Introduction
Hypertension, commonly referred to as high blood pressure, is a medical condition which comprises of incessantly elevated blood pressure in the arteries. Hypertension may cause damage to the organs and several illnesses including renal failure, heart failure, heart attack or stroke. According to (Luehr, Hayes, Johnson & Burke (2012), close to 30% of the adult American (U.S.) population have hypertension. Majority of these people are those over 65 years. This means that nearly 66.9 million U.S. citizens have hypertension. This number is predicted to rise as the number of those above 65 years continues to rise. Poor adherence to medication and lifestyle changes has been associated with this disease. This paper provides insight into hypertension by focusing on the medical history, diagnostics/ testing, treatment options and plan of action recommended.
Medical history of hypertension
Hypertension, as is known today originated around 2600 B.C. The ancient Chinese used the quality of a person’s pulse to check for suspicion of hypertension. If one had a hard pulse which was difficult to compress, they were treated using bleeding and leeches. The actual measurement of hypertension was performed on a horse in 1733 by Rev. Stephen Hales (Basile, & Hector, 2006). The first blood pressure measurement that is similar to what is present today was done by Riva-Rocci who, in 1896, invented the wraparound rubber cuff used for the upper arm. The method was used in the measurement of systolic pressure (Buob, Johnston, & Webster, 2011). Korotkoff would then have a major breakthrough by being able to detect systolic and diastolic pulses through a stethoscope. These findings enabled the clinical blood pressure recordings that are done today. Hypertension remained a disease that could not be treated until the start of the 20th century. As the century progressed to the 1950s, hypertension treatment was still largely ineffective. The treatment often involved Phenobarbital, rest and a low-sodium diet. Sympathectomy, weight reduction, bed rest and emotional tranquility were also practiced as treatment methods. Availability of veratum derivatives, monoamine oxidase inhibitors, reserpine and thiocyanates helped to lower hypertension and reverse damages done by the condition. However, when these agents were used together, they limited effective control of the condition.
A major breakthrough in treatment was when thiazide-type diuretics were made available in 1957. It was discovered that hypertension could be lowered for patients with diastolic measurements of 90-114 mm Hg by using thiazide-type diuretics. These medications reduced cardiovascular mortality and morbidity as compared to placebo.
Diagnosis of Hypertension
Hypertension is diagnosed/ tested by measuring the blood pressure. This is done through an inflatable cuff on the arm which is connected to a measuring gauge. The gauge provides a blood pressure reading in mmHg (millimeters of mercury) in two numbers. The first upper number reading is the measurement of artery pressure during heartbeat (systolic pressure) while the lower/ second number provides the measurement of artery pressure between heartbeats (diastolic pressure) (Galie, Hoeper, & Humbert, 2009). There are four major blood pressure categories as provided by measurements. The first is the normal blood pressure. This is the measurement which is below 120/80 mm Hg. Doctors recommend that 115/75 is a better measurement and that a blood pressure reading above this provides a risk of heart disease.
The second category is known as the Pre-hypertension. This is the condition where the systolic pressure ranges between 120-139 mm Hg. It may also mean a diastolic pressure that ranges between 80 and 89 mm Hg. The third category is the Stage 1 hypertension. This is whereby the systolic pressure ranges between 140 and 159 mm Hg or 100 mm Hg and above for the diastolic pressure. According to Galie, Hoeper & Humbert (2009), both blood pressure numbers are important. However, for those over 50, the systolic reading becomes more important. Isolated systolic hypertension occurs when the diastolic pressure appears normal but the systolic pressure registered is high. Other tests which may be done include a medical history and physical exam. Other tests may also be used to ascertain whether the high blood pressure has damaged any organs or resulted in other health problems. Common tests include blood tests for levels of potassium, cholesterol or sodium; urine tests to determine if there is liver or kidney disease; tests for kidney function; blood glucose test and an electrocardiogram which checks for heart damage.
Symptoms associated with hypertensive crisis include extreme readings such as systolic 180 and above or diastolic 110 and above. Besides the readings, severe headaches, shortness of breath, severe anxiety and nosebleeds may be experienced. Dizziness, facial flushing and bloodspots in one’s eyes are symptoms which are associated with hypertension.
Treatment options
Treatment of hypertension often takes a multi-pronged approach. This is because it involves different types of medication and lifestyle changes. The objective of the different treatment methods available is to lower the blood pressure to a level below 140/90 mmHg. For those adults who have kidney disease or diabetes, the objective is higher: keeping a 130/80 mmHg blood pressure reading (Luehr, Dohmen, F., Hayes, Johnson, & Burke, 2012).
Lifestyle changes that are recommended to help reduce and control blood pressure include maintaining a healthy diet and healthy weight, being physically active, keeping away from smoking and managing stress. Combining healthy lifestyle habits can help achieve better results than through single steps. It may be difficult to maintain lifestyle changes but one should take each lifestyle change at a time. Dietary strategies that may help stop hypertension include eating foods that are low in cholesterol, fat and sodium (salt) (Luehr, Dohmen, F., Hayes, Johnson, & Burke, 2012). Low-fat dairy products such as poultry, nuts and fish are preferred. This approach also involves reducing consumption of red meats, added sugars, sweets and sugary beverages. Alcoholic drinks should also be limited to not more than two bottles per day of alcoholic drinks. Lifestyle changes including weight loss, low-sodium diet and low alcohol use are difficult to maintain especially when no symptoms of the disease exist. However, anyone can develop the condition and it is advisable to practice these measures so as to remain healthy.
Conclusion
Hypertension, also referred to as high blood pressure is comprises of incessantly elevated blood pressure in the arteries. Poor adherence to medication and lifestyle changes are the main causes associated with this disease. The disease is diagnosed through an inflatable cuff on the arm which is connected to a measuring gauge. The gauge provides a blood pressure reading in mmHg (millimeters of mercury) in two numbers representing the systolic and diastolic pressure readings. High blood pressure may be combated through a multi-pronged approach which involves a combination of medication and lifestyle changes. Lifestyle changes which may help one keep off this disease include regular physical exercises and proper dietary practices. Foods that are low in fat, sodium and cholesterol should be taken. In addition, alcohol use should be reduced while smoking should be avoided at all costs.
References
Basile, J. N., & Hector, V. (2006). A Historical Look at Hypertension: Celebrating 100 Years with the Southern Medical Association. Southern Medical Association, 99(12), 1412-1413.
Buob, S., Johnston, A., & Webster, C. (2011). Portal Hypertension: Pathophysiology, Diagnosis, and Treatment. Journal of Veterinary Internal Medicine, 25(2), 169-186.
Galie, N., Hoeper, M. M., & Humbert, M. (2009). Guidelines for the treatment and diagnosis of pulmonary hypertension. European Heart Journal, 30(3), 2493–2537.
Luehr, D., Dohmen, F., Hayes, R., Johnson, M., & Burke, R. (2012). Hypertension Diagnosis and Treatment. Institute for Clinical Systems Improvement. 23(12), 1-23.
