Hypertension or high blood pressure is a referred to as the ‘silent killer’ in the medical community because it does not present with symptoms.  Chances are that if you have high blood pressure, you would never know it unless your doctor takes your routine blood pressure at the clinic.  So why is it referred to as the ‘silent killer’?  High blood pressure, like diabetes, affects many organ systems, especially the heart.

The heart is a muscle that pumps blood through the major arteries to the rest of the organs such that they may receive adequate oxygen and energy to fuel our daily activities.  High blood pressure causes these arteries to narrow and it is this narrowing that creates a high pressure in the heart.  And this chronic high pressure in the heart eventually over time may cause heart disease.  The number one cause of death in individuals with high blood pressure is heart attack.  Heart disease is the number one cause of death in Canada and the U.S, this is why high blood pressure is an important condition to understand and control.

What is high blood pressure?

High blood pressure is diagnosed in the doctors office.  Upon your routine visits, the doctor should normally take your blood pressure reading with a blood pressure monitor.  In order to be diagnosed with high blood pressure, your pressure readings must be above 140/90 mmHg on two separate visits to the doctor’s office. 

Classes of High Blood Pressure:

            There are three stages of high blood pressure.  These are important because the higher the stage, the more aggressive the treatment. 

Pre Hypertension: defined as blood pressure between 120/80 mmHg and 139/89 mmHg.  Patients who have blood pressures within this range are treated with simple lifestyle modification, including low sodium diet and exercise.  Usually no medication is used for treatment unless the patient has underlying medical conditions, such as diabetes, kidney failure, stroke or heart failure.

Stage 1: blood pressure between 140/90 mmHg and 159/99 mmHg. At this stage, medical treatment would be initiated usually involving one drug regimen.

Stage 2: blood pressure above 160/100 mmHg.  At this stage, aggressive treatment would be initiated, usually with two or three drug regimens.  If blood pressure is really high, some patients would present with headache, heart palpitations and blurry vision. 

What are the causes of high blood pressure?

The best answer to this question is simply: nobody really knows.  The number one cause of high blood pressure, accounting for 95% of cases, is unknown (or ‘idiopathic’). 

Other causes of high blood pressure are secondary to other illnesses, such as kidney failure, cancers or tumors of the adrenal glands, etc. 

What are the complications of high blood pressure?

As previously mentioned, high blood pressure mainly affects the heart.  However, many other organ systems are involved. Chronically elevated blood pressure can affect the kidneys, causing kidney failure.  It may affect the arteries in the eyes, causing them to burst.  This affects vision and may even cause blindness.

High blood pressure can frequently affect the brain by causing strokes and bleeding.  Stroke is when parts of the brain fail to receive adequate oxygen due to vessel narrowing.  Bleeding in the brain may occur due to a blood vessel burst from the high blood pressure.  Both of these are very dangerous and may be fatal in some cases.  Strokes also cause a lot of neurological problems such as paralysis of parts of the face, arms/legs, etc.  Studies have found that controlling high blood pressure decreases stroke risk by 40%!! 

How can you protect yourself from this silent killer?

With age, blood pressure normally increases.  If one is obese, diabetic and has kidney problems, the blood pressure would increase more rapidly with age and the complications are more severe.  I cannot stress enough the importance of leading a healthy, balanced life that includes PHYSICAL ACTIVITY and LOW FAT, HIGH FIBRE, LOW SALT DIET.

High blood pressure and WEIGHT:

Studies have found a linear association between high blood pressure and weight.  This means that the heavier a person is, the higher the blood pressure because blood pressure increases with the weight gain.  With every 5 kilogram loss of weight, blood pressure decreases by 5.0 mmHg!

Exercise is a great way to reduce and maintain a healthy weight.  It also helps to relieve stress.  And stress plays a huge role in many chronic medical conditions such as diabetes and high blood pressure.  The hormones of stress – cortisol and catecholamines – keep the body in the ‘fight’ mode.  When we are in chronic stress, cortisol levels remain elevated.  This has the negative effect of keeping blood sugar levels elevated and decreasing insulin sensitivity.  Furthermore, our blood pressure remains elevated because we are chronically in a hypervigilant state.  Exercise helps relieve stress by releasing ‘happy’ hormones such as dopamine and endorphins that are associated with reward centres of the brain (areas that are associated with processing happy thoughts and memories). 

High blood pressure and SALT:

I am a huge lover of salt and having to write this portion of the article really hurts but salt is the ENEMY especially for people with high blood pressure.  Salt pulls water in from the body into the vessels and this keeps blood pressure elevated.  Not only does it increase the volume of blood in the vessels, but it also causes constriction or narrowing of the blood vessels which further increases blood pressure in the arteries.

And many people do not know this but there is a lot of ‘hidden’ salt in many processed foods that we purchase from the grocery store, such as canned soups, beans, packaged lean cuisine, refrigerated foods; basically anything that is packaged or canned has a very high salt content.  Always check the labels for the sodium content in foods.  Daily sodium/salt content should not generally be over 1500 mg.  Usually when I look for the labels on canned goods, anything with sodium above 600 mg per serving, is not worth buying.

Most patients with high blood pressure are on a DASH diet that involves higher servings of fruits, vegetables, reduced alcohol, low salt, high fibre, low fat (especially dairy fat) and exercise.   

Many times I am confronted by my Baba Jan who says to me “Bacheme, I want to enjoy my life.”’  I understand what he means and I would hate to have to live a rigid life.

However, being healthy involves living a life that is balanced.  Too much of anything is never good.  Chronic illnesses such as high blood pressure, diabetes and heart failure are not fun to have.  They markedly not only reduce the number of years in your life but they also reduce your quality of life.  And it is the quality of life that is of utmost importance and the primary reason why I take the time to educate my people about the benefits of taking better care of their health.