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The heart is the principal organ that supplies blood to all other organs of the body via arteries. The force or pressure with which blood is transferred from the head-the topmost region to the extremities of all organs and the edge of the feet is defined as blood pressure. In other words, blood pressure is the force with which blood rushes out from the aorta-the largest artery in the circulatory system as well as the pressure the same exerts on the arterial walls.
Pressure of blood is at its peak when exiting the heart and ebbs steadily as it enters the arteries, capillaries, and arterioles. The oxygenated blood which is distributed throughout the body is transported back to the heart in a deoxygenated form via the veins through muscle contractions and gravitational force. It is only when the regular force of the blood-flow attains an abnormally high level that one is diagnosed with hypertension-the medical terminology for ‘high blood pressure’.
If the blood pressure continues to remain high for a long or an extended period, there is high likelihood of the patient suffering a heart attack or stroke, aortic aneurysms, CHF, and peripheral arterial disease. Clinical hypertension is determined using a sphygmomanometer that comes with a rubberized cuff which is strapped around your upper arm. A graduated console attached to the cuff registers the blood pressure.
As per AHA’s (American Heart Association) prescribed guidelines, the normal blood pressure is 120/80m of Hg. When the systolic to diastolic pressure index of an individual’s BP is 140-159/90-99 or higher, that person is said to be hypertensive. Nearly 60 million adults in USA suffer from hypertension and the lifestyle disorder accounts for the 2nd highest number of visits to physicians.
For an overwhelmingly majority of adults diagnosed with high blood pressure, the exact cause(s) leading to the disorder more often than not remains undetected. For almost 95% of all individuals in the US beset with hypertension, the diagnosis is idiopathic-(1). Such HBP diagnoses are classed as primary or essential hypertensive cases.
Essential hypertension develops on a chronic basis over the years and hence is more prevalent in older people, particularly those in their forties and beyond. If an individual’s HBP could be linked to some underlying cause or condition, then it is defined as secondary HBP.
Diseases related to the kidney are amongst the most prevalent cause of secondary hypertension. Anomalies that lead to adrenal glands secreting excessive quantities of hormones or tumors, both benign and malignant can cause blood pressure spikes and fluctuations (12).
There are numerous causes or factors that can cause one to develop high blood pressure, some of which are inherent and beyond control while others are external and hence can be monitored. An individual’s age, ethnicity, socioeconomic conditions, heredity, and gender are some specific universal factors that can influence his or her blood pressure.
On the other hand, unhealthy lifestyle habits including excessive smoking and drinking, and idleness leading to one becoming overweight or obese can cause hypertension. Evidently enough, giving up damaging habits and getting rid of excessive fatty deposits can go a long way in helping one to maintain blood pressure within normal levels.
It is an established medical fact that hypertension is largely an idiopathic lifestyle disorder as most of the diagnosed cases don’t have identifiable causes. It is because of this peculiar nature of high blood pressure that the medical condition has been dubbed as the ‘silent slayer’. More often than not, those having manifestly high blood pressure may experience spells of:-
As hypertension mostly tends to be without causes, a person with abnormally high blood pressure (chronic or acute) doesn’t go for medical intervention until and unless these symptoms don’t become apparent. A person who has regularly reported hypertension during routine checks spread over a number of years is under high risk of suffering single or multiple organ damage. Ongoing or acute elevated hypertension can cause irreparable damage to bodily organs in the following ways:-
Anyone or more of the above conditions might also be symptomatic of extremely severe hypertension which is a condition that is medically termed as ‘malignant hypertension’. Someone with malignant hypertension registers a blood pressure reading normally above 180/120.
One continuing to register malignant blood pressure readings on a routine basis is likely to suffer one or multiple organ damage sooner or later and therefore should be hospitalized without delay (6)
For a good majority of those diagnosed with malignant hypertension, acutely high blood pressure is the chief cause. Someone may exhibit symptom of malignant hypertension if that individual is suffering from the below-mentioned medical disorders or conditions:-
Taking certain medicines and banned psychotropic substances like cocaine, heroin or marijuana can also lead to one being beset with malignant hypertension. (7)
Of course, the most palpable and sure-shot symptom of malignant hypertension is when your blood pressure reading is 180/120 or above. Organ failure is another sign that may strongly indicate the abovementioned medical condition. The damage in most of the cases happens to the eyes or the kidneys. However, the establishment of a particular pattern in the way blood pressure shoots up may indicate other symptoms.
Therefore, it does not need to be emphasized malignant hypertension calls for urgent medical intervention for bringing down blood pressure to normal levels and thereby allaying the incidence of ischemic stroke or hemorrhage.
As clarified above, symptoms related to high blood pressure may not be that grave so as to warrant medical advice. Nevertheless, this very tendency or peculiarity of hypertension causes the heart, arteries, and other bodily organs to dysfunction progressively over the years ultimately damaging them.
Some of the symptoms surface after one has had high blood pressure for years on end. More often, an individual may report dizziness or have a nagging headache or excruciating pain in the chest warranting a medical examination which in turn, leads to the detection of hypertension. Hence, it is recommended that all adults irrespective of the state of their health should go for habitual medical checkup at least once in a month to keep track of the actual blood pressure.
At the same time, it is also advised that one should ignore or disregard symptoms of lethargy or fatigue, giddiness, nausea, vision change or headaches if these keep recurring. Recurrence of these symptoms time and again, might point towards the presence of some other disorder or ailment, other than hypertension.
High blood pressure or hypertension, even if you’ve had it for a long time, may or may not give you headaches, under normal circumstances. It is only when you’re diagnosed with malignant hypertension whereby your blood pressure shoots up to 180/110 or higher, that you might experience severe or acute headaches. About a century back, it was taken for granted that people who reported high blood pressure readings were the most likely candidates for distressing headaches.
Nevertheless, with rapid strides being made in medical sciences in the subsequent decades, it was established via painstaking research that hypertensive individuals were less prone to suffer headaches in comparison to the rest of the populace.
As per one report published in ‘Neurology’, individuals having normal blood pressure had a 40% higher chance of having headaches compared to those who were hypertensive, especially ones who systolic readings were abnormally high. Medical experts and specialists probed the aspect of ‘pulse pressure’ as well in order to substantiate the aforementioned finding (13).
The pressure at which blood is pumped out from the aorta keeps changing due to the contraction and expansion of the myocardial muscles. This alteration of the blood pressure is defined as pulse pressure and is determined by finding out the difference between the systolic and diastolic readings. It was observed that those whose pulse pressures were significantly higher than normal hypertensive levels, experienced lesser incidences of headaches, at least 50% less.
Researchers and scientists were of the opinion that people whose arteries became stiffened or hardened (atherosclerosis) or had narrowed down (arteriostenosis) reported higher pulse pressures. Arterial sclerosis or stenosis meant that the endings of the sensory nerves were not functioning smoothly thereby numbing the sensation of pain or feeling of a headache.
Hence, it can be convincingly concluded that headaches or their absence is not a sure-shot indication of hypertension. Rather, you’d be better off consulting a physician or medical practitioner and getting your blood pressure checked.
Just as it is with headaches, nosebleeds too are not markers or indicators of hypertension. According to a study, of all the patients undergoing treatment for HBP at hospitals and restorative clinics, only about 17% of these individuals experienced nosebleeds. If you have had nosebleeds quite frequently, characterized by heavy bleeding and you had to struggle to stem the flow, then you should contact an ENT surgeon or healthcare professional as early as possible.
If your nose bleeds far too often and quite profusely, then it may be a sign of high blood pressure. But then again, frequent nosebleeds might be indicative of other disorders or complications as well. Medical conditions including sinusitis and common cold or allergic attacks could cause your nose to bleed.
Attempting to clear mucus from your nose by blowing hard might also trigger nose bleed. Working outdoors in extremely hot weather when the atmosphere is unusually dry causes nasal membranes to get dehydrated rendering the nose vulnerable to bleeding. Besides the above factors, there are numerous other issues that could cause your nose to bleed (9).
There are a host of symptoms that could directly or indirectly attributable to hypertension but you should be aware that the presence of these signs alone are not suggestive of HBP. Having mentioned this, you should take a firm stand against self-diagnosing. In other words, don’t try to make an assessment on your own whether you’re hypertensive (or not) simply on the basis of the symptoms.
It goes without saying that you should always get in touch with a registered medical practitioner the moment you feel that something is amiss. In this context, the following signs may be linked or associated with HBP, albeit in an indirect manner but then again, the same may not be causative of hypertension.
Flushing happens or blotches appear as a result of the dilation of arterioles which are small blood vessels located underneath the epidermis on the face and on other regions of the body. Using skincare items laced with chemicals, intake of spicy foods, excessive consumption of alcohol, and continuous exposure to extreme weather conditions can cause facial flushing or reddening of the skin.
Other triggers include emotional stress, anxiety, strenuous exercises, and showering with excessively hot or cold water. All these triggers associated with skin flushing can result in the spiking up of blood pressure at least for a temporary period. It can be inferred that though flushing in the face might happen your HBP notwithstanding, it is rarely the other way round, i.e. HBP doesn’t lead to facial inflammation
It doesn’t need to be emphasized or stressed that each and every adult should go in for a periodic health check-up, including of course, a review of blood pressure. If you’re between 18 and 40, you should get your BP checked on a biennial basis at the minimum. In case, if you’ve a family history of HBP, you should go for a checkup at least once yearly.
Request the medic or healthcare professional to take readings for both the arms. If you’re not able to schedule visits on a regular basis owing to unavoidable circumstances, you can get your BP checked for free in a health-camp organized by your local community.