Hypertension: Why is it so common?

Hypertension or high blood pressure is a very common chronic medical condition. The incidence increases with age and socio-economic development.

What is hypertension?

Hypertension is defined as blood pressure consistently ranging at 130/80 mmHg or higher. It is ideal to measure your blood pressure after waking up in the morning.

Causes of hypertension

According to a survey of Vietnam National Heart Institute in 2002, people with hypertension accounted for 16.62% of Vietnamese population. Statistics from 2015 shows that the prevalence of hypertension among adults at 25 – 64 years of age was 23.4%.

- For children or young adults: High blood pressure is mainly caused by adrenal gland tumors or renal artery stenosis.

- For older adults: People after age 40 are likely to develop high blood pressure, particularly about 50% of adults over 65 years of age have this condition. For most adults at these ages, there is no identifiable cause of high blood pressure (known as primary/essential hypertension). As you age, the start of atherosclerosis causes arteries to narrow, weaken and be less flexible, making the blood to exert excessive pressure against the vessel walls and forcing the heart to work harder to maintain the pressure. Managing blood pressure is a life-long commitment.

Risk factors for high blood pressure include:

+ Smoking tobacco or drinking too much alcohol.

+ Lack of physical activities.

+ Being overweight or obese that leads to metabolic disorders such as increase of LDL cholesterol or diabetes can contribute to hypertension. Having these conditions may increase your risk of hypertension by 1.4 to 1.6 times.

Today, a growing number of young people are at risk of hypertension. Especially, obese children are more prone to getting hypertension later on. Therefore, unhealthy diet at the early age is also a risk factor for the disease.

Symptoms of hypertension

Generally, people with hypertension may experience headaches, dizziness, fatigue, blurred vision, tinnitus, blushing, etc.

Regularly checking your blood pressure is vital as there is usually no symptoms to make you aware of the condition. Some people might suffer from fluctuating hypertension. In these cases, 24-hour blood pressure monitoring is required.

Complications of hypertension

High blood pressure is the most critical risk factor associated with coronary artery disease (or ischemic heart disease), heart failure, cerebrovascular disease and chronic kidney disease.

- Heart: As the heart has to work harder to pump blood against the higher pressure in your vessels, the walls of the heart’s pumping chamber thicken; the thickened muscle may have a hard time pumping enough blood to meet your body’s needs, which can lead to heart failure. Blocked coronary artery due to atherosclerosis can cause heart attack (myocardial infarction).

- Eyes: Thickened, narrowed or torn blood vessels in the eyes due to high blood pressure can result in retinal hemorrhage. Patients with persistent high blood pressure should have regular eye examinations to detect eye-related complications.

- Brain: A common complication of hypertension is stroke. Complications of stroke can be due to hemorrhage of the blood vessels that supply the brain or can result from poor blood flow through arteries occluded. The complications can lead to paralysis or even death. Hypertensive patients with blood pressure ≥ 160/95 mmHg have the incidence of stroke 2.9 times (for female) and 3.1 times (for male) higher as compared to normotensive people.

- Kidney: Persistent high blood pressure can also lead to kidney failure that frequently requires dialysis.

Treatment of hypertension at American International Hospital (AIH)

At AIH, our doctors will review your medical history and conduct a cardiopulmonary examination. Doctors may also recommend an electrocardiogram, echocardiography, ophthalmoscopy and other routine tests such as blood tests, urine tests. In case of hypertension suspected, doctors will recommend an ambulatory blood pressure mornitor to have a more accurate picture of blood pressure changes over an average day and night. Based on test and examination results, doctors will develop a proper treatment plan that works best for your case.

Prior to any indications for medications, doctors will advise you on how to change your lifestyle first, including: having a heart-healthy diet with less salt and fat, limiting the amount of alcohol you drink, getting regular physical activities, controlling and maintaining a healthy weight. Changing your lifestyle is key to managing high blood pressure.

If the implementation of lifestyle changes produces a stable blood pressure of less than 130/80 mmHg, patients should keep maintaining this method and recheck their blood pressure with 24-hour monitor after 3 months.

In case lifestyle changes are not enough, doctors may recommend medications to lower your blood pressure in addition to diet and exercises. This usually starts with one single drug, then the combination of multiple medications.

Re-examinations should be done every 2 to 3 months depending on the blood pressure status.

Principles of treatment patients should notice

- Hypertension is a chronic medical condition that requires life-long treatment. It is not a problem that you can treat and then ignore after reaching your blood pressure goal. Doing so, you might face the risk of elevated blood pressure.

- A certain prescription cannot be used forever. You should schedule doctor visits every 2 to 3 months. Each stage of the treatment process may require different medications.

- Patients are not allowed to buy over-the-counter drugs at the pharmacy or use other patients’ prescription, because each patient has a different treatment plan.

How to prevent hypertension

- Regularly monitor your blood pressure at home. Patients are advised to measure their blood pressure 3 times a week.

- Maintain a healthy weight or lose your weight if you’re overweight or obese.

- Do not smoke.

- Limit the amount of alcohol you drink.

- Limit the intake of fatty foods, fried foods and high-cholesterol foods (e.g. animal organs, eggs).

- Reduce salt in your diet, eat more fruits and vegetables.

- Manage stress and practice relaxation.

- Play sports such as badminton, tennis (for people not having arthritis) or biking, swimming (for people having arthritis).

- Have regular health check-ups for early detection of hypertension and related conditions.

Lien Duong, MD. MSc. – Cardiologist, Head of Internal Medicine Department, American International Hospital (AIH)
Vy Tran, MD. – Cardiologist, American International Hospital (AIH)