Blood pressure is said to be elevated when the systolic and diastolic readings are persistently greater than 140mmHg and 90mmHg respectively. The systolic blood pressure (Normal between 90 and 140mmHg) refers to the pressure generated by the force of contraction of the heart as it pumps blood throughout the body while the diastolic blood with normal range from 60 to 90mmHg is the pressure when the heart is relaxed in-between contractions.
Experts have aptly described hypertension as a ‘silent’ killer disease because it rarely gives a warning sign before wreaking havoc on major body organs including the brain, heart and kidneys among others. In fact, it is often discovered incidentally when patients visit the clinic for other reasons. Fortunately however, one good side about this condition is that it responds so well to lifestyle modifications and drug treatment that complications can be prevented as long as the patient remains compliant.
Highlighted below are some of the potential dangers of uncontrolled hypertension:
1. Damage to the Brain
Elevated blood pressure is arguably the most important risk factor for cerebrovascular accident (stroke). It can cause progressive narrowing of blood vessels through the process of endothelial injury and plaque formation within the vessel lumen (atherosclerosis) or even lead to rupture of brain arteries with consequent bleeding into the brain parenchyma. The implication of these is loss of function which often leads to motor and/or sensory deficits on the opposite (contralateral) side of the body, seizure attacks, slurring of speech and several other problems depending on the part of the brain affected. Furthermore, dementia may eventually result as brain cells die from lack of oxygen and nutrients, leading to memory and cognitive impairments.
2. Damage to the eyes
When the blood pressure remains elevated over prolonged periods, the small vessels that supply blood to the eyes are damaged. Initially, vision becomes blurry but if the insult persists, the tiny blood vessels rupture with consequent accumulation of blood and body fluids under the retina – condition termed hypertensive retinopathy. Ultimately, permanent blindness to one or both eyes is the end result.
3. Damage to the heart
The heart is one central organ that bears the brunt of high blood pressure. Anytime the blood pressure is high, the heart must do more work to overcome the peripheral resistance and circulate the blood needed for body metabolism. Over time, the heart muscles thicken and become weak to the extent that contraction is no longer efficient and adequate to meet body needs, including those of the heart itself.
At this stage, the heart is said to have failed. Such an individual easily becomes breathless, initially after exertion and then at rest. Other symptoms like leg swelling, abdominal swelling and early satiety soon follow as the condition gets worse. Because the thickened heart muscle can no longer get enough blood and oxygen, the patient may experience severe central chest pain and tightness (angina) which can eventually degenerate into myocardial infarction (Heart attack), a leading cause of sudden cardiac death.
4. Damage to the kidneys
The kidneys are excretory organs which help to get rid of toxic body wastes. With persistently elevated blood pressure, the arteries supplying the kidneys are compromised resulting in Chronic Kidney Disease. Such failed kidneys can no longer eliminate toxins and waste products from the bloodstream. Hence, renal replacement therapy through frequent dialysis or kidney transplant with its huge cost becomes necessary for survival.
5. Damage to blood vessels
When the blood pressure remains uncontrolled, peripheral blood vessels supplying the limbs and penis are progressively narrowed until blood flow to these parts is completely cut off resulting in peripheral vascular disease. If it is the limbs that are involved, gangrene is the ultimate outcome which is a leading indication for limb amputation. Similarly, involvement of the penis leads to failure to achieve sustained erection and erectile dysfunction is a major culprit in male-factor infertility.
Evidently, blood pressure control and complication prevention can be achieved through non-pharmacological and pharmacological means. Non-pharmacological methods (without use of drugs) include the adoption of Diets Appropriate in Stopping Hypertension (DASH) such as fresh fruits and vegetables with low-fat diets, regular exercise and avoidance of risky behaviours like smoking and excessive drinking. Where these measures do not suffice, your doctor will prescribe blood pressure-lowering drugs to you which you need to comply with. Remember that your health is your wealth.