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Blood pressure is the force of the blood pushing against the walls of the arteries. Each time your heart beats, it pumps out blood into the arteries. The blood pressure is highest when the heart beats, pumping the blood.

High blood pressure directly increases the risk of coronary heart disease (which leads to heart attack) and stroke, especially when it is present with other risk factors. One can control high blood pressure through healthy lifestyle habits and taking medicines, if needed.

There are two measurements used to assess blood pressure:
  • Systolic pressure is the blood pressure that is exerted when the heart beats and forces blood around the body.
  • Diastolic pressure is the measure of blood pressure when the heart is resting between beats.
High blood pressure is a blood pressure that is 140/90 mmHg or above each time it is taken. That is, the blood pressure is sustained at 140/90 mmHg or above. High blood pressure can be:
  • just a high systolic pressure, for example, 170/70 mmHg.
  • just a high diastolic pressure, for example, 120/104 mmHg.
  • or both, for example, 170/110 mmHg.
However, it is not quite as simple as this. Depending on various factors, the level at which blood pressure is considered high enough to be treated with medication can vary from person to person.

Blood pressure of 160/100 mmHg or above
This is definitely high. All people with a blood pressure that stays at this level are usually offered medication to lower it (described later).

Blood pressure of 140/90 mmHg or above but below 160/100 mmHg
This is sometimes called mild high blood pressure. Ideally, it should be lower than this but for many people the risk from mild high blood pressure is small, and drug treatment is not indicated. However, certain groups of people with blood pressure in this range are advised medication to lower it. These are people with:
  • a high risk of developing cardiovascular diseases (see below), or
  • an existing cardiovascular disease (see below), or
  • diabetes, or
  • damage to the heart or kidney (organ damage) due to high blood pressure.

Blood pressure between 130/80 and 140/90 mmHg
For most people this level is fine. However, current UK guidelines suggest that this level is too high for certain groups of people. Treatment to lower your blood pressure if it is 130/80 mmHg or higher may be considered if you:

  • Have developed a complication of diabetes, especially kidney problems.
  • Have had a serious cardiovascular event such as a heart attack, TIA or stroke.
  • Have certain chronic (ongoing) kidney diseases.
Causes of high blood pressure
 
in 90 to 95 percent of high blood pressure cases, the cause is unknown. In fact, you can have high blood pressure for years without knowing it. That is why it is a “silent killer” — it creeps up on you. When the cause is unknown, you have what is called essential or primary hypertension. Factors that may lead to high blood pressure in the remaining 5–10 percent of cases, which are known as secondary hypertension.
 
In general the major causes of hypertension are the following:
  • Hectic and stress filled life style
  • Unhealthy food habits
  • Obesity
  • Excessive consumption of liquors
  • Smoking
  • Over consumption of tea/coffee
  • Insufficient rest and sleep
  • Metabolic disorders
  • Hardening of the arteries
  • Excessive use of pain killers and other strong medicines
  • Genetic disorders
  • Over consumption of oily food and fast food
  • High salt intake
  • Emotional and Physical stress
  • Family history of hypertension
Symptoms of High Blood Pressure

Some people may experience warning signs (symptoms). Usually there are no symptoms and you may feel well – until damage occurs. The only way of knowing that you have high blood pressure is to have it measured by your doctor, nurse or pharmacist, and monitored on a regular basis. How often depends on your general health and whether you have other health conditions, and on the use of medicines for blood pressure control. There may be some symptoms like:

Pain at the back of the head and neck

The first symptom of hypertension may appear as a pain at the back of the head and neck on waking in the morning, which soon disappears.

Dizziness, Palpitations

Some of the other common symptoms are dizziness, palpitations, pain in the region of the heart, frequent urination, nervous tension, fatigue, and difficulty in breathing.Nosebleed is quite common, and may be frequent and profuse.

The symptoms may be those of heart disturbances; of kidney trouble; or of cerebral (brain) irregularities irritability, excitability, emotional outbreaks, insomnia or drowsiness, memory affections, visual disturbances, headache, head noises; or various sensations in or clumsiness of different extremities - the extremities may pain, tingle, feel numb, or “go to sleep”. The stomach may be much disturbed, with various symptoms of indigestion, and there may be lung or pleural affections.
 
What are the risk factors?

The risk factors for high blood pressure include:
  • Heredity
  • Obesity
  • Heredity
  • Smoking
  • Age
  • Stress
  • Excessive alcohol
  • Secondary causes include disease conditions that can result in high blood pressure. These are kidney diseases and hormonal diseases such as hypothyroidism and Cushing’s syndrome.
Complications of High Blood Pressure
When blood pressure stays high over time, it can damage the body. HBP can cause:
  • The heart to get larger or weaker, which may lead to heart failure. Heart failure is a condition in which the heart can't pump enough blood throughout the body.
  • Aneurysms (AN-u-risms) to form in blood vessels. An aneurysm is an abnormal bulge or "ballooning" in the wall of an artery. Common spots for aneurysms are the main artery that carries blood from the heart to the body; the arteries in the brain, legs, and intestines; and the artery leading to the spleen.
  • Blood vessels in the kidney to narrow. This may cause kidney failure.
  • Arteries throughout the body to narrow in some places, which limits blood flow (especially to the heart, brain, kidneys, and legs). This can cause a heart attack, stroke, kidney failure, or amputation of part of the leg.
Blood vessels in the eyes to burst or bleed. This may lead to vision changes or blindness
 
Who is affected by high blood pressure?

High blood pressure is common, with 40% of adults in England having the condition. The number of people who have high blood pressure increases with age. For reasons that are not entirely understood, people of Afro-Caribbean and South Asian (India, Pakistan and Bangladeshi) origins are more likely to develop high blood pressure than other ethnic groups.

In 95% of cases, there is no single identifiable reason for a raise in blood pressure. However, all available evidence shows that your lifestyle plays a significant role in regulating your blood pressure. Risk factors for high blood pressure include:
  • Age.
  • Excessive alcohol consumption.
  • Poor diet.
  • Lack of exercise.
  • Obesity.
How Is High Blood Pressure Diagnosed?

Your doctor will diagnose high blood pressure (HBP) using the results of blood pressure tests. These tests will be done several times to make sure the results are correct. If your numbers are high, your doctor may have you return for more tests to check your blood pressure over time.

If your blood pressure is 140/90 mmHg or higher over time, your doctor will likely diagnose you with HBP. If you have diabetes or chronic kidney disease, a blood pressure of 130/80 mmHg or higher is considered HBP.
A one-off blood pressure reading that is high does not mean that you have high blood pressure. Your blood pressure varies throughout the day. It may be high for a short time if you are anxious, stressed, or have just been exercising.

 You are said to have high blood pressure (hypertension) if you have several blood pressure readings that are high, and which are taken on different occasions, and when you are relaxed.

How Is Blood Pressure Tested?

A blood pressure test is easy and painless. This test is done at a doctors office or clinic.

To prepare for the test:
  • Do not drink coffee or smoke cigarettes for 30 minutes prior to the test. These actions may cause a short-term rise in your blood pressure.
  • Go to the bathroom before the test. Having a full bladder can change your blood pressure reading.
  • Sit for 5 minutes before the test. Movement can cause short-term rises in blood pressure.
To measure your blood pressure, your doctor or nurse will use some type of a gauge, a stethoscope (or electronic sensor), and a blood pressure cuff.
.
Who should have a blood pressure check?

High blood pressure usually causes no symptoms. You will not know if you have high blood pressure unless you have your blood pressure checked. Therefore, everyone should have regular blood pressure checks at least every 3-5 years. The check should be more often (at least once a year) in: older people, people who have had a previous high reading,

Treatment of high blood pressure

There are two ways in which blood pressure can be lowered.

Lifestyle treatments to lower high blood pressure

Eat healthy foods:

  • At least five portions, and ideally 7-9 portions, of a variety of fruit and vegetables per day.
  • The bulk of most meals should be starch-based foods (such as cereals, wholegrain bread, potatoes, rice, pasta), plus fruit and vegetables.
  • Not much fatty food such as fatty meats, cheeses, full-cream milk, fried food, butter, etc. Use low fat, mono-, or poly-unsaturated spreads.
  • Include 2-3 portions of fish per week. At least one of which should be oily such as herring, mackerel, sardines, kippers, pilchards, salmon, or fresh (not tinned) tuna.
  • If you eat meat it is best to eat lean meat, or poultry such as chicken.
  • If you do fry, choose a vegetable oil such as sunflower, rapeseed or olive oil.
  • Most important is to take food low in salt.
  • A healthy diet provides health benefits in different ways. For example, it can lower cholesterol, help control your weight, and has plenty of vitamins, fibre, and other nutrients which help to prevent certain diseases. Some aspects of a healthy diet also directly affect blood pressure. For example, if you have a poor diet and change to a diet which is low-fat, low-salt, and high in fruit and vegetables, it can lower systolic blood pressure by up to 11 mmHg.

Maintain a healthy weight - Losing some excess weight can make a big difference. Blood pressure can fall by up to 2.5/1.5 mmHg for each excess kilogram which is lost. Losing excess weight has other health benefits too. .

Regular physical activity -- regular physical activity can help lower blood pressure and keep weight under control. Strive for at least 30 minutes of physical activity a day.
 
Limit alcohol - even if you are healthy, alcohol can raise your blood pressure. If you choose to drink alcohol, do so in moderation.
 
Do not smoke - tobacco injures blood vessel walls and speeds up the process of hardening of the arteries. So quit smoking.
 
Manage stress - reduce stress as much as possible. Practice healthy coping techniques, such as muscle relaxation and deep breathing. Getting plenty of sleep can help, too.

Have a low salt intake
The amount of salt that we eat can have an effect on our blood pressure. Tips on how to reduce salt include:

  • Use herbs and spices to flavour food rather than salt.
  • Limit the amount of salt used in cooking, and do not add salt to food at the table.
  • Choose foods labelled no added salt, and avoid processed foods as much as possible.
Treatment with medication
 
When is drug treatment started for high blood pressure?
Drug treatment to lower blood pressure is usually advised for:
  • All people who have a blood pressure that remains at 160/100 mmHg or above after a trial of any lifestyle changes, where relevant.
  • People with a blood pressure that remains at 140/90 mmHg or above after a trial of any lifestyle changes, where relevant AND who have:
  • Diabetes, or
  • An existing cardiovascular diseases, or
  • A 2 in 10 risk (or more) of developing a cardiovascular disease within the next 10 years (as described above).
  • People with a blood pressure of 130/80 mmHg or more who have certain diseases. For example, people who have certain complications from diabetes, people who have had a recent heart attack, stroke or TIA (transient ischaemic attack). Also, some people with certain chronic (ongoing) kidney diseases.

How long is medication needed for?

In most cases, medication is needed for life. However, in some people whose blood pressure has been well controlled for three years or more, medication may be able to be stopped. In particular, in people who have made significant changes to lifestyle (such as lost a lot of weight, or stopped heavy drinking, etc). Your doctor can advise.

If you stop medication, you should have regular blood pressure checks. In some cases the blood pressure remains normal. However, in others it starts to rise again. If this happens, medication can then be started again.

 How can high BP be controlled?

  • Stop smoking
  • Maintain a normal body weight – reduce if over-weight.
  • Eating too much salt makes high blood pressure worse. Low-sodium diets are prescribed to help control high blood pressure. These limit the amount of sodium in the diet to less than 2 grams per day (about half the amount of sodium in the average diet).
  • Eat a healthy diet containing soluble fibre, such as fruit and vegetables.
  • Avoid high fat foods.
  • Avoid coffee and colas
  • Do not drink excessive alcohol.
  • Exercise regularly to keep fit.
  • Reduce stress and relax after work.
  • Follow-up regularly with the doctor.
When to Seek Medical Care
Call your health care provider if you have any of the following symptoms:
  • Unexplained severe headache
  • Sudden or gradual changes in vision
  • Light-headedness or dizziness
  • Nausea associated with severe headache
  • Chest pain or shortness of breath upon exertion
Tell your health care provider if any family member has or has had high blood pressure, heart attack, stroke, or kidney failure.

 Prevention of high blood pressure

If You Have Normal Blood Pressure
If you do not have high blood pressure (HBP), you can take steps to prevent it. Lifestyle measures can help you maintain normal blood pressure.
  • Follow a healthy eating plan. This includes limiting the amount of sodium (salt) and alcohol that you consume. Lose weight if you are overweight or obese.
  • Do enough physical activity.
  • Quit smoking.
  • Manage your stress and learn to cope with stress
Many people who take one or more of these steps are able to prevent or delay HBP. The more steps you take, the more likely you are to lower your blood pressure and avoid related health problems.

If You Have High Blood Pressure

If you have HBP, you can still take steps to prevent the long-term problems it can cause. Lifestyle measures (listed above) and medicines can help you live a longer, more active life.
Follow the treatment plan your doctor prescribes to control your blood pressure. It can help you prevent or delay coronary heart disease, stroke, kidney disease, and other health problems.
 
Herbal remedies about high blood pressure

 1.    Honey is one of the most common home remedy for the treatment of different health-related problems. Take equal amount of honey, ginger juice, and finely powdered cumin (jeera) seeds, approx 2-3 tablespoon, and make a mixture. Take this mixture 2-3 tablespoon twice a day..

2.    Gooseberry or amla too has a positive effect in the treatment of high blood pressure. Take 1-2 tablespoon of amla juice with honey in empty stomach early in the morning.

 3.    Take onion juice (2-3 tablespoon) and mix honey (2-3 tablespoon) to it. Take this mixture for the treatment of high blood pressure.

4.    Take 1-2 tablespoon of methi seeds and boil in a glass of water. Strain and then take this mixture. This is one of the best home remedy for the treatment of high blood pressure. Patient may continue this drink for 2-3 months twice a day.

 5.    Curry leaves have strong medicinal effect for the treatment of high blood pressure. Take 35-40 green curry leaves and boil in a glass of water. Keep it aside and allow it to cool. Drink it in empty stomach in early morning.

6.    Another way of taking curry leaf tea is with two-three tablespoon of lemon extract.

 7.    Lemon extract also is effective for the treatment of high blood pressure. Take 2-3 tablespoon of lime extract in a cup of water. Freshly prepared lemon juice too has a great effect.

8.    Take equal amount of khus khus and char magaz (150 gm) and grind into fine powder. Take 1-2 tablespoon of this powder with water twice a day. Patient may take the first dose in an empty stomach.

 9.    Two-three seeds of garlic are the best medicine. It has a magical effect in lowering the blood pressure level; it also regulates the heart beat, helps in the proper functioning of the lungs and other parts of the body. It makes the body active and reduces body pain.

Fruits:

Various fruits like grapes, water melon, and papaya play vital role in the treatment of high blood pressure. This regulates blood pressure and bring heart beat to normal. The seeds of water melon can also be dried and finely powdered. This powder can be taken 1-2 tablespoon in a glass of water. Take raw papaya in an empty stomach in the early morning. This clears the bowel movement, prevents constipation, and thus reduces high blood pressure.

Vegetables:

Vegetables like carrot and spinach too will help in reducing high blood pressure. Both these vegetables and other green leafy vegetables are very helpful. Extract fresh juice from carrot and spinach and take a glass of it twice a day.

Boiled rice and potato:

It is said that patient suffering from high blood pressure should take boiled rice, especially brown rice, in their diet. It regulates and soothes the nerves and thus help in lowering high blood pressure. Brown rice is also rich in minerals like calcium, etc. Similarly, boiled potato is also good. Patient with high blood pressure should take less salt in their diet, and taking potato may carve from excess salt intake.

Watermelon is another valuable safeguard against high blood pressure. A substance extracted from watermelon seeds is said to have a definite action in dilating the blood vessels, which results in lowering the blood pressure. The seeds, dried and roasted, should be taken in liberal quantities.

Grapefruit is useful in preventing high blood pressure. The vitamin P content in the fruit is helpful in toning up the arteries.

Parsley is very useful in high blood pressure. It contains elements, which help maintain the blood vessels, particularly, the capillaries. It keeps the arterial system in a healthy condition. It may be taken as a beverage by simmering 20 gm of fresh parsley leaves gently in 250 ml of water for a few minutes. This may be drunk several times daily.
 
Other High Blood Pressure treatment

Persons suffering from hypertension must get at least eight hours of good sleep, because proper rest is a vital aspect of the treatment. Most important of all, the patient must avoid overstrain, worries, tension, anger, and haste.

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