HBP2

Chapter 2.What are the causes of HBP?:
The Two types of HBP, Primary & Secondary
Based on the causes of high blood pressure, there are two types of hypertension: primary and secondary.
• Primary: Primary high blood pressure also known as essential hypertension is a very common and complex disorder. This type of high blood pressure has no underlying causative factor and it affects almost 95% of the hypertensive patients.
• Secondary: As opposed to primary hypertension, secondary hypertension has an identifiable underlying cause that leads to it
It is important to diagnose the type of hypertension to ensure that that proper treatment is administered; in this case the ailment is treated by treating the underlying causative factors.
Their causes:
Causes of Primary Hypertension
Even though primary hypertension by definition does not have an identifiable cause there are several factors that can increase the susceptibility to primary hypertension such as
• A sedentary lifestyle
• A body mass index of more than 25 (it has been observed that 85% of the patients who suffer from primary hypertension have a body mass index greater than 25)
• Sensitivity to salt (sodium)
• Excessive alcohol consumption
• Deficiency of Vitamin D
• It can also be attributed to aging
• Genetic factors and mutation
• An overactive sympathetic nervous system
• Low birth weight has also been pointed out as a possible factor
Causes of Secondary Hypertension:
The causes of secondary hypertension include:
• Kidney ailments: Several diseases of the kidney are known to cause secondary hypertension; the most common among them is polycystic kidney disease, a cystic genetic ailment of the kidneys. The disorder is characterized by the formation of cysts on both kidneys. The ailment can also damage other vital organs like the liver and pancreas. There have also been cases where the brain or the heart of the patient was affected by PKD. High blood pressure can also be caused due to renal artery related diseases. Apart from these two disorders; neuroendocrine tumors are also known to cause secondary high blood pressure
• Certain Drugs: Certain drugs like NSAID’s like ibuprofen and steroids can lead to hypertension. You may also experience secondary hypertension if you go off antihypertensive medication suddenly; this condition is known as Rebound Hypertension. This condition may also result in a hypertensive emergency because the blood pressure shoots up higher than the initial level once the medication is discontinued abruptly. However, this condition can be avoided by gradually going off hypertensive medication as you reduce the doses so that the body can get enough time to adjust to the reduced dosage.
• Pregnancy: Pregnancy may also lead to high blood pressure in women of child bearing age.
• Inadequate sleep: Another common issue that leads to hypertension is sleep apnea. This condition can be treated through tonsillectomy, nasal continuous positive airway pressure or one of the several other treatment recourses
Q & A’s (answers to questions connected to the chapter)
Q. Which is more common primary or secondary hypertension?
A. Primary hypertension which has no identifiable reason is more common with more than 90% of the hypertensive patients suffering from it.
Q. Which is more dangerous?
A. Both are equally dangerous however, secondary hypertension point to an underlying health concern which may often be the causative factor. Depending on the gravity of this condition secondary blood pressure may sometimes be more dangerous. For instance, a common cause of secondary blood pressure is a renal disorder known as polycystic kidney disease which may result in eventual renal failure.
Q. If I don’t suffer from primary hypertension does it mean I am safe?
A. If you lead a healthy and active life style there is no reason why you should develop hypertension. However, if you are a heavy smoker and drinker and enjoy junk food, you may have just been lucky to not have developed the disorder already. But there are always chances that you may run out of luck and before you know it, you will be diagnosed with hypertension. So its always best to take precautionary measures like opting for regular exercise routines and healthy well balanced meals.
Q. Do lifestyle factors have any bearing on secondary high blood pressure?
Yes, even though secondary blood pressure has an identifiable health condition that leads to it life style factors like obesity, sedentary life style, unhealthy eating habits, inadequate sleep, excessive smoking and drinking may worsen the condition.
Q Will my diet influence my primary blood pressure?
Yes, it will, your diet is one of the primary factors in blood pressure control. While a healthy diet low in sodium, saturated fats and cholesterol will help you in controlling your runaway blood pressure, not taking the necessary dietary precautions may lead to disastrous results. People with high blood pressure are extremely susceptible to cardiac ailments which can worsen if you have unhealthy dietary habits.
Q. What are the symptoms of primary hypertension?
A. Most people who suffer from primary hypertension do not experience symptoms and usually the disorder is diagnosed through routine medical exams.
However, if not controlled in time there may be a significant increase in blood pressure which may then cause symptoms like:
• Headaches particularly early in the morning; normally headaches related to high blood pressure originate behind the eyes.
• Vomiting and nausea
• Visual disturbances
• Chest pains
• Heart attack
• Renal Failure
• Stroke
• Peripheral arterial damage
• Abnormal heart beat
• Eye damage
Q. How is secondary hypertension treated?
A. Secondary hypertension is often treated with a combination of medication and surgical procedure. The treatment option will depend on the health condition that causes secondary hypertension.
Chapter 3.Controlling your blood pressure through your weight
How does obesity impact high blood pressure?
Several Medical Studies have proved that a link does exist between obesity and high blood pressure. People who are overweight have a higher blood pressure than people with a normal weight. Obesity not only increases the risk of high blood pressure but also of cardiovascular disorders. Research has revealed that obesity leads to an increase in the cardiac activity, output, volume of blood pumped out and the arterial resistance. Quite simply more blood is needed to feed the extra mass of fats and in cells in individuals who are overweight. Obesity is also a crucial factor in the hyper secretion of insulin. This insulin in turn causes several changes in the body that may predispose to perilous outcomes; for instance:
• It causes the thickening of the walls of the blood vessels which leads to an increase in their rigidity and a consequential increase in the blood pressure
• Obesity is also responsible for inducing the reabsorption of water and sodium into the body through the kidneys. This leads to an increase in the blood volume causing the blood pressure to shoot up.
• Obesity is also causes an increase in the out of the heart because there is excessive secretion of adrenalin in the body.
• Being overweight also leads to the development of oversensitivity to sodium; this is a known cause in increased rigidity in the peripheral arteries.
• When subjected to the hyper secretion of insulin for an extended period of time, the body develops a natural resistance to it; this in turn leads to the further increase in the synthesis of insulin, causing a rise in the blood pressure.
The obesity and high blood pressure are so closely related that even a decrease of 2.2 pounds in your weight will cause a decrease of 1mm/hg in your blood pressure.
A study conducted at the University of Cambridge has identified the exact cause of blood pressure increase due to obesity. According to the researchers, as your weight increases, more fats are stored into the body; these fats produce a hormone called leptin. The excessive leptin then enters the blood stream and reaches the brain. Here it triggers the MC$R which in turn triggers the sympathetic nervous system leading to an increase in your blood pressure.
Where can obesity and high blood pressure together lead?
There are several risks associated with both hypertension and obesity including cardiovascular disorders and coronary issues. However, if you suffer from both at the same time your risk factor is doubled. Here is a list of some of the complications that can be attributed to obesity.
Obesity leads to an increase in blood pressure by increasing the volume
Obese people have more visceral fat, which is the fat around the organs in the viscera/ abdominal cavity; these fats secrete angiotensinogen which in turn makes angiotensin II, a powerful vasoconstrictor which induces the kidneys to absorb more sodium.
High blood pressure is responsible for 395,000 deaths in the US alone while obesity is responsible for 216,000 deaths making them the second and third risk factors that lead to death after smoking.
Obesity is known to increase an individual’s susceptibility to over 50 health problems
Being overweight causes type 2 diabetes which in turn can cause serious health complications related to the kidneys, eyes, nerves and heart.
A study conducted by Harvard where obese people were tracked for 10 years revealed that their chances of developing diabetes increased 20 times due to obesity, it also augmented the risk of stroke, gallstone and heart diseases.
Cardiac issues and stroke: People who are overweight showed a marked increase in their susceptibility to heart disorders. One of the reasons for this is the increase in the blood pressure and the cholesterol level caused due to obesity. These two factors together lead to concurrent health issues; for instance, if we were to look at the statistics, blood pressure is 6 times more common in overweight people. An increase of 22 pounds would lead to an increase of 3mm/hg in the systolic blood pressure and this would equate to a 12% higher risk of heart ailments.
Diabetes: The close links between diabetes and obesity has led researchers to coin a new term known as ‘diabesity’. The statistics are equally starling here, with an astounding 90% of type 2 diabetes sufferers being overweight. Diabetes if not controlled, can lead to several other conditions such as limb amputations, blindness, renal failure etc and unfortunately there is no way to cure diabetes it can just be controlled.
How can you lower your cholesterol?
Cholesterol is a lipid or fatty substance found in the outer lining of the cells. These lipids eventually enter the blood stream; the two major sources of this fatty substance are liver production and dietary intake. This cholesterol is considered primarily responsible for arterial blockages leading to stroke and heart attack. Fortunately, there are several ways to keep your cholesterol level in check such as: life style and dietary changes and through medication.
Lifestyle changes:
Go from fat to fit: Obesity is big contributor to the production of cholesterol. Even if you lose a few pounds it can create a marked impact on your cholesterol levels. To begin with you need to analyze your eating habits. Remember that dietary intake also leads to an increase in cholesterol levels.
Choose heart healthy food: A diet that is rich in fiber and other food items that are known to reduce cholesterol may help to lower the overall cholesterol level in the body as much as medication.
Go for healthier fats: Saturated fats and trans fat will increase your total cholesterol level. The saturated fat found should not be responsible for more than 10 percent of your calories each day. Monosaturated fat in canola and peanut oils is healthier.
Avoid trans fats: These are found in commercial baking and baked products like cookies, margarine etc. Not only do trans fats increase the level of bad cholesterol but they also decrease the level of good cholesterol
Reduce your consumption of cholesterol: Make sure that you consume no more than 300 mg of cholesterol if you are healthy and less than 200 mg if you have an underlying heart condition.
Eat whole grains: Ensure that you go for products like bread, pasta etc manufactured from whole wheat flour, Also oatmeal, brown rice and oat bran are good items to reduce cholesterol levels
Increase your consumption of fruits and veggies: Frits and vegetables have a high content of dietary fiber, which helps to lower cholesterol levels. Instead of choosing fat and sugar laden snacks go for a fruits.
Fish and more Fish: Some fishes which are rich in Omega 3 fatty acids help to keep your heart healthy such as mackerel, tuna and salmon.
Limit Alcohol Consumption: Control your alcohol consumption; you should consume no more than one drink a day if you are a woman and no more than two drinks if you are a man.
Regular Exercise: Working out for 30 to 60 minutes each day can help to lower your cholesterol. You can choose an outdoor activity that you enjoy; for instance, swimming cycling or jogging.
Quit Smoking: Smoking not only causes severe pulmonary problems and cancer but it is also responsible for reducing your HDL cholesterol level.
Good vs. Bad cholesterol
Cholesterol is attached to proteins in the blood together they form lipoproteins. These lipoproteins can be categorized as high and low density. Not only cholesterol but also fats called triglycerides can prove precarious for your health and have a bearing on the overall cholesterol in the body.
Bad Cholesterol: Low density lipoproteins or LDL are known as bad cholesterol, this type of lipoprotein has very little protein and more fat, this is carried by the blood stream from the liver to the other parts of the body. Because of the high content of fat it can pose the risk of coronary artery disease.
Good Cholesterol: HDL or high density lipoproteins are considered to be good cholesterol. HDL prevents cholesterol build up in the arteries because it is made up of more proteins and less fat. It also helps clear LDL from the body. A diet high in HDL protects against heart disorders
The importance of eating healthy
Food can be one of the most potent weapons against high blood pressure. If you eat healthily, you can get the same benefits as you would by taking drugs to lower your blood pressure level. When choosing food to battle high blood pressure you need to remember that two dietary factors; salt and fat will have a major impact on your blood pressure levels. The idea behind an anti high blood pressure diet should be to restrict the consumption of these two components which will help to maintain your weight or may even help in reducing it. The daily allowance of salt should not exceed 2400 miliigrams.
The things to avoid
• Butter milk because its high in sodium
• Cheese and cheese spreads
• Canned fish including salmon, sardines, tuna and mackerel, if you do want t consume canned fish, make sure you rinse it properly it wash away the salt.
• Salty snacks including chips, pretzels, french fries, pork rind and nuts.
• Quick meals like quick cooking rice, instant noodles, pizza, potpies, frozen dinners etc.
• Canned vegetables, instead opt for fresh vegetables
• Instant soup and canned soup
• Condiments like soy sauce, ketchup, garlic salt, barbecue sauce, steak sauce, meat tenderizer, onion salt etc
• Pickles and relishes like olives, herrings, sauerkraut.
Some food items that can do wonders
• Fresh and frozen fish
• Chicken and Turkey (without the skin)
• Lean meat
• Loaf bread, English muffins, pita bread, bagel and dinner rolls
• Cereals (low sodium content)
• Plain noodles and rice
• Skimmed milk
• Fresh and frozen vegetables
• Soups (low sodium content)
• Fruits
• Specific vegetable oils
• Spices and herbs such as oregano, parsley, garlic, onion
• Fruit juices and vinegar.
Do water and dark chocolates really help?
Water can regulate the viscosity of blood. When we drink enough water it prevents the thickening of the blood and thin blood can flow through the blood vessels smoothly. Also, drinking a lot of water will keep your body free of toxins. When you exercise and the other demands of a hectic lifestyle depletes the body of necessary fluids and by drinking water you hydrate the body. In fact, the consumption of water is known to improve your metabolic rate. Drinking ample of water also helps the kidneys to purify the blood , if the blood flow to the kidney is limited because of lack of water, the kidney will pass a signal to the brain telling it to constrict the blood vessels which will further increase the blood pressure. So it is essential to have an adequate amount of eater each day.
Dark chocolate and cocoa contain anti oxidant rich compounds called flavonoids. These flavonoids are also found in fruits and plants. These compounds can offer great health benefits and are responsible for several favorable heart effects similar to the ones produced through the consumption of red wine and vegetables and fruits. Dark chocolate helps to reduce blood pressure because its rich in flavonoids. It also improves insulin sensitivity.
FAQ
Q. Should stop eating salt all together?
A. No your body needs salt even though very few people have experienced favorable results through salt restriction it is imperative to not over consume salt.
Q. Will any chocolate do?
A. No, you should only eat a small piece of dark chocolate each day to get the benefits for its flavonoid content. Other chocolates may end up giving you too much sugar and increasing your weight.
Q. What type of diet is highly recommended for patients with high blood pressure?
A. Even though there are several diets like DASH that are recommended for high blood pressure patients you could also use a Mediterranean diet which is rich in fruits, fish and olive oil as a preventative measure.