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On the occasion of world hypertension day falling on 17th May 2015 Dr S.S. Bansal, Sr. Interventional Cardiologist share & answer his views on high blood pressure.

For all above 30-35 years of age they must know their important health number-

While the cause of high blood pressure in most people remains unclear, a variety of conditions - such as doing no exercise, high salt diet, obesity, older age and genetics-can lead to hypertension. Disease of kidney, aorta, and adrenals can also cause high BP.

The blood pressure reading is measured in millimeters of mercury (mmHg) and is written as systolic pressure-the force of the blood against the artery walls as your heart beats - over diastolic pressure - minimum blood pressure between heartbeats. For example, a blood pressure reading is written as 120/80mmHg, or "120 over 80". The systolic pressure is 120 and the diastolic pressure is 80.

Blood pressure measurements can be classified as:

• Normal or ideal blood pressure is a systolic pressure of 120mmHg or less and a diastolic pressure of 80mmHg or less.
• Systolic pressure between 120-130mmHg or diastolic between 80-89mmHg is normal but higher than it should be?
• Systolic blood pressure of 140mmHg or more and/or diastolic blood pressure of 90mmHg or more is hypertension (high blood pressure)

Several potentially serious health conditions are linked to high blood pressure, including:

• Heart attack: a disease of the arteries caused by a build-up of plaque, or fatty material, on the inside walls of the blood vessels. Hypertension contributes to this build-up by putting added stress and force on the artery walls.
• Heart failure (the heart can't adequately pump blood), ischemic heart disease (the heart tissue doesn't pump enough blood), and hypertensive hypertrophic cardiomyopathy (enlarged heart) are all associated with high blood pressure.
• Kidney disease: hypertension can damage the blood vessels and filters in the kidneys, so that the kidneys cannot excrete waste properly.
• Stroke (Paralytic): hypertension can lead to stroke, either by contributing to the process of atherosclerosis (which can lead to blockages and/or clots), or by weakening the blood vessel wall and causing it to rupture.
• Eye disease: hypertension can damage the very small blood vessels in the retina.

Most of the time high blood pressure usually doesn't have any symptoms, so you usually don't feel it. For that reason, hypertension is usually diagnosed by a health care professional on a routine visit. This is especially important if you have a close relative who was hypertensive or you yourself have risk factors for it.

If your blood pressure is extremely high, you may have unusually strong headaches, chest pain and heart failure (especially difficulty breathing and poor exercise tolerance). If you have any of these symptoms, seek medical advice immediately.

High blood pressure treatment usually involves making lifestyle changes and, if necessary, drug therapy. Lifestyle changes for high blood pressure includes:

• Losing weight
• Stopping smoking
• Eating a healthy diet, such as fruits & vegetables
• Reducing the amount of salt in your diet
• Regular aerobic exercise (such as brisk walking)
• Limiting alcohol consumption

High blood pressure drugs include Angiotensin-converting enzyme (ACE) inhibitors, Angiotensin receptor blockers, diuretics, beta-blockers and calcium channel blockers etc.

A healthy diet is very effective at lowering high blood pressure.

The following steps can also help:

• Eating more fruits, vegetables and low-fat dairy foods
• Eating less of foods that are high in saturated fat and cholesterol, such as fried foods
• Eating more wholegrain products, fish, poultry and nuts
• Eating less meat and sweets, chips, Pickles & other salty food.
• Eating foods that are high in magnesium, potassium and calcium like Banana, Coconut water, Lemon, Orange Juice.

If you are diagnosed with high blood pressure, it's important to see your doctor on a regular basis. He or she can answer your question during these visits.

However, there may be other times when you may need to speak to your doctor. For instance:

If you aren't responding to the prescribed treatment and your blood pressure is still high.

If you are having any side effects from the blood pressure medication. If this happens, your doctor may wish to adjust the dosage or put you on another medication.

Some drugs that you take for another condition may cause high blood pressure. These include amphetamines, corticosteroids, hormones (including birth-control pills), migraine medications, cyclosporine and erythropoietin & many pain killers.

Also, many over-the-counter medications that contain pseudoephedrine and ephedrine (for example, allergy, cold and cough medication and appetite suppressants) can cause high blood pressure.

Don't stop taking any prescribed medication, including high blood pressure drugs, on your own without talking to your doctor.

Many people do think that stress can cause high blood pressure, particularly long term stress at work or at home. Stressful situations can cause your blood pressure to go up in the short-term, but it will come back down once that stress has gone. Long-term stress is not thought to cause high blood pressure on its own. However, if as a result of your stress you also have an unhealthy lifestyle, drink alcohol excessively and being overweight for example, this may have an effect on your blood pressure.

High blood pressure does run in families and it is even more important that if you have high blood pressure that you help your children to lead a healthy lifestyle too. If your children follow the same diet that you should be able to reduce their own risk of developing high blood pressure too.

I want to convey you all that you must know your health numbers and especially when you are a high risk patient, ie with high BP, uncontrolled Blood Sugar & Family history of any chronic disease.

Dr. S.S. Bansal
MD, DM, DNB, FSCAI (USA), FACC (USA)
Managing Director & Sr. Interventional Cardiologist
Metro Heart Institute, Faridabad