P.O Box 22494-00505, Nairobi
WHAT IS HYPERTENSION ?
Hypertension is sustained elevation of resting systolic BP (≥ 140 mm Hg), diastolic BP (≥ 90 mm Hg), or both. Hypertension with no known cause (primary; formerly, essential hypertension) is most common. Hypertension with an identified cause (secondary hypertension) is usually due to chronic kidney disease or primary aldosteronism. Usually, no symptoms develop unless hypertension is severe or long-standing. Diagnosis is by sphygmomanometry. Tests may be done to determine cause, assess damage, and identify other cardiovascular risk factors. Treatment involves lifestyle changes and drugs, including diuretics, β – blockers, ACE inhibitors, angiotensin II receptorblockers, and Ca channel blockers
• Urinalysis and urinary albumin:creatinine ratio; if abnormal, consider renal ultrasonography
• Blood tests: Fasting lipids, creatinine, K
• Renal ultrasonography if creatinine increased
• Evaluate for aldosteronism if K decreased
• ECG: If left ventricular hypertrophy, consider echocardiography
• Sometimes thyroid-stimulating hormone measurement
• Evaluate for pheochromocytoma or a sleep disorder if BP elevation sudden and labile or severe
WHAT IS HIGH BLOOD PRESSURE ?
- Not doing enough physical activity
- Being overweight or obese
- Having too much salt in your diet
- Regularly drinking too much alcohol or
- Having a family history of high blood pressure.
Even if you don’t have high blood pressure, making some simple lifestyle changes may help prevent you developing it in the future.
WHAT DO THE NUMBERS MEAN?
The first (or top) number represents the highest level your blood pressure reaches when your heart contracts and pumps blood through your arteries – your systolic blood pressure. An example might be 130mmHg.
The second (or bottom) number represents the lowest level your blood pressure reaches as your heart relaxes between beats – your diastolic blood pressure. An example might be 75mmHg.
SYMPTOMS AND SIGNS
Hypertension is usually asymptomatic until complications develop in target organs. Dizziness, headache, fatigue, epistaxis, and nervousness are not caused by uncomplicated hypertension. Severe hypertension can cause severe cardiovascular, neurologic, renal, and retinal symptoms.A 4th heart sound is one of the earliest signs of hypertensive heart disease.
WHAT IS BLOOD PRESSURE?
HOW DOES MY GP KNOW I HAVE HIGH BLOOD PRESSURE?
Everyone’s blood pressure varies during the day. Some people have a condition known as ‘white coat hypertension’ or ‘white coat syndrome’. This is a condition where your blood pressure rises only because someone is taking your blood pressure, and not because you have an underlying medical problem.
If you have white coat hypertension, your blood pressure will return to normal when your doctor or nurse stops taking it. It can be very difficult to diagnose and this is why you may need to have your blood pressure rechecked several times, or you may be sent home with a 24 hour blood pressure monitor.
HOW DO I REDUCE MY BLOOD PRESSURE?
If your blood pressure is very high or these lifestyle changes do not reduce it enough, your doctor is likely to prescribe you medication to control it and to reduce your risk of having a heart attack or stroke