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Im 27 years old. Very much disturbed. Im suffering frequent heart palpitations since 2 years. Did do ecg test, thyroid and blood test, everything normal. But palpitation doesn't seem to go. Please help.
Guidelines for vary from time to time, but generally accepted classification of hypertension ( JNC7)is
Average of two or more properly measured readings at each of two or more visits after an initial screen:
Normal < 120 mm Hg SBP AND DBP < 90 mm Hg
Prehypertension 120 -139 mm Hg SBP OR DBP 80 to 89 mm Hg
Stage 1 HTN 140 -159 mm Hg SBP OR DBP 90 to 99 mm Hg
Stage 2 HTN >/= 160 mm of Hg SBP OR DBP >/= 100 mm Hg.
Prevalence of prehypertension among adults in United States is approximately 37 percent.
Study done by Yadhav S et al showed prevalence of prehypetension was 32.3 percent in India with highest 36% among 30-39 yrs age group, indicates that awareness is necessary for regular blood pressure check up.
People diagnosed with hypertension represents “tip of an iceberg”.
Many patients get to know about their raised blood pressures at the time of diagnosis, heart attack, stroke or kidney disease( end organ failures) which would have been preventable if treated at an early stage.
Why hypertension should be diagnosed and treated ?
Hypertension currently causes 2/3rd s of all strokes and half of all cases of ischemic heart disease.
Reduction in high blood pressure leads to large reduction in stroke, heart failure, renal failure, aortic dissection, coronary events and death.
Prehypertension: It is an entity where SBP >120 -139 mm Hg or DBP 80-89 mm Hg.
Multiple epidemiological studies demonstrated increased cardiovascular risk in patients with prehypertension.People with prehypertension have increased risk of progression to sustained hypertension, the prevalence of hypertension increases from approximately 10 percent at age of 30 yrs to as high as 90 percent after age of 65 yrs.
Framinham hypertension risk prediction score, may help identification of prehypertensive patients who are at gretest risk for pregression to hypertension. Risk calculator includes variables like age, sex, family history of hypertension, body mass index and smoking. Most important predictors of these were higher baseline blood pressure and older age.
Screening for hypertension: optimal interval for screening is not known.
2007 USPSTF( United States Preventive Services Task Force) guidelines recommend
Screening every two years for persons with SBP <120 mm Hg and DBP < 80 mm Hg
Yearly for persons with SBP 120-139 mm Hg or a DBP 80 -89 mm Hg
How to manage Prehypertension:
TROPHY stydy( TRial Of preventing Hypertension) results showed that there is no role for pharmacotherapy in prehypertension except in special conditions like diabetes, chronic kidney disease etc.
Treatment:As per JNC 7 reccomendations patients with prehypertension who do not have diabetes, chronic kidney disease , end organ damage , or clinical evidence of cardiovascular disease are generally treated with non pharmacological therapies.
Major non pharmacological therapies that aid to decrease blood pressure are:
Weight reduction: Maintain normal body weight ( BMI 18.5 to 24.9 kg/m2) this can reduce BP by 5 to 20 mm hg per 10kg weight loss.
Adopt DASH eating plan : (DASH- Dietary Approach To Stop Hypertension) consists of fruits, vegetables, legumes, low-fat dairy products with reduced saturated and total fat.This can reduce BP by 8 to 14 mm Hg.
Dietary sodium Restriction: Reduce dietary sodium intake to no more than 100meq/day(2.4 gm sodium or 6 gm of sodium chloride). This can reduce BP by 2 to 8 mm Hg.
Physical activity: Engage in a regular aerobic physical activity such as brisk walking (at least 30 min per day, most days of the week). This can reduce BP by 4 to 9 mm Hg.
Moderation of alcohol: Limit consumption of alcohol to no more than 2 drinks per day in most men and no more than 1 drink in women and lighter weight persons. This can reduce BP by 2 to 4 mm Hg.
I am from delhi. Kindly let me know precautions needed to keep heart healthy. Also list test required to be done ?
Hi Doctor, My husband age is 39 weight is 66 kg height is 5 feet 4 inches. He is suffering from insomnia for past 1 year and now his bp is in level 170/110 as he is not getting adequate sleep. We took ECG as his bp level is high but it looks normal. Please advice how to cure insomnia and will curing that reduce blood pressure.
I am a heart patient my bypass surgery had done in 2008 I am also a diabetic patient please suggests me tablets.
I am 24 year old boy. My left chest is paining constant. Nd persistent cough since one month. What causes it?
My mom is a diabetic patient from 5 years. Please suggest some diet. How to balance the sugar level?
My mother is suffering from high blood pressure. On 11th oct her bp was 170, on 12th oct it was 150 and on 13th oct it was 160 .so what remedy should we take? Before this their was no such problem infact her parents also do not have BP problem.
Hypertension or high blood pressure can be defined as a condition wherein the thrust of the blood against the walls of the arteries is excessively high, thereby, increasing chances of health hazards. The amount of blood that is pumped by the heart and the resistance put up by the arteries usually determine one’s blood pressure count. For instance, if the heart pumps excess amount of blood while the arteries shrink, the blood pressure can soar high. High blood pressure or hypertension may give rise to symptoms such as nosebleeds, short breaths or headaches.
There are two types of hypertension, one is primary and the other is secondary. For essential or primary hypertension, there is no significant reason and the condition slowly develops over years. The secondary one appears all of a sudden as a result of a repressed condition such as thyroid or kidney problems, defective blood vessels and certain medications such as pain-killers, cold relievers, pills for birth control and others.
Other factors responsible for hypertension are:
- As you age it increases
- Family history
- Being obese or overweight
- Being physically inactive
- Consuming too much of sodium or salt in your diet
- Little intake of potassium and Vitamin D in meals
- Being subject to high levels of stress
- Chronic medical disorders such as diabetes
- Alcohol or drug abuse
- Thiazide diuretics can be administered. These help to flush out excess water and sodium from the body in order to reduce excessive volume of blood thrusting against the arteries.
- Beta blockers ease the workload of the heart by opening up the blood vessels.
- Angiotensin-converting enzyme (ACE) inhibitors help inhibit the production of chemicals narrowing the blood vessels.
- Angiotensin II receptor blockers (ARBs) are used to obstruct and curb the action of the chemicals contracting the blood vessels.
- Calcium channel blockers help to loosen the blood vessel muscles
- Renin inhibitors can delay the production of an enzyme called ‘renin’ by the kidneys that increase one’s blood pressure
- One should follow a well-balanced diet that comprises of less salt.
- There is no substitute to regular exercises. Exercising regularly helps one maintain a balanced body weight that further reduces the chances of this condition.
- Abstaining from smoking and limiting alcohol intake helps provide that holistic cover to all the treatment modes mentioned above.