Diagnosis of Hypertension and Possible Complications

It has been estimated that about 1.2 billion people worldwide have hypertension with two-thirds of cases seen in low and middle income countries, yet less than 1 in 5 people with hypertension have it well managed. No wonder, hypertension remains a major cause of premature death worldwide. In our last exposition, we had an overview of hypertension, the causes, symptoms and risk factors. Today, we take a look at how hypertension is diagnosed and the possible complications the silent killer presents with.

Diagnosis

Hypertension is diagnosed by taking blood pressure readings. Measurement of blood pressure can be done at home or as part of routine checkups done when one visits the hospital. At hospital visits, the nurses or doctor puts the inflatable cuff of the sphygmomanometer around your arm to take blood pressure readings. The blood pressure in the other arm is also checked with inflatable arm cuff of right size for comparison.

Blood pressure readings are generally classified into five for adults, they include:

  • Healthy/Normal blood pressure: The acceptable blood pressure in a healthy adult is below 120/80mmHgwhere 120mmHg is systolic blood pressure and 80mmHg is diastolic blood pressure.
  • Elevated blood pressure: This is also referred to as prehypertension. Here, blood pressure values are between 120-129mmHgsystolic and less than 80 mmHg diastolic blood pressure. This is an indication that the individual has to take up lifestyle modifications for healthy feeding and living to prevent progression to hypertension. At this stage, medications are not given, rather patients are counselled on lifestyle modifications.
  • Stage 1 hypertension: Here, systolic blood pressure is 130-139mmHg and diastolic blood pressure is 80-89mmHg.
  • Stage 2 hypertension: This is a more severe presentation as systolic blood pressure is greater than or equal to 140mmHgand diastolic is 90mmHg or higher.
  • Hypertensive crisis: This is the extreme of the different classes as patients might have symptoms such as chest pain, breathing difficulty, headache, numbness, weakness, vision impairments, etc. blood pressure here has a systolic reading of greater than 180mmHgand diastolic of greater than 120mmHg. Here, patients are admitted and treated as an emergency with prompt medical care administered alongside battery of investigations.

In cases of high blood pressure readings on initial examination, patients are often advised to have blood pressure checked over the course of subsequent days to weeks to ensure there are no present stress factors or circumstances surrounding your visit to the hospital. The doctor would also take a medical history from you and conduct some physical examinations to support or rule out hypertension.

On subsequent visits, if blood pressure remains on the high side, further examinations will be done to investigate possible causes of the hypertension and the state of essential organs affected by high blood pressure. The following investigations are usually made:

  • Electrocardiography
  • Echo
  • Urinalysis
  • Blood cholesterol
  • Blood sugar, etc.

 

Complications

Long standing hypertension or high blood pressure has deleterious effects on the blood vessels, the heart and other essential body organs. The longer hypertension stays without being managed, the more havoc it wrecks on the body system. The common complications include:

  • Heart attack: The increased blood pressure in vessels result in progressive thickening and hardening of the blood vessels, the mechanical stress on the vessel walls could enhance blood clots formation and dislodgement which could clog up blood supply to coronary arteries of the heart causing a heart attack.
  • Stroke:This is a medical emergency caused by interruption of blood flow to the brain which could be a complication of hypertension.
  • Heart failure:The increased labor due to thickening of blood vessels causes the heart muscles to thicken over time, and with progressive thickening comes less ability to pump enough blood accumulating a strain on heart muscles and eventual heart failure as the heart is able to meet the oxygen and nutrient demand of the body.
  • Aneurysms:These are small bulges or ballooning out of blood vessels formed due to the increased blood pressure. If aneurysms eventually rupture, bleeding ensues and it could be a deadly emergency.
  • Vision impairment:This could be as a result of blood vessels in the eye progressively destroyed by high blood pressure.
  • Kidney injury:Blood vessels of the kidneys are weakened or get narrow over time due to hypertension.
  • Dementia:Loss of memory due to limited blood flow to brain due to narrowed or blocked blood vessels.

It is very important that we maintain a high index of suspicion when it comes to health matters. If you have not had your blood pressure checked in a long while, please do so. This is not only a call to the elderly, as even the incidence of high blood pressure is on the increase in young individuals. The earlier hypertension is diagnosed, the less complications are discovered. Spread the news today.

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