Leukemia (Blood Cancer)

Hypertension (High Blood Pressure)        

            Over a billion people around the world have hypertension or high blood pressure so that pretty much means it's pretty common, let's start by defining it typically it's represented by two numbers the top number is the systolic blood pressure which is the arterial pressure when the heart's contracting and the lower number is the diastolic blood pressure which is the arterial pressure when the heart's relaxing or refilling most of the time blood pressure is taken in the brachial artery in your upper arm because of the pressure's high there it's probably high throughout all of the arteries.

The guidelines for categorizing blood pressure have recently changed to reflect a growing body of evidence that shows even moderately high blood pressure can significantly increase your risk for developing heart disease. Now normal systolic blood pressure is defined as less than 120 millimeters of mercury and normal diastolic pressure is less than 80 millimeters of mercury. Elevated systolic blood pressure is Considered between 120 and 129 millimeters of mercury and less than 80 millimeters of mercury on the diastolic side Stage 1 hypertension is between 130 and 139 millimeters of mercury on the systolic side and between 80 and 89 millimeters of mercury on the diastolic side. Stage 2 hypertension is defined as anything that's 140 millimeters of mercury or higher on the systolic side and 90 millimeters of mercury is higher on the diastolic side.

Typically both systolic and diastolic pressures tend to climb or fall together but that's not always the case sometimes you can have systolic or diastolic hypertension when one number's normal and the other is really high this is referred to as isolated systolic hypertension or isolated diastolic hypertension. High blood pressure is a serious problem for the blood vessels because it causes wear and tear on the endothelial cells that line the inside of the blood vessels just like a garden hose that's always under higher pressure in the long term blood vessels can develop tiny cracks and tears that can lead to serious problems like myocardial infarctions, aneurysms, and strokes.

Now about ninety percent of the time hypertension happens without a clearly identifiable underlying reason and we call this primary hypertension or essential hypertension. In other words over time pressure in the artery starts to silently creep up and there are a bunch of risk factors that we've identified for primary hypertension and these include old age obesity salt heavy diets and sedentary lifestyles with the exception of age all of these can be improved with lifestyle changes and those changes can help reduce hypertension about 10 percent of the time though there is a specific identifiable underlying condition that's the cause of hypertension and we call this secondary hypertension, for example, anything that limits the blood flow to the kidneys or the renal blood flow can cause hypertension as well as things like atherosclerosis, vasculitis or aortic dissection.

This is because the kidneys play a super important role in blood pressure regulation when not enough blood flows to the kidney secretes the hormone renin which ultimately helps the kidneys retain more water than water contributes to more blood in the arteries making them more full which leads to higher pressures other diseases can also cause secondary hypertension fibro-muscular dysplasia which affects young women can cause the walls of the large and medium-sized arteries to thicken if it involves the renal artery and limits blood flow to the kidneys it triggers more renin another example is a tumor that produces excess aldosterone and just like renin this leads to fluid retention.

Finally, if the blood pressure gets really high really fast it's referred to as a hypertensive crisis it involves a systolic pressure greater than 180 millimeters of mercury or diastolic pressure greater than 120millimeters of mercury hypertensive crisis can be further split into hypertensive urgency and hypertensive emergency with hypertensive urgency there hasn't yet been damage to end organs like the brain, kidneys, heart, and lungs in a hypertensive emergency there has been shown to be evidence of damage to end organs, so for symptoms usually primary hypertension isn't actually accompanied by any symptoms which is why it's sometimes referred to as a silent killer secondary hypertension might involve a variety of symptoms associated with the underlying cause and finally, a hypertensive emergency might involve symptoms like confusion, drowsiness, chest pain, and breathlessness.  The first choice for treatment of hypertension is lifestyle changes like changes to the diet exercise and stress reduction techniques in addition there are a variety of anti-hypertensive medications that might be given in some cases as well.

All right as quick recap hypertension or high blood pressure affects over a billion people around the world and overtime is a major risk factor for heart disease and stroke stage 1 hypertension is defined as 130 to 139millimeters of mercury for the systolic blood pressure and between 80 to 89millimeters of mercury for the diastolic pressure while stage 2 hypertension is defined as greater than 140 millimeters of mercury on the systolic side and greater than 90millimeters of mercury on the diastolic side, hypertension usually doesn't cause any symptoms and the first line of treatment is lifestyle changes helping current and future clinicians focus learn retain and thrive.

 

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