HYPERTENSION WITH HEART DISEASE

About half of individuals with untreated hypertension may die of heart disease due to poor supply of blood to different parts of body. The changes in heart may occur gradually and progressively but are not immediate.

Effects of hypertension on heart are: 

  1. Coronary and ischemic heart disease:

It is a condition that occurs due to narrowing or stiffness with decreased elasticity of arteries supplying blood to heart when hypertension is left untreated. Untreated hypertension may cause damage to the inner lining of arteries, leading to formation of clots/plaques. The complications can be heart failure, heart attack.

Symptoms can be left sided chest pain, radiating to left arm, shoulder, back, associated with nausea, dizziness, sweating, shortness of breath, fatigue, pounding heart, etc.

2. Left ventricular hypertrophy:

This is nothing but enlarged left side of heart, that actively pumps blood to all the parts of the body. The walls of left chamber of heart may thicken and stiffen due to increased workload of heart to pump blood effectively to the body, to overcome the resistance offered by the high blood pressure. It may lead to heart failure, sudden cardiac death, if left untreated.

3. Heart failure:

Untreated hypertension may cause the muscles of heart to weaken, decreasing its efficiency to pump blood effectively leading to heart failure eventually. This can lead to kidney dysfunction, leading to fluid collection in the body, including around heart.

Symptoms include difficulty in taking breaths, swelling of ankles and feet, bloated abdomen, increase frequency of urination at night, etc.

Testing needs to be done when any of the symptoms are experienced based on history and physical examination finding. The tests are Chest Xray, Electrocardiogram (ECG), Echocardiogram (ECHO), cardiac stress test, Coronary angiogram, etc.

Treatment options for hypertension include

  • Medications to control hypertension.
  • Regular exercise.
  • Healthy diet with restricted carbohydrates and fats, low sodium diet, fiber and potassium rich foods.
  • Avoiding smoking and alcohol consumption

It is also very important to go for routine medical checkups to the treating doctor, monitor BP readings regularly

References:

https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045868

https://www.webmd.com/hypertension-high-blood-pressure/guide/hypertensive-heart-disease#2

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/LearnHowHBPHarmsYourHealth/How-High-Blood-Pressure-Can-Lead-to-Heart-Failure_UCM_490534_Article.jsp#.Wzx1bNIzbDd

https://emedicine.medscape.com/article/162449-overview

https://www.ncbi.nlm.nih.gov/pubmed/19505285
 Dr. Divya Teja Pasupuleti

Long Term complications of Hypertension

High blood pressure is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, affecting almost every organ systems.

You can have high blood pressure (hypertension) for years without any symptoms. Even without symptoms, damage to blood vessels and your heart continues and can be detected. Uncontrolled high blood pressure increases your risk of serious health problems, including heart attack and stroke.

Complications of Hypertension

The excessive pressure on your artery walls caused by high blood pressure can damage your blood vessels, as well as organs in your body. The higher your blood pressure and the longer it goes uncontrolled, the greater the damage.

Uncontrolled high blood pressure can lead to complications including:

  • Heart attack or stroke. High blood pressure can cause hardening and thickening of the arteries (atherosclerosis), which can lead to a heart attack, stroke or other complications. Keeping the blood pressure at check ensures further delaying and prevention of these complications.
  • Aneurysm. Increased blood pressure can cause your blood vessels to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can be life-threatening. Avoiding spikes in blood pressure over the years is protective for these complications.
  • Heart failure. To pump blood against the higher pressure in your vessels, the heart has to work harder. This causes the walls of the heart’s pumping chamber to thicken (left ventricular hypertrophy). Eventually, the thickened muscle may have a hard time pumping enough blood to meet your body’s needs, which can lead to heart failure.
  • Weakened and narrowed blood vessels in your kidneys. This can prevent these organs from functioning normally. Kidney complications are preventable if measures to keep blood pressure at check are adopted from the start.
  • Thickened, narrowed or torn blood vessels in the eyes. This can result in vision loss.This also is a preventable complication,if the spikes in blood pressure over the years is avoided.
  • Metabolic syndrome. This syndrome is a cluster of disorders of your body’s metabolism, including increased waist circumference; high triglycerides; low high-density lipoprotein (HDL) cholesterol, the “good” cholesterol; high blood pressure and insulin resistence. These conditions make you more likely to develop diabetes, heart disease and stroke. Maintaining the blood pressure at check during the years prevents these complications in later years.
  • Trouble with memory or understanding. Uncontrolled high blood pressure may also affect your ability to think, remember and learn. Trouble with memory or understanding concepts is more common in people with high blood pressure. Repeated damage to the brain cells by high blood pressures can be prevented by managing blood pressure from the start by various lifestyle changes.
  • Neurological complications like dementia (Memory loss),can also be prevented by avoiding undue surge in BP over the years.

Lifestyle changes can help you control and prevent high blood pressure along with the blood pressure medications advised by your doctor. Here’s what you can do:

  • Eat healthy foods. Eat a heart-healthy diet. Avoid saturated fats and trans fats.
  • Decrease the salt in your diet.
  • Maintain a healthy weight. Keeping a healthy weight, or losing weight if you’re overweight or obese, can help you control your high blood pressure and lower your risk of related health problems.
  • Increase physical activity. Regular physical activity can help lower your blood pressure, manage stress, reduce your risk of several health problems and keep your weight under control.
  • Limit alcohol. Even if you’re healthy, alcohol can raise your blood pressure. If you choose to drink alcohol, do so in moderation.
  • Don’t smoke. Quitting smoking is the only way to prevent complications.
  • Manage stress. Reduce stress as much as possible.
  • Monitor your blood pressure at home.
  • Control blood pressure during pregnancy. If you’re a woman with high blood pressure, discuss with your doctor how to control your blood pressure during pregnancy.

Regular visits to your doctor and getting the right tests done is important. They can detect irregularities in your blood pressure early on.

It’s vital to pay attention. This is especially true when it starts to show up with problems in other parts of your body.

Pay attention to your body and take care of yourself.

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/LearnHowHBPHarmsYourHealth/Health-Threats-From-High-Blood-Pressure_UCM_002051_Article.jsp#.Wx37VUiFPIU

https://www.healthline.com/health/high-blood-pressure-hypertension

https://www.nhlbi.nih.gov/health-topics/high-blood-pressure

-Dr Prerna Gaur

 

HOME BP MONITORING – DOs AND DON’Ts

Why is Blood pressure monitoring at home is important?

  1. To make sure blood pressure is maintained normal and to keep an eye on the blood pressure in individuals whose medications or dose of medications for hypertension are changed, lifestyle changes are made, recently.
  2. It is important to make a note of all the BP readings in an app/a book, as a single reading of blood pressure doesn’t warrant diagnosis of hypertension or a need of medication unless, it is consistantly high.
  3. To avoid biased blood pressure readings as many people may get anxious, stressed at the doctor’s clinic leading to false high blood pressure called white coat hypertension.
  4. To avoid frequent visits to the doctor for checking blood pressure.
  5. If one feels dizzy, lightheaded after waking up from bed/ on standing from sitting position, it is best to check blood pressure on standing and sitting position as well to check if there is a decrease in BP on standing.

Pre-requisites for blood pressure recording:

  1. Avoid smoking, food, alcohol intake, exercises, caffeinated drinks such as coffee, tea, aerated drinks, etc. at least 30 minutes before measuring blood pressure.
  2. Empty bladder before taking the blood pressure reading as full bladder may rise blood pressure.
  3. Sitting in a comfortable position, staying calm and relaxed for at least 5 minutes before measuring the blood pressure is important to get an accurate reading.
  4. Sitting straight with a back rest, with feet flat on the surface of floor (without cross-legged) and resting the elbow and forearm flat on a cushion/a pillow with upper arm at the heart level is also important.
  5. The cuff of the BP apparatus should cover at least 80% of the upper arm with its lower part placed just above the elbow crease.
  6. Do not tie the cuff too tight or too loose to get accurate reading.
  7. The cuff should be tied over arm but not over sleeve/clothing to avoid false readings of BP. If the sleeve is too tight when folded up, it may be best to remove the sleeve off arm.
  8. The readings should be taken only at the same time every day, ideally in the morning (not immediately after waking up) before breakfast and in the evening.
  9. At least two readings of blood pressure should be taken about 2-3 minutes apart to get accurate measurement.
  10. BP from both arms should be measured at least once in a while
  11. Do not talk, do not make a fist but keep the hand and arms relaxed while BP is being measured.
  12. Make sure the cuff is of right size of the arm while buying the BP apparatus.
  13. Make sure the BP apparatus that is going to be used at home and the procedure of measuring BP by self is correct by practicing once before the treating doctor.
  14. Start measuring blood pressure every day at least after 2 weeks of starting a new dose or a new medication for hypertension and at least 1 week before next appointment with the doctor.

References:

https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20047889

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/KnowYourNumbers/Monitoring-Your-Blood-Pressure-at-Home_UCM_301874_Article.jsp#.Wx-hoYozbDd

https://www.health.harvard.edu/heart-health/tips-to-measure-your-blood-pressure-correctly

https://doctor.ndtv.com/living-healthy/world-hypertension-day-2017-dos-and-donts-of-checking-blood-pressure-at-home-1698016

https://www.aafp.org/afp/2005/1001/p1391.html

-Dr. Divya Teja Pasupuleti

Importance of Regular Consultation for Hypertension

Importance of maintaining doctors’ follow ups and taking medications for control of Hypertension.

Persistently elevated blood pressure (BP) is a leading risk factor for cardiovascular disease   development.

-Making effective hypertension management strategy is the most important step in controlling hypertension and preventing its complications.

Regular visits to your doctor(Follow up)  and compliance to medication are an important part of keeping your  blood pressure under control.

Here are a few important benefits that regular follow up will provide.

  1. You will be educated by your doctor as to what your blood pressure numbers mean to you and your health.
  2. Your doctor, will advise you to maintain your blood pressure in a range which is suitable to you. If it is not, your treatment plan will be adjusted by your doctor.
  3. Follow-up visits are a good time to let your health care provider know about any side-effects  you are having from your medication. He or she will have suggestions for coping with side effects or may change your treatment.
  4. Follow-up visits provide an opportunity for you to be screened for damage to the heart, eyes, brain, kidney, and peripheral arteries that may be related to high blood pressure.
  5. If you have diabetes or have had a prior heart attack or stroke, your blood pressure control will need to be more stringent to prevent recurrent events. Regular visit to your doctor will help you to maintain safe blood pressure levels on a constant basis.
  6. Follow-up visits are a great opportunity for monitoring other associated risk factors, such as high cholesterol and obesity.
  7. With aging and progression of the process of hardening of the arteries, your systolic blood pressure may creep up with time. A treatment that once worked well may no longer work and regular follow up visits are an excellent way to figure it out and change the dosage or the medication.

Importance of taking hypertension medicine as advised by your doctor

Blood pressure medications are one of the best weapons against hypertension and when taken properly, can help control blood pressure levels and reduce risk of heart attack and stroke.

-However, medications can only do their job when taken correctly, which means taking the proper dose of medication at the right time and in the right way for as long as you’re supposed to. Failing to adhere to medication can not only render the drug ineffective, it can be dangerous and pose a threat to your health

  1. Take the medication as advised by your doctor-There are many blood pressure medications that work in different ways to lower your blood pressure. Your doctor chooses 1 medicine or a combination based on your health status. It is very important to take the medicine as and when advised by your doctor.
  2.  If you feel the side effects or costs pose problems, don’t stop taking your medications. Ask your doctor about other options.
  3. Unless advised by your physician, you should never stop taking your blood pressure medicines even when your blood pressure has reached its goal. Doing so can cause dangerous rebound hypertension that complications.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4687379/

http://www.heart.org/HEARTORG/Conditions/HighBloodPressure/MakeChangesThatMatter/Partnering-With-Your-Doctor-to-Treat-High-Blood-Pressure_UCM_460131_Article.jsp#.WxYxu0iFPIU

https://www.webmd.com/hypertension-high-blood-pressure/guide/high-blood-pressure-follow-up-care

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4998775/

https://www.jwatch.org/jc200403190000006/2004/03/19/how-often-should-we-see-patients-with

http://www.healthcommunities.com/high-blood-pressure/follow-up-doctor-visits-blood-pressure_jhmwp.shtml

https://www.webmd.com/hypertension-high-blood-pressure/how-take-blood-pressure-medicine-properly-why-you-should#1

https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/diagnosis-treatment/drc-20373417

https://www.sharecare.com/health/high-blood-pressure-treatment/to-take-my-high-blood-pressure-medication

-Dr.Afroze Fatima

 

Common misconceptions about Hypertension and facts

Number of people with high blood pressure are increasing day by day. This article will cover some common misconceptions and the truth behind them.

1.Misconception: Nothing to worry much about high blood pressure.

Truth: It is absolutely wrong. High blood pressure is a killer disease and if not treated properly can lead to heart problems and even stroke.

2.Misconception: No need to take treatment for high blood pressure.

Truth: Treatment to control blood pressure is very important to prevent complications. During early days you may not see any difficulties with it but in a long run you will face more complications.

3.Misconception: High blood pressure cannot be prevented.

Truth: There is a good news for you, by taking some preventive steps for your risk factors you can prevent high blood pressure. It all depends upon your determination. Regular exercise, healthy diet, maintaining weight, low salt intake, avoiding alcohol and smoking can really make a big change.

4.Misconception: Decreasing table salt alone can control blood pressure

Truth: It is good to decrease intake of table salt but by doing that alone won’t help in reducing blood pressure. Decrease the salt intake means the sodium intake. 75% of sodium we consume is present in processed food. So, avoiding them plays a vital role.

5.Misconception: Doctor anyway checks my Blood pressure in office, so i don’t need to monitor my B.P at home.

Truth: It is necessary to check blood pressure on regular basis at your home to know how you are doing. Sometimes you will have high readings only in doctors’ office, we call it as white coat hypertension because this is due to anxiety. So, if you measure your blood pressure regularly and tell your doctor about the readings, they can adjust the doses accordingly.

6.Misconception: If blood pressure is controlled after taking medication then you can stop taking medicine.

Truth: Hypertension is a lifelong disease and unless and until your doctor asks you to stop taking medicine you must continue it. Otherwise you will have a rebound hypertension.

7.Misconception: One abnormal reading means hypertension

Truth: It’s not true. Doctors usually check your blood pressure multiple times before diagnosing you with hypertension, except when the blood pressure is very high that it warrants a diagnosis.

8.Misconception: Only elderly people get hypertension

Truth: No, any one can get hypertension even children. It is true that elderly people are more prone for it but children and young can also have high blood pressure.

9.Misconception: I would know if I had high blood pressure

Truth: Hypertension is also called as “silent killer” as it won’t show any symptoms in most of the people. So, it’s better to get your blood pressure checked.

10.Misconception: Hypertension seen during pregnancy disappears immediately after giving  birth

Truth: In most of the cases after birth the high blood pressure issue is resolved. But now a days research says that the problem can continue even after giving birth. So, if you had hypertension during pregnancy monitor your blood pressure regularly and inform your doctor if there is any abnormality.

FACTS

 

  • 30% of women and men have high blood pressure
  • 30% of people with high blood pressure DO NOT KNOW that they have it.
  • Less than 30% individuals reach target goals

 

References:

https://www.webmd.com/hypertension-high-blood-pressure/5-misconceptions-about-hypertension#1

https://www.gedeonrichter.pl/en/arterial-hypertension-eight-facts-and-myths/

 

-Dr.Y.Alekhya.

 

Role of exercise in Hypertension

Want to feel better, have more energy and even add years to your life?

Just exercise.

The health benefits of regular exercise and physical activity are hard to ignore. Everyone benefits from exercise, regardless of age, sex or physical ability.

Being physically fit contributes to longevity, no question about it. In fact, improving your fitness is a more important factor in determining how long you’ll live than whether you have moderately high blood pressure or are a little overweight. In addition, fitness improves quality of life, gives you more energy, helps you sleep better, combats depression and helps fight obesity.

Your risk of high blood pressure (hypertension) increases with age, but getting some exercise can make a big difference. And if your blood pressure is already high, exercise can help you control it. 

For people with increased blood pressure (hypertension),  exercising regularly is often regarded as a specific medical measure aiming to reduce the increased risk of late complications.

The benefits of daily exercise are incredible, and they are free! Start a daily exercise regimen today, and enjoy all the proven “extras” that come with moving around more.

Benefits of Exercise

  1. Regular physical activity at least 30 minutes most days of the week — can lower your blood pressure by 4 to 9 millimeters of mercury (mm Hg). It’s important to be consistent because if you stop exercising, your blood pressure can rise again.
    If you have slightly high blood pressure (prehypertension), exercise can help you avoid developing full-blown hypertension. If you already have hypertension, regular physical activity can bring your blood pressure down to safer levels.
    The best types of exercise for lowering blood pressure include walking, jogging, cycling, swimming or dancing. Strength training also can help reduce blood pressure.
  2. Lowers the risk of cardiovascular disease, stroke and cholesterol.
    3. Helps you maintain a normal weight.
    4. Enhances your mood.
    5. Reduces the amount of stress
    6.Gives glow to your skin.
    7. Keeps your bones strong.
    8. Improves your immune system.
    9. Helps you sleep better.
    10. Burns more calories- but did you know that strong muscles burn more calories? Yes, The more muscle mass you have the more calories you burn.

Which ever activity you choose, make sure you start with mild activity and gradually increase the intensity.

Advice:
At work place, too much sedentary time can contribute to many health conditions. Aim for five to 10 minutes of low-intensity physical activity — such as getting up to get a drink of water or going on a short walk — each hour. Consider setting a reminder in your email calendar or on your Smartphone.

Stop exercising and seek immediate medical care if you experience any warning signs during exercise:
Chest, neck, jaw or arm pain or tightness
Dizziness or faintness
Severe shortness of breath
Palpitations
Exercise can help you control it. Don’t think you’ve got to run a marathon or join a gym. Instead, start slow and work more physical activity into your daily routine.

                                                           
References:
https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20045206

https://teens.webmd.com/benefits-of-exercise#3

-Dr Krishna priya

 

DASH DIET

DASH stands for Dietary Approaches to Stop Hypertension. The DASH diet is a lifelong approach to healthy eating that’s designed to help treat or prevent high blood pressure (hypertension). The DASH diet encourages you to reduce the sodium in your diet and eat a variety of foods rich in nutrients such as potassium, calcium and magnesium that help lower blood pressure.

By following the DASH diet, you may be able to reduce your blood pressure by a few points in just two weeks. Over time, your systolic blood pressure could drop, which can make a significant difference in your health risks.

Because the DASH diet is a healthy way of eating, it offers health benefits besides just lowering blood pressure. The DASH diet is also in line with dietary recommendations to prevent osteoporosis, cancer, heart disease, stroke and diabetes.

The DASH eating plan

  • Emphasizes vegetables, fruits, and whole-grains
  • Includes fat-free or low-fat dairy products, fish, poultry, beans, nuts, and vegetable oils
  • Limits foods that are high in saturated fat. These foods include fatty meats, full-fat dairy products, and tropical oils such as coconut, palm kernel, and palm oils.
  • Limits sugar-sweetened beverages and sweets

The DASH diet calls for a certain number of servings daily from various food groups. The number of servings you require may vary, depending on how many calories you need per day.

The DASH diet suggests getting –

Grains: 7-8 daily servings

Vegetables: 4-5 daily servings

Fruits: 4-5 daily servings

Low-fat or fat-free dairy products: 2-3 daily servings

Meat, poultry, and fish: 2 or less daily servings

Nuts, seeds, and dry beans: 4-5 servings per week

Fats and oils: 2-3 daily servings

Sweets: try to limit to less than 5 servings per week

How Much Is a Serving?

When you’re trying to follow a healthy eating plan, it helps to know how much of a certain kind of food is considered a “serving.” One serving is:

  • 1/2 cup cooked rice or pasta
  • 1 slice bread
  • 1 cup raw vegetables or fruit
  • 1/2 cup cooked veggies or fruit
  • 8 ounces of milk
  • 1 teaspoon of olive oil (or any other oil)
  • 3 ounces cooked meat
  • 3 ounces tofu

Dash Diet Tips:

  • Add a serving of vegetables at lunch and at dinner.
  • Add a serving of fruit to your meals or as a snack. Canned and dried fruits are easy to use, but check that they don’t have added sugar.
  • Use only half your typical serving of butter, margarine, or salad dressing, and use low-fat products  
  • Drink low-fat or skim dairy products any time you would normally use full-fat or cream.
  • Limit meat to 6 ounces a day. Make some meals vegetarian.
  • Add more vegetables and dry beans to your diet.
  • Instead of snacking on chips or sweets, eat unsalted nuts, raisins, low-fat and fat-free yogurt, frozen yogurt, unsalted plain popcorn without butter, and raw vegetables.
  • Read food labels to choose products that are lower in sodium.

Health Benefits of the DASH Diet:

Reduce Blood Pressure

The DASH diet helps to lower blood pressure related to its composition of potassium, calcium, and magnesium. Each key nutrient plays a role in the lowering of blood pressure. Since the DASH diet innately limits salt and sodium intake, some individuals may see further reductions.

With the inclusion of whole grains, comes the natural addition of fiber. Whole wheat products, brown rice, and oats are excellent fiber sources. Adequate fiber has been shown to reduce cholesterol levels.

Weight Loss

Weight loss comes with a calorie deficit. Although the DASH diet does not stress calorie reduction, filling the diet with nutrient-dense foods rather than calorie-rich foods can shed off pounds in a sustaining manner. Diets rich in fiber have also been shown to contribute to weight loss.

Reference:

https://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/dash-diet/art-20048456

https://www.nhlbi.nih.gov/health-topics/dash-eating-plan

– Dr. Chandrashekar.