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Hypertension

Hypertension

Hypertension or high blood pressure is a major problem afflicting one out of four adults in the United States alone. It is a precursor to other serious health complications - kidney disease, atherosclerosis, stroke and eye damage to name a few.

Normal Blood Pressure

For normal adults normal blood pressure is below 120/80 mmHg. In other words, the systolic pressure (when the heart pumps) should be below 120 and the diastolic pressure (when the heart relaxes) should be below 80. A reading between 120/80 and 140/90 might be seen as pre hypertension stage and in some cases may indicate the need for further investigation.

A reading above 140/90 indicates hypertension and requires a thorough investigation into the cause and treatment.

Cause of HyperTension

Many factors have been implicated in the development of hypertension - obesity, genetics, sodium sensitivity, glomerulonephritis and other kidney diseases, among other etiologies. Elevated levels of blood pressure can be also due to drug interactions. There are 2 kinds of hypertension - the primary hypertension where it occurs due to unknown etiology and the secondary hypertension which is the result of another underlying condition.

Diagnosis: Blood tests:

Renal Function - Creatinine
Electrolytes Level
Glucose - Glucose Tolerance Test
Cholesterol Level

In addition ECG may be ordered to check for left ventricular hypertrophy.

Treatment Options

Diuretics: bendroflumethiazide, chlortalidone, hydrochlorothiazide
Angiotensin Converting Enzyme (ACE) inhibitors: creatine captopril, enalapril, fosinopril, Monopril, lisinopril , quinapril, ramipril
Angiotensin II receptor antagonists: telmisartan, irbesartan, losartan, valsartan, candesartan
Alpha blockers: prazosin, terazosin.
Beta blockers: atenolol, labetalol, metoprolol, propranolol.
Calcium channel blockers: nifedipine, amlodipine, diltiazem, verapamil
Direct renin inhibitors: aliskiren

Treadmill stress test

A treadmill stress test is used to evaluate any irregular heart beats on exercise and exertion. Those suffering from borderline hypertension may be asked to undergo treadmill stress test to evaluate blood pressure response to exercise. The treadmill stress test is a cardiac stress test that is used to diagnose coronary artery disease or any heart-related ailments. Treadmill Stress Test is sometimes called an exercise electrocardiogram. The person is fitted with electrodes in about 10 locations on the arm and chest to measure blood pressure and EKG. Then the treadmill is started, initially at slow pace and later much faster. Some heart medications may be need to be stopped for a day or two. The treadmill stress test is much like any strenous exercise such as running up a flight of stairs. It is essential that the treadmill stress test is conducted under proper supervision. This test indicates how well the heart functions and if the blood supply in the arteries is reduced on exertion. Persons scheduled for treadmill stress test must not eat or drink for about 3 hours prior to the test.

Preeclampsia

Preeclampsia is a condition that affects some pregnant women and affects the mother and unborn baby. This condition is characterized by high blood pressure and excess protein in the urine after 20 weeks of pregnancy. Preeclampsia is also known as pregnany induced hypertension and toxemia. This condition can either develop over time or come on rapidly. Preeclampsia is noticed more often in the last few weeks of pregnancy. Women suffering from preeclampisa are likely to give birth to low birth weight babies since this condition hampers the placenta from receiving enough blood.

Pregnant women over the age of 40 or those carrying multiple babies are at higher risk for developing preeclampsia. Women who are already suffering from hypertension or kidney disease are more susceptible for developing preeclampsia. Lack of magnesium or calcium can lead to preeclampsia. This can occur due to poor diet or immune problems. Hormonal disruption can also lead to preeclampsia. Symptoms of preeclampsia include sudden weight gain and swelling. The pregnant women is likely to experience headaches and vision problems. There might be upper abdominal pain, dizzines and vomiting.

In most cases, the woman is relieved of this condition on delivering the baby. If the symptoms of preeclampsia are noticed early in pregnancy, care must be taken to keep blood pressure under control. The physician will advice the pregnant woman on the amount of salt to be consumed as well as the amount of water to be taken in a day. Often this may require hospitalization. The baby is closely monitored with ultrasound. Aspirin or additional calcium may be prescribed to prevent preeclapsia in women who are more susceptible to developing it. Magnesium sulfate is given to women suffering from preeclampsia when they go into labor.