Hypertension is also known as high blood pressure, is a medical condition that can increase your risk of heart disease, stroke, and other severe health complications. The heart pumps blood into arteries (blood vessels) that carry blood away from the heart to the tissues and organs of the body.
Blood pressure is the measure of the force of blood against blood vessel walls. When the force of the blood against the artery walls is too high, it increases the blood pressure, and this condition is known as hypertension.
It is dangerous and needs to be controlled because high blood pressure makes the heart work harder to pump blood out to the organs. This can result in hardening of the arteries (atherosclerosis), stroke, kidney disease, and heart failure.
Blood pressure is expressed by two measurements, maximum and minimum pressures, or a top number and bottom number. Let’s see what these numbers are:
Systolic blood pressure – Top number (maximum pressure) tells your systolic pressure. When the heartbeats, it contracts and pumps blood through the arteries to the rest of the body, the contraction creates pressure on blood vessels. This is called systolic blood pressure. Normal systolic pressure is below 120 millimetres of mercury (mm Hg). A reading of 130 mm Hg or higher means high blood pressure.
Diastolic blood pressure – The bottom number (minimum pressure) tells your diastolic pressure. The heart contracts to pump blood to the rest of the body and relaxes before it contracts again. The resting time between beats is when your heart fills with blood and gets oxygen. Diastolic pressure is the pressure of the blood in the arteries when the heart is filling. Normal diastolic pressure is below 80 millimetres of mercury (mm Hg). A reading of 80 mm Hg or higher means high blood pressure.
Among both the numbers, systolic blood pressure is more important than diastolic blood pressure because systolic blood pressure gives the best idea of your risk of having a heart attack or a stroke.
Classifications of Blood Pressure
Classification of blood pressure for adults aged 18 and older as per ACC/AHA (American College of Cardiology and American Heart Association) and ESC/ESH (European Society of Cardiology and the European Society of Hypertension).
As per ESC/ESH blood pressure level, 140/90 mm Hg count as hypertension, whereas new guidelines of ACC/AHA count 130/80 mm Hg as hypertension. It is because a new study has found that blood pressure levels between 130/80 mm Hg to 139/89 mm Hg is enough to cause substantial heart and blood vessel complications.
Symptoms of High Blood Pressure
In high blood pressure, it is quite possible that you won’t experience any symptoms for years or even decades, this is the reason why hypertension counts as a silent killer. However, once blood pressure reaches in hypertension stage, a person may have the following symptoms:
- Severe headache (specifically on the back of the head in the morning)
- Chest pain
- Shortness of breath
- Fatigue and confusion
- Vision problems
- Blood in the urine
- Pounding in your chest or neck
The best way to determine whether your blood pressure is high or not is to voluntarily ask your doctor to check your BP when you go for a health check-up. You should get your BP checked every four months. If your blood pressure is elevated, do get checked every month. If you have high blood pressure and you are on medicines, you should check your BP twice a day.
The first measurement should be in the morning before eating or taking any medications, and the second in the evening. Each time you measure, take two or three readings at an interval of 1 or 2 mins to make sure your results are accurate.
Let’s first understand what actually happens in the body that causes blood pressure to rise.
Mechanisms Through Which Blood Pressure Rises
1. Abnormalities of the sympathetic nervous system
You must have heard it many times “do not stress, or else your blood pressure will go up,” and it’s absolutely right.” The sympathetic nervous system influences the blood vessels of the body in a dangerous or stressful condition.
When you stress out, sympathetic outflow increases. The sympathetic nervous system releases the hormones adrenaline and noradrenaline (also known as norepinephrine). These hormones increase the rate of blood pumping from the heart to deliver fresh oxygen to the brain and muscles.
The repeated stress means a continuous increase in blood pumping from the heart, which is attained by constricting the blood vessels. The constant constriction of the blood vessels causes the narrowing of the blood vessels and increases the resistance of the blood vessels to blood flow (peripheral resistance). As a result, blood pressure increases.
2. Abnormalities in the intrarenal renin-angiotensin-aldosterone system (RAAS)
This system controls blood pressure by regulating the volume of fluids in the body. When blood flow to the kidneys decreases, the kidneys secrete enzyme renin into blood circulation. Plasma renin then converts angiotensinogen to angiotensin I, which has no direct biological activity.
However, an enzyme known as Angiotensin-Converting Enzyme (ACE) converts Angiotensin I to Angiotensin II (the primary hormone responsible for high blood pressure). Angiotensin II is a peptide hormone that causes vasoconstriction, which means it contracts the muscular wall of the vessels, which causes the narrowing of the blood vessels, resulting in increased blood pressure.
Below are the contributory factors that increase your blood pressure:
- Excess alcohol
- Family history of high blood pressure
- Excess salt intake
- A diet that lacks potassium
- Lack of exercise
- Certain drugs such as NSAIDs, steroids and contraceptive pills
Why Is Hypertension Dangerous?
Hypertension or High Blood Pressure is dangerous because it causes other health complications. Blood vessels are responsible for delivering oxygen and nutrients to vital organs and tissues. Over time, high blood pressure damages the blood vessels.
The damaged blood vessels disrupt the blood flow in the body that cause other health problems to arise. The most affected part of the body by hypertension is the heart, followed by, brain, kidney, and reproductive system.
Damage to the arteries
Blood vessels that carry oxygen-rich blood from the heart to the body are called arteries. Arteries are flexible, elastic, and their inner lining is smooth. Blood flows freely and unobstructed through healthy arteries and supplies oxygen and nutrients to vital organs and tissues.
High blood pressure reduces the elasticity of arteries. It damages their inner lining that makes it easier for dietary fats to collect in the damaged arteries, limiting blood flow throughout your body. These blockages eventually can lead to heart attack and stroke.
Damage to the heart
Hypertension makes your heart pump more frequently, and with more force than a healthy heart, which causes part of your heart (left ventricle) to thicken. An enlarged heart increases your risk of heart attack, heart failure, and sudden cardiac death.
Also, high blood pressure damages the vessels that supply blood to your heart. When blood flow to your heart is obstructed, it can cause arrhythmia (irregular heart rhythms), angina (chest pain), or can cause a heart attack.
Damage to the brain
Our brain depends on nourishing oxygen-rich blood supply to work properly. But high blood pressure can reduce blood and oxygen supply to the brain that can cause several problems, including:
Transient ischemic attack (TIA): Hardened arteries or blood clots caused by high blood pressure can temporarily disrupt the blood supply to the brain, which is called a transient ischemic attack (TIA) or mini-stroke. TIA counts as a warning of a full-blown stroke.
Stroke: High blood pressure can cause blood clots to form in the arteries, leading to significant blockages in blood flow. Reduced blood flow makes the brain deprived of oxygen and nutrients, causing brain cells to die. This is known as a stroke.
Dementia: Certain types of dementia, such as vascular dementia, is caused by a lack of blood flow in the brain, which may have been caused by narrowed/blocked arteries or a stroke.
Damage to the kidneys
Kidneys filter excess fluid and waste from the blood. High blood pressure damages the blood vessels and leading to your kidneys. Damaged vessels obstruct the blood flow to the kidneys and prevent kidneys from effectively filtering waste from your blood, allowing dangerous waste to accumulate. Hypertension is one of the most common causes of kidney failure.
Damage to the eyes
Studies show that high blood pressure can damage the blood vessels that supply blood to your eyes. Limited blood flow can damage the retina and the optic nerve, leading to bleeding in the eye, blurred vision, and even complete loss of vision.
Mechanism Through Which Anti-Hypertensive Medicines Work
The primary purpose of all the anti-hypertensive drugs is to produce vasodilation means to make the blood vessels wider or more open. When blood vessels dilate, blood freely flows through them, causing a fall in blood pressure.
There are different mechanisms through which different classes of drugs achieve vasodilation. Let’s see in brief how do these drugs work and how can we produce similar effects through foods, which are safer and have no side effects:
The first-line therapy or most common drugs that are used in hypertension lower the blood pressure by decreasing the salt reabsorption in the kidneys. That means your body now has less salt because more and more salt, along with water, are flushed out from the body through urine.
Because you have less fluid in your blood vessels, the pressure inside will be lower. The drugs that work on this mechanism are called Diuretics. Our aim is to include foods that naturally have a diuretic effect. We will later see in detail the foods that are natural diuretics.
As we discussed above, the Angiotensin II hormone is the main culprit behind high blood pressure. So, the other class of drugs produces vasodilation either by blocking the conversion of angiotensin I to angiotensin II (ACE inhibitors drugs) or by blocking the actions of angiotensin II (Angiotensin receptor blockers drugs).
This allows blood vessels to widen and relax, making it easier for blood to flow through, which lowers your blood pressure. Calcium stimulates the heart to contract more forcefully. A class of drugs called calcium channel blockers limits the rate at which calcium flows into the cells of the heart and blood vessel walls.
As a result, blood vessels widen, and your heart doesn’t have to work as hard to pump, making it easier for blood to flow through, and your blood pressure lowers.
Strategy To Prevent and Control Hypertension
Hypertension is food and lifestyle-related disease that means foods play the most significant part in correcting as well as worsening the condition. Hypertension cannot be solely managed with medicines.
Certain diet and lifestyle modifications are necessary for controlling the disease effectively. Medications prescribed in hypertension have side effects that include erectile impotence, gout, cough, and lack of energy.
By adding the right foods for high blood pressure in your diet and avoiding the bad foods, you can effectively lower your blood pressure and can drastically reduce the dose of your blood pressure medicines.
Below are certain ways by which you can lower your blood pressure naturally:
- Eat foods that reduce sodium levels in the body.
- Exclude foods that silently add salt to your body.
- Eat foods that are naturally diuretic.
- Eat foods that reduce fluid retention in the body and increase urine production.
- Eat foods that are rich in magnesium as magnesium is a natural calcium channel blocker.
- Eat foods that are rich in potassium because potassium negates the sodium effect.
- Eat foods rich in nitrates, which convert into nitric oxide in your body.
- Nitric oxide widens the blood vessels and lowers blood pressure.
- By increasing water intake.
Some natural supplements might help you lower blood pressure. I have reviewed a lot of dietary supplements, if you are interested, you might check them out.
Salt and Blood Pressure
It must have come to your mind that why is it said to avoid table salt in hypertension? What is the exact relationship between salt and blood pressure?
So, let’s see why salt is dangerous for blood pressure. Sodium is the main reason for rising blood pressure, and your table salt is basically a combination of sodium (40%) and chloride (60%). Are salt and sodium the same? No, not exactly. Sodium is a mineral that occurs naturally in foods.
With table salt, you eat sodium in the form of sodium chloride. This is the reason why table salt is considered dangerous for high blood pressure. Other forms of sodium that you consume are Sodium bicarbonate (baking soda) and Monosodium glutamate (MSG): Generally used as salt in Chinese foods.
How Does Salt Increase Blood Pressure?
Studies show that eating salt raises the amount of sodium in your bloodstream. It affects the performance of your kidneys to remove the water. As a result, your body holds extra water to flush out the extra sodium from your body. This is called fluid retention. The excess fluid in the body puts stress on blood vessels and the heart and causes blood pressure to rise.