Hypertension is the pressure required for blood circulation in the vessels higher than normal. Hypertension is an important risk factor for stroke and heart disease, and therefore, it is one of the most important preventable causes of premature morbidity and mortality in developed and developing countries.
In our country, one out of every three people over the age of 18 has high blood pressure: if not diagnosed and treated early, they are candidates for heart failure, heart attack, stroke, kidney failure, vision loss. Most of the patients are asymptomatic. tinnitus, palpitations, shortness of breath, nosebleeds are common symptoms.
How is hypertension diagnosed?
Hypertension is diagnosed by measuring blood pressure in accordance with the rules and accurately. Blood pressure measurements may vary during the day and on different days. Blood pressure measurements should be made after the patient is resting. In the first examination, measurements should be made on both arms. It is normal to have a difference of up to 10 mmHg between them. Blood pressure measurement doctor or nurse in hospitalIt can be done by the patient as well as by the patient at home. Blood pressure can be recorded with portable devices that measure blood pressure for 24 hours. The threshold values accepted for hypertension are also different in these different measurement methods. 140/90 mmHg in measurements made in the hospital, 135 in measurements made at home. Hypertension above /85 mmHg and over 130/80 mmHg in 24-hour Holter measurements should be considered as hypertension.
JNC-7 hypertension classification:
Normal 120-129 and/or 80-84
High normal 130-139 and/or 85-89
Stage-1 hypertension 140-159 and/or 90/99
Stage-2 hypertension 160/179 and/or 100/109
Stage-3 hypertension over 180 and/or above 110
Isolated systolic hypertension 140 and 90
What are the causes of high blood pressure?
Genetic and environmental factors cause blood pressure to rise. Although a gene defect in a specific chromosome has not been found to be responsible for hypertension, it is thought that many gene defects cause high blood pressure. Excess weight facilitates the emergence of hypertension. In 95% of patients, there is no underlying cause and it is called essential hypertension. In 5% of patients, hypertension is due to an underlying disease and is called secondary hypertension.
Causes of secondary hypertension:
1. Parenchymal kidney diseases: chronic kidney failure, glomerulonephritis VS.
2.Stenosis in kidney vessels due to atherosclerosis
3. Excessive hormone secretion of the adrenal gland: Cusing syndrome, pheochromocytoma, hyperaldosteronism
4. Excessive salt consumption
5. Coarctation of the aorta
6. Increased intracranial pressure
7. Thyroid gland diseases: Hypothyroidism, hyperthyroidism
8. Drugs used in the treatment of rheumatism and depression may cause blood pressure to increase.
The effects of hypertension on the body
The organs most affected by hypertension are the heart, brain, kidneys, great arteries and eyes. High blood pressure can affect these organs and cause permanent disability and death in a long time. High blood pressure increases the workload of the heart and causes irreversible damage to the arteries.
The main harms of hypertension to the body:
-Heart failure, narrowing of the vessel feeding the heart, occlusion, heart attack
-Brain hemorrhage, narrowing of cerebral vessels
– Obstruction of neck and leg veins
– Enlargement, rupture of large vessels
Diabetes, hyperlipidemia and obesity often accompany hypertension. The coexistence of these diseases with hypertension increases the risk of atherosclerosis.
Detailed blood tests, telecardiogram, echocardiography should be performed in all patients diagnosed with hypertension. If secondary hypertension is considered, kidney USG, kidney Doppler USG, adrenal gland hormones should be checked.
Risk classification is made for patients diagnosed with hypertension, diabetes, cardiovascular disease, high cholesterol, age and gender. When the treatment is started, it is decided whether to start diet alone or to start diet and medication together according to this risk classification.
-Body weight should be at the ideal weight. If the body weight is more than the ideal weight, cholesterol and blood pressure increase, which causes heart disease.