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Hypertension – The What, the Who and the How
Globally, the World Health Organization (WHO) estimates that about 26% of the world’s population has hypertension and that it is the cause of 6% of deaths annually. With only a rough analysis of these statistics, it is enough for us to conclude that hypertensive disorder is quite common and has a great impact on our community and our lives, directly or indirectly.
What is hypertension? The fact is, because normal blood pressure varies so much among individuals in any population that clinicians do not recommend giving exact word-for-word or concrete numerical definitions of values, in order to avoid confusion. However, in layman’s terms, hypertension is a diagnosis given by a doctor to a patient with a long-term increase in blood pressure. Medical schools around the world have chosen a blood pressure value above which the risk of complications such as developing a heart attack is greatly increased. Most disavowed medical textbooks suggested that a person is considered hypertensive when his or her average daytime systolic blood pressure is greater than 140 mm Hg, diastolic blood pressure is greater than 90 mm Hg, the patient has at least one symptom such as headache, and he or she she is treated with antihypertensives.
What causes hypertension? There are many conditions that can cause spikes in blood pressure. Events such as emotional changes, exercise, temperatures and pregnancy temporarily increase blood pressure, in order to increase blood circulation according to the needs of the body, these are the normal adaptive processes of the human body or the scientific term for this is ‘physiological’. But when blood pressure is constantly lowered, it does more harm than good, damaging organs such as the eyes, heart, brain and kidneys. First of all, a constant increase in blood pressure can be a sign of other diseases that a person has, this is called ‘secondary hypertension’, examples are renal (renal) diseases, cancers, various hormonal (endocrine) disorders and taking steroid drugs. Secondary hypertension is only 5% of all cases of hypertension, what about the other 95%? In 95% of cases, the exact cause of hypertension is not well known, so the condition of high blood pressure is identified as a primary disease in itself, so-called ‘essential hypertension’. Although there is no exact cause, there are several risk factors that are suspected to contribute to the development of essential hypertension. Among other things, weight gain, high salt intake in the diet, diabetes, alcohol consumption, psychosocial stress, lack of exercise and a positive family history (presence of hypertensive patients in the family).
Who can get essential hypertension? In short, everyone! But the prevalence is significantly higher in a certain race, geographic area, age group and gender. The risk is higher for people living in urban areas, the incidence of hypertension is higher among people of African ethnicity compared to whites, and is lowest among Hispanics. Middle-aged men, the elderly population, citizens of industrialized countries, postmenopausal women, white-collar workers, and people with the above-mentioned risk factors are more prone to essential hypertension. Essential hypertension is rarely diagnosed in children and teenagers.
How does hypertension occur? The mechanics of blood pressure fluctuations in the body are determined by three factors. First the heart, the stronger the heart contracts and the higher the heart rate, the more blood is pumped into the circulation, thereby increasing the volume of blood in the blood vessels. Second, the condition of blood vessels throughout the body, blood vessels, especially arteries, are not just a rigid network of tubes that carry blood, but their size and diameter change. It is logical that when the size and diameter of the arteries decreases, the greater the resistance to blood flow, the correct term for this is ‘increased peripheral resistance’, when this happens, the pressure inevitably rises. Third, blood volume, since the body’s circulation is a closed system, any addition or subtraction of fluid will change the pressure load. The normal volume of circulating blood of an adult is 3.5 – 4 liters; the extent is actively regulated by the kidneys. Hypertension occurs as a total effect of all three factors.
In conclusion, hypertension is a common disorder, well studied but yet to be well understood. It’s not an equal opportunity disorder, but everyone is at risk of getting it nonetheless.
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