive crisis (180/120 mmHg or higher), can manifest through severe headaches, chest pain, dizziness, difficulty breathing, nausea, vomiting, blurred vision, anxiety, confusion, nosebleeds, and abnormal heart rhythms. Such symptoms require immediate medical attention.

Untreated hypertension can lead to severe complications, including heart disease, stroke, and kidney damage. The excessive pressure can harden arteries, diminishing blood flow and oxygen to the heart, which can result in chest pain (angina), heart attacks, heart failure, and irregular heartbeats. Additionally, hypertension can damage arteries supplying the brain, leading to strokes, and impair kidney function, potentially causing kidney failure.

Diagnosis and Treatment

The diagnosis of hypertension is straightforward: blood pressure readings of 140/90 mmHg or higher on two separate days. Regular monitoring by healthcare professionals is essential for accurate diagnosis and assessment of associated risks.

Effective management of hypertension often involves a combination of lifestyle changes and medication. Lifestyle modifications include adopting a healthy, low-salt diet, increasing physical activity, losing weight, and quitting tobacco use. These changes can significantly reduce blood pressure and improve overall health.

When lifestyle changes are insufficient, medications may be prescribed. Common antihypertensive drugs include ACE inhibitors (such as enalapril and lisinopril), angiotensin II receptor blockers (ARBs like losartan and telmisartan), calcium channel blockers (such as amlodipine and felodipine), and diuretics (including hydrochlorothiazide and chlorthalidone). These medications work by relaxing blood vessels, reducing blood volume, and protecting against kidney damage.

Prevention

Preventing hypertension involves adopting a proactive approach to health. Key preventive measures include:

• Consuming a balanced diet rich in fruits and vegetables and low in salt, saturated fats, and trans fats.

• Engaging in regular physical activity, aiming for at least 150 minutes of moderate-intensity or 75 minutes of vigorous-intensity exercise per week, alongside strength-building activities twice weekly.

• Maintaining a healthy weight.

• Limiting alcohol intake and avoiding tobacco use.

• Managing stress through relaxation techniques and regular health check-ups.

Global Perspective

Hypertension is a global health issue, with varying prevalence across regions. The WHO African Region reports the highest prevalence at 27%, while the Americas have the lowest at 18%. The number of adults with hypertension surged from 594 million in 1975 to 1.13 billion in 2015, predominantly in low- and middle-income countries due to rising risk factors.

WHO's Response

The World Health Organization (WHO) plays a vital role in combating hypertension globally. In 2021, WHO issued new guidelines for the pharmacological treatment of hypertension in adults, providing evidence-based recommendations for treatment initiation, follow-up intervals, and target blood pressure levels. The guidelines also outline the responsibilities of healthcare professionals in managing hypertension.

The Global Hearts Initiative, launched in 2016 by WHO and the United States Centers for Disease Control and Prevention (CDC), aims to enhance cardiovascular health worldwide. This initiative includes the HEARTS technical package, which focuses on healthy lifestyle counseling, evidence-based treatment protocols, access to essential medicines and technology, risk-based management, team-based care, and robust monitoring systems. Since 2017, the initiative has facilitated the treatment of 7.5 million people in 31 low- and middle-income countries through standardized hypertension control programs.

Conclusion

Hypertension is a silent yet potentially deadly condition that requires vigilant monitoring, lifestyle changes, and, when necessary, medication. By understanding the risk factors, symptoms, and complications, individuals can take proactive steps to manage their blood pressure and reduce the risk of severe health issues. Global initiatives like those led by WHO are crucial in addressing this widespread health challenge, demonstrating that with concerted effort, effective hypertension control is achievable.

Source by World Health Organization