When we think of high blood pressure (HBP), we always associate it to older people and believe that, Nah! I am too young for HBP!! But, now a days, it is becoming relatively common for people in their 30s & 40s to be diagnosed with high blood pressure. Therefore, it is critical for people to have their blood pressure monitored regularly starting in their 30s. HBP is a “silent killer” because most times it is asymptomatic. Some people with HBP experience headaches and dizziness among other symptoms, but most of the times it is not associated with any symptoms. If left undiagnosed and untreated HBP can lead to severe complications including stroke and even death.

What is high blood pressure?

Quite simply put HBP is excessive constriction of the small blood vessels, that causes the heart to have to push blood through those constricted vessels with more force, so you need more pressure to get the blood through. When this pressure increases above certain levels it is problematic and is called high blood pressure.

• HBP can accelerate the build-up of plaque on the artery walls (atherosclerosis), clogging blood flow to your heart muscle, putting you at risk of heart attack.
• HBP also weakens the walls of arteries in your brain which can cause stroke. Stroke doubles the incidence of dementia.
•  It can affect arteries to other parts of your body too, such as the eyes, kidneys and legs.
• Long term high blood pressure is known as hypertension and is one of the main risk factors for heart disease.
• If left untreated very high blood pressure called malignant blood pressure (blood pressure above 180/120mmHg) can lead to death in 6 months, however, with medications you can live a completely normal life!

How is high blood pressure diagnosed?

It is good practice to get the blood pressure assessed by the doctor periodically. Blood pressure is normally measured in the doctor’s office using a sphygmomanometer. The technique involves wrapping an inflatable cuff around the upper arm. The cuff is inflated until blood flow in the arteries of the arm is stopped. The cuff is slowly deflated and a stethoscope is used to hear sounds coinciding with the heartbeat.

What do the numbers mean?

The pressure at which sounds start is the systolic pressure. This is the maximum pressure developed by the beating heart (contracting heart which pushes the blood throughout the body). The lowest pressure between heartbeats (when the heart relaxes and refills with blood) is also recorded when sounds disappear. This is the diastolic pressure. Pressures are usually recorded in millimeters of mercury (mmHg) and cited as systolic pressure (SP) over diastolic pressure (DP), for example, 120/80 mmHg (SP/DP). 

Readings over 120/80mmHg and up to 139/89mmHg are in the normal to high range. Your doctor will advise what your ideal blood pressure should be based on your circumstances. Blood pressure over 140/90mmHg is generally considered to be high.

Blood pressure, is however, very variable and can be elevated transiently by factors such as stress, emotional state, recent physical activity, smoking, caffeine and even talking. Hypertension is not therefore diagnosed until resting blood pressure is shown to be consistently elevated during several successive visits to your doctor. Sometimes blood pressures can be measured by automated machines at home, but it is important to use reliable and well calibrated equipment. More comprehensive measures of blood pressure can be made using ambulatory monitors that are fitted to patients for a 24-hour period. These readings give a measure of blood pressure during normal daily activities and can be helpful in determining the diagnosis of hypertension in certain cases in which clinic measures are inconclusive.

What causes high blood pressure?

The exact cause of high blood pressure is often not clear. However, various lifestyle conditions and behaviours have been known to significantly contribute to high blood pressure. Some of them are listed below. I will get into the details for these and how to manage each one in my future blogs.

• Being overweight
• Lack of exercise
• Alcohol
• Stress
• Salt intake
• Old age
• Smoking
• Family history of high blood pressure

How is HBP treated or managed?

HBP can be easily monitored and treated with lifestyle modifications and/or medications. Maintaining a health weight, reducing stress, meditation, decreasing smoking and alcohol intake, reducing salt intake and exercise are some of the lifestyle modifications which will help in maintaining a healthy blood pressure. In addition, the medications available for treating HBP are the most potent and effective medicines out there that can actually save lives. There are 9 different types of medications available to treat HBP : beta blockers, centrally acting alpha adrenergics, diuretics, peripherally acting alpha adrenergics, vasodilators, calcium channel blockers, angiotensin converting enzymes inhibitors, angiotensin receptor II receptor blockers and renin inhibitors. These medicines are well tolerated by most people with few known side effects which can be easily managed.

Why people tend to ignore HBP?

It is mainly due to lack of knowledge and the hassle of taking regular medications that people tend to ignore HBP. If your doctor has diagnosed you with high blood pressure and you ignore it, you do it at your own peril. It could be fatal. Well no one likes to take tablets everyday but the fact remains that high blood pressure has to be managed. Especially since HBP is so common among people today, people assume it is the norm and most people are unaware of what the normal blood pressure readings should be or what the numbers mean. So we need to educate ourselves about our blood pressure readings and monitor it periodically. It is never too early to start and we need to acknowledge the fact that HBP is no longer associated with just the aged population.

A link between HBP in your 30s and 40s and dementia?

A recent study published in Lancet Neurology suggests that high blood pressure between the ages of 36 and 53, had the strongest associations with smaller brain size and increases in white matter brain lesions (a sign of blood vessel damage in the brain and are a hallmark sign of aging and a risk factor for cognitive decline or dementia) in later life. These changes in brain, may, over time, result in a decline in brain function, for example, impairments in thinking and behavior. These findings reinforce the need to monitor and manage blood pressure even before mid-life.

So there are plenty of reasons to make monitoring and keeping your blood pressure under check your priority. Have you checked your pressure lately?