What is hypertension

Understanding Hypertension

Hypertension, commonly known as high blood pressure, is a chronic condition where blood pressure remains abnormally elevated, typically defined as 130/80 mmHg or higher. Blood pressure measures the force exerted by blood against artery walls, expressed as two numbers: systolic pressure (top number, when the heart beats) and diastolic pressure (bottom number, when the heart rests). While temporary blood pressure elevation is normal during stress or activity, hypertension involves persistent elevation that strains the cardiovascular system and damages blood vessel walls over time.

Types of Hypertension

Hypertension is classified into two main types. Primary or essential hypertension accounts for approximately 95% of cases and develops gradually over time without a single identifiable cause. It results from a combination of genetic predisposition, aging, and lifestyle factors including diet, physical activity, stress, and excess sodium intake. Secondary hypertension (5% of cases) develops as a result of underlying medical conditions such as kidney disease, hormonal disorders, thyroid problems, or sleep apnea. Medications like oral contraceptives or decongestants can also cause secondary hypertension.

Risk Factors and Consequences

Several factors increase hypertension risk, including advancing age, African American ancestry, obesity, physical inactivity, excessive alcohol consumption, high sodium diet, chronic stress, and family history. Hypertension is dangerous because it's often asymptomatic, earning the nickname 'silent killer.' Over time, elevated blood pressure damages artery walls, leading to atherosclerosis (plaque buildup). This damage significantly increases risk for heart attack, stroke, kidney disease, heart failure, and vision problems. Hypertension frequently coexists with other cardiovascular risk factors, compounding danger.

Diagnosis and Monitoring

Hypertension diagnosis typically requires multiple blood pressure readings over time rather than a single measurement, as single elevated readings may reflect white coat syndrome (anxiety-related elevation in medical settings). Accurate diagnosis involves office measurements, home monitoring, or 24-hour ambulatory monitoring. Blood pressure classification includes normal (less than 120/80), elevated (120-129 and less than 80), stage 1 hypertension (130-139 or 80-89), and stage 2 hypertension (140 or higher or 90 or higher).

Treatment and Lifestyle Management

Hypertension management begins with lifestyle modifications including reducing sodium intake, maintaining healthy weight, increasing physical activity to at least 150 minutes weekly, limiting alcohol, managing stress, and following the DASH diet (rich in fruits, vegetables, whole grains). For many people, these changes can significantly lower blood pressure. When lifestyle modifications prove insufficient, medications including ACE inhibitors, angiotensin II receptor blockers, diuretics, calcium channel blockers, and beta-blockers effectively reduce blood pressure. Treatment aims to achieve target blood pressure goals while minimizing medication side effects.