Kidney Dialysis Foundation

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Hypertension or high blood pressure is called the “silent killer” because it seldom causes symptoms unless it is severe.

WHAT IS BLOOD PRESSURE?
This is the force of blood against the walls of the blood vessels. Your blood pressure consists of two numbers. The first top number is called the systolic pressure and it measures the maximum pressure of your blood when the heart is pumping. The lower reading is the diastolic and it measures the pressure in the blood vessels when the heart is in the relaxation phase and filling up before pumping again.

Hypertension is classified as follows

Grade	Systolic blood pressure	Diastolic blood pressure
Grade I hypertension	140 to 159	90 to 99
Grade II hypertension	≥ 160	≥ 100

WHAT CAUSES HIGH BLOOD PRESSURE?
Factors known to increase blood pressure include:
Obesity
High intake of alcohol
High intake of salt
Family history
Aging
Sedentary lifestyle

HOW WILL I KNOW IF I HAVE HYPERTENSION?
Usually there are no symptoms and you may not be aware until your blood pressure is checked using a blood pressure set or sphygmomanometer. However, some patients do experience some non-specific complaints and these include the following:

Grade I Hypertension
	Headache
	Nausea and vomiting
	Visual disturbances

Grade II Hypertension
	Tiredness
	Anxiety
	Excessive perspiration
	Facial redness
	Muscle tremors

COMPLICATIONS OF HYPERTENSION

If you are hypertensive and treatment is not received, it can lead to:
	Heart attack, heart failure or abnormal heartbeat
	Kidney Failure
	Stroke

HOW IS HIGH BLOOD PRESSURE DIAGNOSED?
We say that there is definite hypertension when blood pressure measurement is high on three or more separate occasions. They are usually measured 1 or 2 weeks apart.

TREATMENT OF HIGH BLOOD PRESSURE
For Grade 1 hypertension, the doctor usually advises lifestyle changes. These include cutting salt intake, quit smoking reduce alcohol intake, healthy diet, and to lose weight if you are overweight through regular exercises. The doctor may also prescribe medications if the blood pressure control is inadequate or if a person has one or more risk factors.

For Grade II hypertension, the doctor will recommend lifestyle changes and prescribe medications to control blood pressure. Treatment is more aggressive in preventing organ damage especially if you are in the high-risk group.

You must take your medication (which may be of more than one kind) daily according to your doctor’s prescription. Do not stop your medication without checking with your doctor.

Inform your doctor if the medications prescribed have side effects on you. There are many kinds of blood pressure medications and a suitable type can usually be found.

WHAT KIND OF LIFESTYLE CHANGES MUST I MAKE TO LOWER MY BLOOD PRESSURE?
Prevention
Lifestyle modification is recommended for all persons at risk of target organ damage. It is especially important to start these good habits early in persons who have risk factors for high blood pressure that cannot be changed. Risk factors include a personal or family history of hypertension, diabetes, heart disease and stroke.

Lifestyle modification includes:
1.	Maintaining normal blody weight with a body mass index of 20 to 23. To calculate the body mass index (BMI), use the formula as follows:
2.	Reducing your dietary sodium intake
3.	Exercising regularly
4.	Stop smoking
5.	Healthy eating
6.	Limit alcohol intake to no more than 2 glasses of wine of 30ml each or equivalent.

WHAT SHOULD I DO IF MY BLOOD PRESSURE IS HIGH?
You should see a doctor. Occasionally, high blood pressure is a symptom of another disease which may be curable or potentially a larger problem than just hypertension. In any case, the high blood pressure must be treated. If no cause is found and it is determined to be the “essential type”, you must still maintain a regular follow-up with your family doctor, or doctor in the polyclinic or hospital from whom you are taking medication.

Your doctor may also order a series of investigations to determine your risk of developing complications or associated problems. These may include:
	Blood samples for kidney function, sugar and cholesterol levels.
	Urine test to detect early kidney damage.
	Electrocardiogram to determine whether there is any damage to the heart.

If you have other medical condition, other tests may be needed.

High blood pressure is usually not curable, but it can be controlled if you make changes to your lifestyle and by taking medication. Treatment is a life long process.

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