What Is Hypertension?

Did you know that high blood pressure or hypertension is a symptom, not a disease.

Blood pressure is highest when the heart contracts and drives the blood into the arteries. This is called the systolic pressure. When the heart muscle is relaxing, no blood is being pushed from it and blood is leaving the arteries through the arterioles. At this time the blood pressure is lower (diastolic pressure).

Blood pressure varies with different people; and it also varies in your own body under different conditions. A certain range of blood pressure is usually considered normal, but if it is consistently higher, you have high blood pressure (hypertension). If it is much below the normal range, you have low blood pressure (hypotension).

Hypertension, or high blood pressure affects millions of people.

Blood pressure is measured by a sphygmomanometer, which is constructed on the following principle.

A rubber bag enclosed in a cloth bag is wrapped around the bare upper arm of the subject. This rubber bag has two openings, each of which is connect with a rubber tube. One of the tubes runs to a rubber bulb which acts as a pump, and the other is connected with a mercury manometer which indicates the pressure on a millimeter scale. A stethoscope is placed over the artery in the bend of the elbow, while by means of the bulb the rubber bag or cuff around the arm is inflated with air. When the air pressure in the cuff slightly exceeds the blood pressure in the artery, the flow of blood is closed off. This is detected by the stethoscope as a snapping sound. The pressure gauge on the mamometer is read in millimeters. This is the systolic pressure. The minimal pressure, which is recorded between the pulsations of the heart, is the diastolic pressure. The difference between systolic and diastolic pressure is the pulse pressure, which indicates the variation in pressure in the artery brought about by the heart beat.

Sometimes, in older people, the walls of the arteries undergo a fatty degeneration and infiltration by fatty deposits (atherosclerosis) or they may become quite hardened by deposits of calcium (arterioscerosis). In either case, the flow of blood through the affected heart is impeded by the restricted vessel and high blood pressure is the result. But arteries have thick walls and can withstand high pressure for a long time without serious trouble.

About 90 percent of all cases of hypertension cannot be attributed to any particular cause. These are called essential hypertension. Most of the others can be traced to kidney diseases, such as Bright's disease, to adrenal tumors, or to congenital narrowing of important arteries, such as the aorta. Malignant hypertension is a rare but severe form of high blood pressure which does its damage quickly and may prove fatal in a few months.

Certain types of people, frequently the heavy-set, stocky builds, seem to be more susceptible to high blood pressure than others. Heredity seems to have a bearing. Those who are inclined towards hypertension usually begin to show it in the early thirties.

Often there are few symptoms and the individual himself is not aware of the condition until a doctor checks his pressure. In some cases there are palpitation of the heart, headache, dizziness, and fatigue, but there are many exceptions to these symptoms. The eyes may reveal the condition because small blood vessels in the retina often appear different when hypertension is present. If high blood pressure is unusually severe, changes may occur in the heart and other organs. The doctor will not judge the severity of the disease merely by the height of the pressure on his instrument. Higher pressure does not necessarily mean greater risks.

One of the risks of hypertension is the direct effect upon the heart which is forced to do more work. The additional strain, particularly on the left ventricle may lead to heart trouble. Persistent high blood pressure may predispose to arteriosclerosis and the danger of coronary thrombosis. The kidneys may be affected because less blood flowing through them means less waste eliminated, and the possibility in extreme cases of uremic poisoning. If the pressure is high enough it may cause a blood vessel to rupture. If this occurs in the brain, where the walls of the vessels are thin, the result is a stroke, or apoplexy.

While there is no specific treatment for high blood pressure, much has been done in individual case, for hypertension varies with the patient. In severe cases, such as malignant hypertension, sympathectomy or cutting the sympathetic nerves in the abdominal and thoracic regions has been fairly effective in lowering the pressure. Drugs have long been used for treatment, and some have been developed in recent years which offer some promise.

Hypertension authorities agree that proper conditioning of the patient is particularly important in the treatment of high blood pressure. He should live a sensible life, avoid overweight, take things easy, cultivate a complacent attitude towards the problems of life, and cooperate with his doctor. If he realizes his limitations, and is moderate in his activities he can enjoy one the whole a happy normal life.

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