CHAPTERS

Chapter 1: Hypertension and You

How can we tell if we are susceptible to hypertension or, worse, already suffer from it? With so much uncertainty around us, it should help to know that there are some things over which we have some control. Yes, it’s true that is not always something consistently present in our lives, but there are some areas where we can work on to be able to live better, healthier lives. There are a number of factors which put individuals at risk for developing hypertension. Aside from leading an unhealthy lifestyle, age comes into factor for tendency of developing primary or essential hypertension for people over 60 years old. Blood pressure can increase incrementally because of the arteries stiffening up and narrowing down due to the buildup of plaque.

Ethnicity also comes into play with regard to hypertension development. The risk of developing hypertension is equally the same for both male and females; however men have notably been more prone to hypertension even at a young age. On the other hand increase in susceptibility for women increase as a female matures.

Let’s delve in a little more to discover and identify factors that make people prone to hypertension. We want to reveal how to detect if this mute killer with little indication can in fact be detected or if there are signs that would give rise to concern about having the condition.

When do I have Hypertension?

Hypertension is not always apparent nor is it usually accompanied by visible symptoms, and is typically identified through screening. Most people with the condition are made aware of having the condition or when they seek healthcare for a physical issue unrelated to hypertension. There are a few individuals with high blood pressure that report headaches particularly describing the location of the pain at the back of the head and during the morning. Vertigo, lightheadedness, a buzzing or ringing in the ears – called tinnitus is also reported by other individual as well as a change in vision or episodes of fainting. However, these symptoms may also be associated with some sort of anxiety or a situation of duress rather than with high blood pressure itself.

What are the causes high blood pressures? Knowing the causes can make quite the difference to anyone who may suspect they could be prone to the condition. Hypertension comes in two sorts and each type is caused by different things.

Let’s discuss Primary hypertension which is the most typical sort found in most individuals. Primary hypertension is also known as essential hypertension. This sort of hypertension is developed over a period of time giving hardly any signs of identifiable cause. Researchers are admittedly still quite unclear of what mechanisms cause blood pressure to slowly increase however; it is suspected that a combination of factors could play a role.

Amongst these factors include a person’s genes. There are some individuals who are predisposed genetically to hypertension. This could happen because of genetic abnormalities or gene mutations which were passed down from parents to child.

Another factor is physical changes in your body. If a part of your body does not function properly or accurately as it should, you may start to experience challenges in and throughout your body which was normally not felt. One of those issues could be high blood pressure.

An example we can cite is transformation in kidney functions. It is surmised that transformations in kidney function can upset a person’s natural balance of salts and fluid. The change in functionality may cause your body’s blood pressure to increase. Other existing health conditions such as cardiovascular disease are also indicators and predictors of hypertension.
The choices we make on our daily lives play a big part in our overall wellness. As time passes, unhealthy lifestyle choices we make like lack or complete absence of physical activity and poor dietary choices can truly take a bad toll on an individual’s body. Our lifestyle and the choices we make, like smoking, excessive drinking and constantly being in stressful situations can and may lead to weight issues. When a person is overweight or obese it increases a person’s risk for hypertension.

Time to look at the other sort of hypertension called Secondary hypertension. Secondary hypertension frequently happens fast and can be a lot more serious than that of primary hypertension. There are several conditions which may cause secondary hypertension and these include obstructive sleep apnea, kidney disease, problems with an individual’s thyroid, side effects of medications, congenital heart defects, alcohol abuse or chronic use, use of illegal drugs, adrenal gland problems, as well as certain endocrine tumor.

In a nutshell, high blood pressure which isn’t caused by other conditions or diseases is called primary, or essential, hypertension. If it develops as a result of another medical condition, this is what is called secondary hypertension.

How do I Measure my Blood Pressure?

There are a few steps which are simple enough to do by yourself to help get an accurate blood pressure reading. The first thing you want to do is find a quiet place before taking your blood pressure.

• You also need to make certain that the sphygmomanometer you have has the proper size cuff. If you are not sure or if you find yourself stumped with a plethora of questions you want to talk to your healthcare provider before making a purchase. Your physician or a registered nurse can give you recommendations. You want to avoid finger and/or wrist monitors as these do not ensure an accurate blood pressure reading as well as a proper sphygmomanometer does.
• You want to roll up the sleeve on your left arm and take off clothing which has tight sleeves, if required. if you are right-handed it would be better to take your blood pressure from your left arm.
• You need to take a load off and rest by sitting on a chair beside a table for at least 5 to 10 minutes with your left arm comfortably resting at a level with your heart. Remember how your mother or teacher barked at you to sit up straight? That is what you want to do with your back against the chair, with your legs uncrossed and feet squarely on the floor.
• You need to rest your forearm on the table positioning your arm so that you have the palm of your hand facing up. You must not talk, do anything else like read a newspaper, play video games or watch television during the process of taking your BP reading if you want an accurate one.

Let’s now focus on taking your blood pressure accurately. When you purchase a sphygmomanometer, whether it is a manual or digital blood pressure monitor, first read then follow the instructions in the booklet mindfully.

The following steps provide an overview on how to take your blood pressure whether using either a manual or digital blood pressure monitor.

On a manual monitor:

• Find your pulse. Do this by lightly applying pressure to the crook of your arm – that is the inside bend of your elbow where the brachial artery is located. if you can’t find your pulse then you may want to use a stethoscope, if you are using a manual monitor. If you are using a digital monitor then you may use the arm cuff in the area of your arm mentioned.
• Slip on the cuff onto your arm and make certain that the head of the stethoscope is resting over the brachial artery. The bottom part of the cuff should be about an inch over the crook of your elbow. Make sure that the fabric of the cuff if fastened securely on your arm but not too tightly.
• Place the earpieces of the stethoscope in your ears tilting the ear pieces ever so slightly forward to get the best sound results.
• When using a manual blood pressure device, you want to grip the pressure gauge in your left hand and the bulb on the other.
• Shut the airflow valve on the bulb of the device by turning the crew of the bulb clockwise.
• Proceed to inflate the cuff by squeezing the bulb. You will hear the sound of your pulse with the stethoscope.
• Mind the gauge of the monitor. Continue to inflate the cuff until you see the gauge read about 30 mmHg above the systolic pressure. You will not be able to hear your pulse at this point.
• Keep your eyes on the monitor gauge. Slowly let out the pressure in the cuff. Do this by turning the airflow valve counterclockwise.
• Still keeping your eyes on the gauge, the gauge should drop about 2 to 3 point with each heartbeat. You may have to practice doing this by turning the valve slowly. (Be patient. And if you feel insecure about making accurate readings, ask your practitioner if you are doing the procedure correctly).
• You want to listen carefully for the first beat. Once you hear it, take note of the number reading on the monitor – this is your systolic pressure; that is the exertion of the blood against the walls of your artery as your heart beats.
• Continue to deflate the cuff little by little.
• You want to listen until you do not hear the sound of your pulse. When you can no longer detect the sound of your pulse, take note of the reading on the gauge – this is your diastolic pressure or the pressure of your blood between heartbeats.
• You may proceed to deflate the cuff completely.

Things to take note of:

• Keep your arm held straight for the most accurate reading.
• Should you make a mistake and release pressure out too fast or perhaps was not able to locate of hear your pulse, remove the cuff, wait one minute, put it on again, and repeat the steps above.

On a digital monitor:

• Using your right hand, hold the bulb.
• Switch on the power button and all display symbols should briefly light up followed by a zero. This is an indication that the monitor is ready to use.
• Keep your eyes on the gauge. Inflate the cuff and continue doing so until you see the gauge read about 30 mmHg above your expected systolic pressure.
• Sit still and keep your eyes on the monitor. You should see the pressure reading show up on the screen. Values will appear on the screen.
• Wait for the long beep sound which signals the measurement is finished.
• Take note of the numbers on the screen. Systolic readings should appear on the left side of the screen and the diastolic pressure reading is on the right.
• Deflate the cuff.

Keep a record of your blood pressure readings. Keeping tabs on your blood pressure helps you monitor how your blood pressure fluctuates and differs from the time of the day. You want to take note of the date you took your blood pressure, the time of day when you did, the numbers of the systolic and diastolic readings, your heart rate as well as the arm which you used to take it. It would also be useful to jot down any events or situations which you may find useful for future reference. Taking down notes make it easier for you to relay information to your health care provider. It is also important specially if you are asked to take your blood pressure on a regular basis.

You should check the accuracy of the monitor you purchase at least once a year and bring it in with you to your doctor’s office to make sure that it is giving you accurate results. This is carried out by making comparisons of your reading using your doctor’s blood pressure monitor device and your machine.

Factors that Influences Blood Pressure Reading

Keep in mind that there are factors which influence your blood pressure to spike temporarily and should avoid to get proper and accurate reading. Some of these are cold temperatures, exercise, stress, smoking, caffeine and even some medicines. Try as best you can to avoid these before taking your blood pressure. You will also want to schedule specific times each day to take your blood pressure. Your medical practitioner may also request that you take your blood pressure readings a few times a day to help identify if it fluctuates.

Benefits of Home Blood Pressure Monitoring

Most doctors, if not all, make it a point to get a reading of your blood pressure with each visit. Diagnosing hypertension doesn’t have to be complicated and is in fact as simple as taking your blood pressure reading routinely.

Should you have a high blood pressure reading, your physician may ask you to get more frequent readings over a period of a few days. Make sure to keep a tab on your readings by jotting them down on your little BP journal. Your doctor will need evidence which shows a sustained elevated reading before their patient is given a diagnosis of being hypertensive. Rarely is a hypertension diagnosis given after one reading.

Keep in mind that environmental factors could be affecting your blood pressure thereby giving varied results each time. You also need to remember that the levels of your blood pressure changes as the day wears on and you will need to be mindful about keeping a religious schedule. Set an alarm for each time of the day you have to monitor your blood pressure and veer not from those times each day.

Should your blood pressure consistently show a high reading, your physician will most likely request to have more tests carried out to rule out any other underlying conditions which may attribute to the high numbers of your blood pressure. These laboratory tests would likely include a cholesterol screening, a test of your heart’s electrical activity and urine test. These tests are to help your physician any secondary underlying conditions which may be contributing to the elevation of your blood pressure.

Your doctor may likely to start treatment of your hypertension at this time. Your physician will want to give early treatment to reduce the likelihood of any further or lasting damage.

What is White Coat Hypertension?

Notice how your heart starts pounding at the thought of a looming visit to your dentist? This is also true for some individuals who are due for a physician visit. A visit to the doctor, for some is an experience ridden by inherent anxiety. So there will be times when you get a high reading when your doctor does this simple procedure.

This is mostly all in the mind and the phenomenon is quite a real one for many, hence the term White Coat Hypertension. It is identified by high readings of your doctor but a relatively lower one when done in the comfort of your own home.

What is Labile Hypertension?

Labile hypertension is not to be mistaken for borderline hypertension. Labile hypertension is in fact what doctors call the condition of individuals who have frequent high or low blood pressure level changes. The condition is defined by a sudden onset and continuing fluctuation in an individual’s blood pressure, which typically heighten from a normal, healthy blood pressure reading to a high blood pressure reading during varied times throughout the day.

There is a divide in the medical community about labile hypertension. Some see it as a faulty concept and, hence a faulty diagnosis whilst other see it as a condition which is treatable. Either way, labile hypertension is believed generally to have less clinical impact and significance on a patient as compared to the better understood condition called “fixed” hypertension.

Fixed hypertension is also a more dangerous condition. Guidelines for treatment of labile hypertension are vague and there are no accepted quantitative criteria to identify or understand the condition even though most physicians and health care providers are aware and know of the term. Nor are there guidelines for criteria of giving it as diagnosis.

What is Masked Hypertension?

Masked hypertension may happen to as much as 10% of the general population, and is crucial  since masked hypertension  is not diagnosed by regular  medical exams, but it sums up to an adverse prognosis, either in terms of heightened  target organ damage and cardiovascular episodes.

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