Heart Complications: High blood pressure is a major risk factor for hypertensive heart disease- the leading cause of illness and death from high blood pressure, heart attacks, heart failure, irregular beats, among others.

Stroke: About two-thirds of people who suffer a first stroke have moderate elevated blood pressure (160/95 mmHg or above). Hypertensive people have up to 10 times the normal risk of stroke, depending on the severity of the blood pressure, in the presence of other risk factors.

Diabetes And Kidney Disease
Diabetes: High blood pressure, and some of the medications used to treat it, can increase the risk for developing diabetes.

Kidney Failure
High blood pressure causes 30 per cent of all cases of end-stage kidney disease (medically referred to as end-stage renal disease, or ESRD). Patients with diabetes and hypertension need to be monitored very closely for the development of kidney disease.

Dementia: Isolated systolic hypertension may pose a particular risk for dementia (memory loss).

Eye Damage: High blood pressure can injure the blood vessels in the eye’s retina, causing a condition called retinopathy.

Sexual Dysfunction: Sexual abnormality is more common and more severe in men with hypertension and in smokers than it is in the general population.

Although older drugs used to treat hypertension caused erectile dysfunction as a side effect, more recent evidence suggests that the disease process that causes hypertension is itself the major cause of erectile dysfunction. Men who take nitrate medications for heart disease cannot take erectile dysfunction drugs.

Pregnancy And High Blood Pressure
Many women, who are likely to develop hypertension when they are older, have their first elevated blood pressure readings during pregnancy. Elevated blood pressure readings generally show up early in pregnancy, before 16 - 20 weeks. (This condition is different from preeclampsia, described just below.) These women often require anti-hypertensive medications during pregnancy and closer monitoring of themselves and the fetus. Continued hypertension after the pregnancy is also common.

Severe, sudden high blood pressure in pregnant women is one component of a condition called preeclampsia (commonly called toxemia) that can be very serious for both mother and child. Preeclampsia occurs in up to 10 per cent of all pregnancies, usually in the third trimester of a first pregnancy, and resolves immediately after delivery. Other symptoms and signs of preeclampsia include protein in the urine, severe headaches, and swollen ankles.

In preeclampsia, the reduced supply of blood to the placenta can cause low birth weight and eye or brain damage in the developing baby.

Symptoms Of Hypertension
Hypertension has aptly been called the “silent killer” because it usually produces no symptoms. Untreated hypertension increases slowly over the years. Everyone 18 years and older should have their blood pressure measured on a regular basis. It is particularly important for anyone with risk factors to have their blood pressure checked regularly and to make appropriate lifestyle changes. Such recommendations are especially important for individuals who have pre-hypertension or hypertension, a family history of hypertension, are overweight, or are over age 40 years.

Symptoms of Malignant Hypertension
In rare cases (less than 1 per cent of all patients with hypertension), the blood pressure rises quickly (with diastolic pressure usually rising to 130 mmHg or higher), resulting in “accelerated hypertension.’’ This is a life-threatening condition and must be treated immediately. People with uncontrolled hypertension or a history of heart failure are at increased risk for this crisis.

A doctor should be called immediately if these symptoms occur:
•Drowsiness
•Confusion
•Headache
•Nausea
•Loss of vision
•Respiratory distress (difficulty breathing)
Treatment Of Hypertension
As have been mentioned earlier, hypertension is dangerous because it can lead to strokes, heart attacks, heart failure, or kidney disease. The goal of hypertension treatment is to lower harmful high pressures and protect important organs, such as the brain, heart, and kidneys. High blood pressure has been classified to “normal blood pressure” as less than 120/80 mmHg, “pre-hypertension” as 120-139/80-89 mmHg, and “hypertension” as greater than 140/90 mmHg. All patients with blood pressure readings greater than 120/80 should be encouraged to make lifestyle modifications. Treatment with medicine is recommended to lower blood pressure to less than 140/90 mmHg. For patients who have diabetes, or chronic kidney disease, the recommended blood pressure is less than 130/80 mmHg.

Treatment of hypertension involves lifestyle changes and drug therapy.
To be coninued next week