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What You Need To Know About High Blood Pressure

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What You Need To Know About High Blood Pressure

A national survey shows that one in four Filipino adults has high blood pressure or hypertension. By the time we reach the age of 60, almost half will have high blood pressure. 



High blood pressure, if uncontrolled, can be a deadly disease. It’s unfortunate that many people do not take the necessary steps to control it.



Some cases of high blood pressure have no symptoms whatsoever. That is why high blood pressure is regarded as a silent killer. However, there are patients who develop symptoms such as headache, nape pain, dizziness, flushing of the face, palpitation and nose bleeding.













Monitor Your Blood Pressure:

A person is said to have high blood pressure if there is a persistently high pressure of blood within the arteries. If this isn’t lowered down to normal levels, then over time, the excessive pressure can damage and stiffen the arteries. In addition, the heart will slowly thicken, enlarge and eventually weaken. The brain can suffer a stroke and the kidneys and eyes will also be damaged. 



Diagnosis of high blood pressure is easy. You just need a blood pressure apparatus (called sphygmomanometer) to check your blood pressure. The blood pressure reading has two numbers. The first and higher number (systolic pressure) refers to the pressure inside the arteries when the heart is beating.  The second and lower number (diastolic pressure) refers to the pressure in the arteries when the heart is resting. Both numbers are important. (See accompanying tables.)

Table 1. Classification of Hypertension: Based on at least two separate readings.
Hypertension Category	Systolic (mm Hg)	Diastolic (mm Hg)
Normal	< 120	< 80
Prehypertension	120 - 139	80 – 89
Hypertension Stage 1 (mild)	140 - 159	90 – 99
Hypertension Stage 2 (moderate to severe)	160 or higher	100 or higher

Table 2. Recommendations for Follow-up Based on Initial Blood Pressure Reading.
Initial Blood Pressure (mm Hg)		Follow-up Recommendation
Systolic	Diastolic
< 120	< 80	Recheck yearly
120 - 139	80 – 89	Advise healthy lifestyle and recheck in 6 months
140 - 159	90 – 99	Confirm hypertension within 1 month
160 or higher	100 or higher	Refer to a physician for treatment

Primary Versus Secondary High Blood Pressure:

In 95 percent of patients, the cause of the high blood pressure is unknown. We call this primary or essential hypertension. In these patients, we can still treat and control the hypertension by addressing some of the risk factors involved. The risk factors we can still change include being overweight, cigarette smoking, high salt consumption, lack of exercise, excessive alcohol intake, and use of oral contraceptives.

However, in 5 percent of patients, the high blood pressure is due to a specific disease, such as kidney disease, illegal drug use, hyperactive thyroid or a tumor. We call these cases as secondary hypertension. 

Doctors need to differentiate between primary from secondary hypertension, because some secondary causes can be completely cured if we address the main culprit. One clue that we are dealing with secondary hypertension is when a young apparently healthy individual suddenly develops very high blood pressure. 

Beware Of White Coat Hypertension:  

There is a peculiar type of patient who only develops high blood pressure in a doctor’s clinic. However, when you take the blood pressure in another setting, like his house, the blood pressure goes back to normal. 

We label these cases as “white coat hypertension,” which means that the patient’s blood pressure shoots up upon seeing the doctor’s white coat. No treatment is given to such patients except reassurance and occasional monitoring of the blood pressure.

The laboratory work-up for a person with high blood pressure may include the following:

1. Complete Blood Count

2. Serum Potassium and Calcium: To check for electrolyte abnormalities.

3. Fasting Blood Sugar: To check for diabetes.

4. Creatinine: To check for kidney complications.

5. Total Cholesterol, HDL, LDL and Triglycerides: To check for other risk factors such as cholesterol abnormalities.

6. 12-lead ECG: To check for heart disease.

First Aid For High Blood Pressure:

1. Make sure that the blood pressure reading is correct especially if the patient has no symptoms such as headache or chest pains.

2. Keep the patient relaxed. To calm the patient, you can instruct him to breathe slowly and deeply. Sometimes, slow breathing can already lower the blood pressure.

3. If the patient has maintenance medicines for high blood pressure, let him take it.

4. You can usually give the patient medicines for high blood pressure in the following circumstances: (1) If the blood pressure is over 140/90 and the patient has symptoms such as headache, dizziness, or chest pains, and (2) If the blood pressure is 160/100 or higher.

5. The usual first aid medicines to lower the blood pressure include (1) Clonidine (Brand name: Catapres) 75 mcg, one tablet orally or (2) Captopril 25 mg, one tablet orally.  These medicines can also be place and dissolved under the tongue for faster action. But for most cases, taking it orally is good enough. 

6. Take note that not all cases of high blood pressure should be given medications. Sometimes there are external causes of high blood pressure such as anger, tension or pain. In such cases, other medications such as a sedative or pain reliever may help lower the blood pressure.

7. Depending on the severity of the situation, you can bring the patient to the Emergency Room or make an appointment with a doctor the following day. Good luck.

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