Hypertention

Definition:

Blood pressure above 140/90 constitutes hypertension. Increase in diastolic pressure is more important in the definition of hypertension. As part of our increasing engagement in improving blood pressure measurement we are now undertaking active validation of new blood pressure devices for the measurement of blood pressure. Intracardiac left-to-right shunts (such as a ventricular or atrial septal defect, a hole in the wall between the two ventricles or atria) can cause too much blood flow through the lungs. Hypertension occurs when blood is forced through the arteries at an increased pressure.In patients with diabetes mellitus or kidney disease studies have shown that blood pressure over 130/80 mmHg should be considered a risk factor and warrants treatment. Accordingly, the diagnosis of high blood pressure in an individual is important so that efforts can be made to normalize the blood pressure and, thereby, prevent the complications.Whereas it was previously thought that diastolic blood pressure elevations were a more important risk factor than systolic elevations, it is now known that for individuals older than 50 years of age systolic hypertension represents a greater risk.

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Hypertension , commonly referred to as “high blood pressure”, is a medical condition where the blood pressure is chronically elevated.The arteries are the vessels that carry blood from the pumping heart to all of the tissues and organs of the body.High blood pressure does not mean excessive emotional tension, although emotional tension and stress can temporarily increase the blood pressure. Because the risk to an individual patient may correlate with the severity of hypertension, a classification system is essential for making decisions about aggressiveness of treatment or therapeutic interventions. Generally, the higher the blood pressure, the greater the risk. Untreated hypertension affects all organ systems and can shorten one’s life expectancy by 10 to 20 years.An elevation of the systolic and/or diastolic blood pressure increases the risk of developing heart (cardiac) disease, kidney (renal) disease, hardening of the arteries (atherosclerosis or arteriosclerosis), eye damage, and stroke (brain damage).This can cause an artery to rupture or the heart to fail under the strain – in the worst case stopping altogether.If the pressure is high enough, eventually the heart can’t keep up, and less blood can circulate through the lungs to pick up oxygen.

Blood pressure is a continuously distributed variable and the risk of associated cardiovascular disease likewise rises continuously. Therefore, determinants of blood pressure include factors that affect both cardiac output and arteriolar vascular physiology. The diastolic pressure, which is the bottom number, represents the pressure in the arteries as the heart relaxes after the contraction. Blood is pumped from the heart through the arteries out to our muscles and organs. High blood pressure is a major risk factor for heart disease, congestive heart failure, stroke, impaired vision, and kidney disease. The British Hypertension Society has a track record of producing internationally renowned guidelines for the management of hypertension which are widely adopted in primary care in the UK and elsewhere. Furthermore, changes in vascular wall thickness affect the amplification of peripheral vascular resistance in hypertensive patients and result in reflection of waves back to the aorta, increasing systolic blood pressure.

Kidneys play a key role in keeping blood pressure in a healthy range, and blood pressure, in turn, can affect the health of kidneys. High blood pressure, also called hypertension, can damage the kidneys

Hypertension can result from too much fluid in normal blood vessels or from normal fluid in narrow blood vessels.

Blood pressure measures the force of blood against the walls of your blood vessels. Blood pressure that remains high over time is called hypertension. Extra fluid in your body increases the amount of fluid in your blood vessels and makes your blood pressure higher. Narrow or clogged blood vessels also raise your blood pressure.

Causes of Hypertention:
The common Causes of Hypertention :

*Renal parenchymal disease
*Polycystic kidney disease
*Vasculitis
*Hyperthyroidism and hypothyroidism
*There does not appear to be a direct relationship between caffeine and chronic hypertension, even though caffeine intake can *cause an acute (rapid but brief) increase in blood pressure.
*chronic alcohol abuse
*Dangerous expansion of the main artery either in the chest or the abdomen, which becomes weakened and may rupture.
*Erythropoietin
*Smoking
*Lack of Exercise

Secondary causes include certain types of kidney disease, abnormal functioning of certain glands (adrenal glands, thyroid gland, parathyroid glands), chronic intake of certain substances and medications (e.g., alcohol, steroids), and the presence of a rare tumor (e.g., pheochromocytoma, which secretes adrenaline-like substances).

Symptoms of Hypertention

Most people with high blood pressure have no symptoms. The only way to know whether your blood pressure is high is to have a health professional measure it with a blood pressure cuff. The result is expressed as two numbers. The top number, which is called the systolic pressure, represents the pressure when your heart is beating. The bottom number, which is called the diastolic pressure, shows the pressure when your heart is resting between beats. Your blood pressure is considered normal if it stays below 120/80 (expressed as “120 over 80”). People with a systolic blood pressure of 120 to 139 or a diastolic blood pressure of 80 to 89 are considered prehypertensive and should adopt health-promoting lifestyle changes to prevent diseases of the heart and blood vessels. If your systolic blood pressure is consistently 140 or higher or your diastolic pressure is 90 or higher, you have high blood pressure and should talk with your doctor about the best ways to lower it.

Some are common Symptoms of Hypertention :

• Confusion
• Vision changes
• Cyanosis, a condition in which the baby’s skin has a bluish tint, even while they are receiving extra oxygen to breathe
• Dizziness
• Tiredness
• Swelling in the ankles or legs (edema)
• Bluish lips and skin (cyanosis)
• Angina-like chest pain (crushing chest pain )
• Ear noise or buzzing
• Nausea and vomiting.
• Respiratory distress, including signs such as flaring nostrils and grunting

Hypertention or High Blood Pressure ultimately damages the Kisny:
High blood pressure makes your heart work harder and, over time, can damage blood vessels throughout your body. If the blood vessels in your kidneys are damaged, they may stop removing wastes and extra fluid from your body. The extra fluid in your blood vessels may then raise blood pressure even more. It’s a dangerous cycle.

High blood pressure is one of the leading causes of kidney failure, also commonly called end-stage renal disease (ESRD). People with kidney failure must either receive a kidney transplant or go on dialysis. Every year, high blood pressure causes more than 25,000 new cases of kidney failure in the United States.

How to know that Kidney Damage
Kidney damage, like hypertension, can be unnoticeable and detected only through medical tests. Blood tests will show whether your kidneys are removing wastes efficiently. Your doctor should order tests to measure your serum creatinine. Having too much creatinine in your blood is a sign that you have kidney damage. The doctor should use the serum creatinine to estimate the main kidney function called glomerular filtration rate, or GFR.

Another sign is proteinuria, or protein in your urine. Proteinuria has also been shown to be associated with heart disease and damaged blood vessels. (For more information, see the fact sheet Proteinuria from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).)

How to Control Hypertension:

NHLBI has found that five lifestyle changes can help control blood pressure:

• Maintain your weight at a level close to normal. Choose fruits, vegetables, grains, and low-fat dairy foods.
• Limit your daily sodium (salt) intake to 2,000 milligrams or lower if you already have high blood pressure. Read nutrition labels on packaged foods to learn how much sodium is in one serving. Keep a sodium diary.
• Get plenty of exercise, which means at least 30 minutes of moderate activity, such as walking, most days of the week.
• Avoid consuming too much alcohol. Men should limit consumption to two drinks (two 12-ounce servings of beer or two 5-ounce servings of wine or two 1.5-ounce servings of “hard” liquor) a day. Women should have no more than a single serving on a given day because metabolic differences make women more susceptible to the effects of alcohol.
• Limit caffeine intake.

Treatment:
Many people need medicine to control high blood pressure. Two groups of medications called ACE (angiotensin-converting enzyme) inhibitors and ARBs (angiotensin receptor blockers) lower blood pressure and have an added protective effect on the kidney in people with diabetes. Additional studies have shown that ACE inhibitors and ARBs also reduce proteinuria and slow the progression of kidney damage in people who do not have diabetes. You may need to take a combination of two or more blood pressure medicines to stay below 130/80. Doctor may also prescribe a diuretic in addition to your ACE inhibitor or ARB. Diuretics are also called “water pills” because they help you urinate and get rid of excess fluid in your body.

Here is the list of the methods for treating Hypertention :

• Medications may include diuretics, beta-blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), or alpha blockers.
• Medications such as hydralazine, minoxidil, diazoxide, or nitroprusside may be required if the blood pressure is very high.
• Increase the supply of blood and oxygen to the heart, while reducing its workload.
• 100 percent supplemental oxygen may be given to your baby through a mask or plastic hood.
• Research has shown that this gas is effective in treating PPHN because it relaxes contracted lung blood vessels and improves blood flow to the lungs.
• For the compelling indications, other antihypertensive drugs (eg, diuretics, ACE inhibitor, ARB, beta-blocker, calcium channel blocker) may be considered as needed.
• Maintain weight at 15 percent or less of desirable weight
• Stop smoking and reduce intake of dietary saturated fat and cholesterol for overall cardiovascular health.
• This type of ventilation may improve the oxygen level in the blood if other types of ventilation are not effective.

Prevention:
If you have kidney damage, you should keep your blood pressure below 130/80. The National Heart, Lung, and Blood Institute (NHLBI), one of the National Institutes of Health (NIH), recommends that people with kidney disease use whatever therapy is necessary, including lifestyle changes and medicines, to keep their blood pressure below 130/80.

Risk factor for kidney failure related to HIGH BLOOD PRESSURE :

All racial groups have some risk of developing kidney failure from high blood pressure. African Americans, however, are more likely than Caucasions to have high blood pressure and to develop kidney problems from it—even when their blood pressure is only mildly elevated. In fact, African Americans are six times more likely than Caucasions to develop hypertension-related kidney failure.

People with diabetes also have a substantially increased risk for developing kidney failure. People who are at risk both because of their race and because of diabetes should have early management of high blood pressure.

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), also part of NIH, sponsored the African American Study of Kidney Disease and Hypertension (AASK) to find effective ways to prevent high blood pressure and kidney failure in this population. The results, released in 2003, showed that an ACE inhibitor was better at slowing the progression of kidney disease in African Americans than either of two other drugs.

Hope through Research
In recent years, researchers have learned a great deal about kidney disease. NIDDK sponsors several programs aimed at understanding kidney failure and finding treatments to stop its progression.

NIDDK’s Division of Kidney, Urologic, and Hematologic Diseases supports basic research into normal kidney function and the diseases that impair normal function at the cellular and molecular levels, including diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://kidney.niddk.nih.gov/kudiseases/pubs/highblood/index.htm

Hypertention