Hypertension or High Blood is a condition in which a person experiences an increase in blood pressure above normal or chronic (in a long time). Hypertension is a disorder that is difficult to know by our own bodies. The only way to know for hypertension is to measure your blood pressure regularly.
Given 9 out of 10 people suffering from hypertension can not be identified the cause of the disease. That is why hypertension is called the silent killer or the silent killer. Someone recently felt the impact of the gravity of the complications of hypertension when it has occurred. So only realized when it has cause malfunctioning organs such as the heart, coronary, renal function, impaired cognitive function or stroke. Hypertension essentially reduces the life expectancy of sufferers.
Hypertension in addition to resulting in high case fatality rate also affects the high cost of treatment and care that must be borne by the patient. Hypertension should also be remembered for the impact the loss of quality of life.
Hypertension can actually be passed from parents to their children. If one parent affected by hypertension, the tendency of children to suffer from hypertension is greater than those who do not have parents with hypertension.
Diagnosis
In general, a person is said to have hypertension if the systolic blood pressure / diastolic exceeds 140/90 mmHg (normal 120/80 mmHg). Systolic blood pressure is the pressure when the heart pumps blood into arteries (when the heart is contracting). Diastolic blood pressure is when the heart expands and suck blood back (deflate arteries empty).
Actually, the line between normal blood pressure and high blood pressure is not clear, so the classification is based on the level of hypertension high blood pressure resulting in increased risk of heart and blood vessel disease.
According to the WHO, in the last guidelines in 1999, the limit of blood pressure that is still considered normal is less than 130/85 mmHg, whereas when more than 140/90 mmHg expressed as hypertension, and in between they will be referred to as the normal value-high. (Restrictions are intended for mature individuals over 18 years old).
Symptom
The mechanism of occurrence of hypertension hypertension symptoms include dizziness, flushing, headache, bleeding from the nose suddenly, sore neck, and others. The impact that can be caused by hypertension is kidney damage, bleeding in the cornea (the eye's retina), rupture of blood vessels in the brain, and paralysis.
Causes
Based on the cause, Hypertension can be classified into two, namely:
1.Hipertensi essential or primary
The exact cause of essential hypertension is still not yet known. However, various factors thought to play a role as a cause of primary hypertension, such as increasing age, psychological stress, and heredity (offspring). Approximately 90% of hypertensive patients classified as primary hypertension while 10% is classified as secondary hypertension.
2.Hipertensi Secondary
Secondary hypertension is hypertension that cause can be determined, such as renal vascular abnormalities, disorders of the thyroid gland (hyperthyroidism), adrenal gland disease (hyperaldosteronism), and others. Since the largest group of patients with essential hypertension is hipertensia, the investigation and treatment more targeted to people with essential hypertension.
Based on the factors due to an increase in blood pressure Hypertension in the arteries can occur in several ways:
- The heart pumps more powerful that drain more fluid at every second
- There was thickening and stiffness of the arterial wall due to old age. Large arteries lose elasticity and become rigid, so they can not inflate when the heart pumps blood through the arteries. Because of blood on each beat of the heart is forced to pass through the narrow vessels than usual and cause a rise in pressure.
- Increased fluid in the circulation can cause increased blood pressure. This occurs when there is abnormal kidney function and is unable to throw some salt and water from the body. The volume of blood in the body increases, so the blood pressure also increases.
Therefore, if the pumping activity of the heart is reduced, arterial widening experience, and a lot of fluid out of the circulation. Then the blood pressure will decrease or become smaller.
Based on the trigger factors, hypertension divided into uncontrollable such as age, gender, and heredity. In 70-80% of cases of primary hypertension, found in the family history of hypertension. If a history of hypertension was found in both parents, the alleged primary hypertension is greater. Hypertension is also often found in patients with monozygotic twins (one egg), when one of them suffers from hypertension. Alleged endorses that genetic factors have a role in the occurrence of hypertension.
While that can be controlled such as overweight / obesity, stress, lack of exercise, smoking, and alcohol consumption and salt. Environmental factors also affect the onset of essential hypertension. The relationship between stress and hypertension, presumably through activation of the sympathetic nerves. The sympathetic nerve is the nerve that works when we move, parasympathetic nerve is the nerve that works when we do not move.
Increased sympathetic nerve activity can increase blood pressure intermittent (irregular). If stress is prolonged, can lead to high blood pressure settled. Although this has not been proven, but the incidence is higher in urban than in rural areas. This can be attributed to the influence of stress experienced by the people living in the city.
Based on the investigation, are characteristic of obesity hypertension population and demonstrated that this factor has a close connection with the occurrence of hypertension in the future. Although it can not be explained the relationship between obesity and essential hypertension, but the investigation proved that the power of the heart and circulation pump blood volume of obese people with hypertension is higher compared with patients who had normal weight.
Prevention
Hypertension can be prevented by setting a good diet and adequate physical activity. Avoid habits such as smoking and consuming alcohol allegedly influential in increasing the risk of hypertension onset although the mechanism is not known for sure.
Treatment
Exercise is more associated with the treatment of hypertension as an isotonic sports (such as cycling, jogging, aerobic) which regularly can accelerate blood circulation so that it can lower blood pressure. Exercise can also be used to reduce / prevent obesity and reduce salt intake into the body (the body will excrete salt through sweating skin).
Treatment of hypertension is broadly divided into 2 types:
1. Non-medicine treatment (non-pharmacological)
2. Treatment with medication (pharmacologic)
Non-medicine treatment (non-pharmacological)
Nonpharmacologic treatment sometimes can control blood pressure that pharmacological treatment be necessary or at least postponed. While in a state where anti-hypertensive medications required, non-pharmacological treatment can be used as a complement to obtain better treatment effect.
Nonpharmacologic treatment are:
1. Diets low in salt / cholesterol / saturated fat
2. Reducing salt intake into the body.
Advice salt reduction, patients should pay attention to eating habits. Reducing salt intake will drastically difficult. This treatment should not be used as a single treatment, but it is better used as an adjunct to pharmacological treatment.
3. Create a relaxed state
Various methods of relaxation such as meditation, yoga or hypnosis can control the nervous system that ultimately can lower blood pressure.
4. Exercise such as aerobics or brisk walking for 30-45 minutes 3-4 times a week.
5. Quitting smoking and reducing alcohol consumption
Treatment with medication (pharmacologic)
Antihypertensive drugs. There are many types of antihypertensive drugs currently available. For the selection of the right drug is expected to call the doctor.
• Diuretics
Type diuretic Medications work by removing the body fluids (through urine) so that the volume of body fluids resulting in reduced cardiac pump power into a lighter.
Examples Medication is hydrochlorothiazide.
• Sympathetic inhibitors
This class of drugs works by inhibiting the activity of the sympathetic nerves (nerves that work when we move).
Examples medicine are: methyldopa, Clonidine and reserpine.
• Betabloker
Mechanism of action of anti-hypertensive medicine is through a reduction in pumping power of the heart. Type betabloker not recommended in patients who have been known to suffer from respiratory disorders such as bronchial asthma.
Examples medicine are: Metoprolol, Propranolol and Atenolol. In patients with diabetes mellitus should be careful, because it can mask the symptoms of hypoglycemia (a condition in which blood sugar levels dropped to very low which can result in harm to the sufferer). In older people there are symptoms of bronchospasm (airway narrowing) that drug administration should be careful.
• Angiotensin converting enzyme inhibitors
The workings of this class of medicine is to inhibit the formation of angiotensin II substances (substances that can cause increased blood pressure).
Examples of drugs that belong to this group are captopril. Possible side effects are: dry cough, dizziness, headache and fatigue.
• Calcium antagonists
Class of drugs may reduce the power of the heart pump by inhibiting the contraction of the heart (contractility). That includes drug classes are: Nifedipine, and Verapamil Diltiasem. Side effects that may arise are: constipation, dizziness, headache and vomiting.
• Vasodilators
These drugs act directly on the blood vessels by relaxing the smooth muscle (muscle of blood vessels). Were included in this group are: Prasosin, Hidralasin. The side effects are likely to occur from this administration are: headache and dizziness.
• Angiotensin II Receptor Inhibitors
The way these drugs work is by blocking the attachment of agents Angiotensin II receptor, resulting in a light heart pump power. Medications included in this group are Valsartan (Diovan). Possible side effects are: headache, dizziness, weakness and nausea.
With regular treatment and control, and avoid the risk factors of hypertension, the mortality from this disease can be suppressed.
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