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Hypertension- A Silent Killer

Hypertension, also commonly known as ‘high blood pressure”, is one of the most common long-term medical conditions.

WHO (World Health Organization) reports that nearly 1.13 billion people have hypertension worldwide. As per a study released by ICMR (Indian Council of Medical Research) in early 2021, an alarming one in every four people has hypertension in India, and only 50% of such individuals are aware of having the condition. This is because hypertension usually does not show symptoms until your blood pressure shoots extremely high. When high blood pressure is combined with high cholesterol and abnormal blood glucose levels, the damage to your arteries, kidneys, and heart speeds up tremendously. Fortunately, High blood pressure is easy to diagnose and manage. In some rare and severe cases, high blood pressure causes sweating, anxiety, facial flushing (reddening of the facial skin), and problems with sleep. A few cases can result in headaches and nosebleeds. However, most individuals with hypertension have no symptoms at all.

Keeping your blood pressure under control is vital for maintaining good health and reducing the risk of various diseases such as stroke, heart attack, and heart failure. Discover how to keep your blood pressure within the healthy range simply by making lifestyle changes, such as reducing weight, increasing physical activity and eating more healthfully

Signs and Symptoms

Hypertension is usually detected during routine examinations. But you can also measure your blood pressure levels at home. If you are at a high risk of developing hypertension, then it is better to check your blood pressure regularly or as directed by your doctor.

Here are some common symptoms of severe hypertension.

  • Shortness of breath
  • Non-uniform heartbeat
  • Severe headaches
  • Confusion
  • Blurry or double vision
  • Lightheadedness/Fainting
  • Fatigue
  • Nose bleeding
  • Pounding in the ears, neck, or chest
  • Nausea and/or vomiting

Hypertension and its types

Blood pressure is the pressure of blood pushing against the artery walls.

When you have hypertension (high blood pressure) the pressure against the blood vessel walls in your body is consistently too high. High blood pressure is sometimes referred to as “silent killer” because you may be unaware that anything is wrong, but the damage is still occurring within your body.

Your blood pressure varies throughout the day because of your activity. Having blood pressure readings that are regularly higher than normal may result in a diagnosis of high blood pressure.

The blood pressure reading is given in millimeters of mercury (mm Hg). The normal range is 120/80 mm Hg, A blood pressure reading depicts two numbers:

  • Systolic pressure (upper number). The first or the upper number indicates the pressure in your arteries when your heart pumps blood to the rest of your body.
  • Diastolic pressure (lower number). The second or the lower number indicates the pressure in your arteries between the beats.

Blood pressure is categorized as follows:

High blood pressure is diagnosed when one or both the readings are high. If the blood pressure reading indicates hypertensive crisis (sudden increase in blood pressure), the reading has to be repeated after 2 to 3 minutes. If the reading is the same or higher, it indicates a medical emergency, and the individual should seek immediate medical attention.

You may not realize the harm silent hypertension has been doing to your body until you are suddenly struck by a major condition like heart attack, stroke, and kidney failure.

There are two main types of high blood pressure:

  • Primary hypertension. This type of hypertension develops gradually over the years, and it does not have an identifiable cause. However, researchers say it is caused due to aging and unhealthy habits such as smoking, alcohol, poor diet and not getting enough exercise.
  • Secondary hypertension. This type appears suddenly, and the blood pressure is higher when compared to primary hypertension. It occurs due to an underlying condition and the common medical conditions that can lead to secondary hypertension include
    • Thyroid diseases.
    • Kidney disorders.
    • Obstructive sleep apnea (a sleep disorder where your breathing stops for brief periods during sleep).
    • Certain congenital disorders (conditions that are present from birth) affect your blood vessels.
    • Certain drugs such as birth control pills, decongestants, and pain relievers.

What are the causes and risk factors of hypertension?

Certain factors that increase the risk of developing hypertension include the following:

  • Age: The risk of developing hypertension increases with age. It is more common in individuals who are above the age of 60 years. Blood pressure can rise with age, as the arteries harden and constrict due to plaque formation,
  • Gender Hypertension is slightly more common in men than in women. However, this is only true until females reach menopause.
  • Family history. It tends to run in families. Therefore, if your family members have hypertension, then you are at a higher risk of developing the condition.
  • Being overweight. Obesity can cause hypertension or aggravate it if you already have it. Having more fat tissue can induce changes in the body that cause or aggravates hypertension.
  • A sedentary lifestyle. A sedentary lifestyle leads to arterial stiffness and plaque buildup. When your arteries become stiff and narrow, your heart has to work harder to circulate blood throughout your body, raising your blood pressure.
  • Dietary habits. Too much salt in your diet can lead to water retention (the amount of fluid in your blood) and increase your blood pressure. High-fat & high-calorie foods can lead to a fatty plaque buildup on the blood vessel walls, which constricts the blood vessels and forces the heart to work harder to push enough blood to your extremities. This, in turn, increases the pressure against the artery walls, potentially injuring or causing them to rupture.
  • Smoking: Smoking and even chewing tobacco can temporarily increase your blood pressure. Chronic use of tobacco can damage and narrow your artery walls. This can increase the risk of developing hypertension.
  • Alcohol consumption. Excess consumption of alcohol can increase your blood pressure. Therefore, alcohol should be consumed in moderation. It can be reduced to one drink a day for women and up to two a day for men.
  • Stress. When you are stressed, there is an increase in adrenaline (stress hormone) levels in your body. This, in turn, increases your heart rate and your blood vessels become narrower causing an increase in blood pressure.
  • Certain medical conditions. Certain chronic medical conditions such as diabetes and kidney disease can increase the risk of hypertension.

How is hypertension treated?

The treatment for hypertension depends upon various factors such as the type of hypertension (primary or secondary) and the underlying cause.

If your doctor diagnoses you with primary hypertension, he/she may recommend certain lifestyle changes.

Effectiveness of lifestyle modifications for lowering BP



Approximate BP reduction

Weight Loss

Maintain normal body weight (BMI 18.5 – 24.9)

5 – 20 mmHg per 20 lb weight loss


Diet rich in fruits, vegetables, and low fat dairy products

8 – 14 mmHg

Physical Activity

Aerobic Exercise >30 min most days

4 – 9 mmHg

Low Salt Diet

Reduce dietary sodium to max 2400 mg/day (only if + Hypertension)

2 – 8 mmHg

Stress Reduction

Practice a stress reduction technique such as meditation regularly

5 mmHg

Moderate alcohol consumption

Limit consumption to max 1 drink per day for women and 2 drink per day for men

2 – 4 mmHg

Tobacco Cessation

Incorporate cessation modality of choice

2 – 4 mmHg (1 week after cessation)

In the case of secondary hypertension, the treatment focuses on managing the underlying cause. For example, if a medication causes an increase in your blood pressure, then your doctor will recommend an alternate medication that does not have such side effects.

Treatment plans for hypertension often evolve with time as what worked for you, in the beginning, might become less effective over time. Your doctor will continue to work on refining your treatment and finding the most effective medication or combination of medications. Always take blood pressure medicines as prescribed. Never skip a dosage or stop taking blood pressure medication abruptly. Stopping certain medications abruptly, such as beta blockers, can result in a sudden spike in blood pressure known as rebound hypertension.

If you skip doses due to cost factor, side effects, or forgetfulness, talk to your doctor about alternatives.  Don’t change your treatment without consulting your provider.

Lifestyle Changes for High Blood Pressure

Certain healthy lifestyle changes can help control the factors that cause hypertension. Here are some common measures that will help lower your blood pressure:

  • Have a healthy diet. A healthy diet plays a vital role in reducing your blood pressure.
    • Eat a diet rich in fruits and fibrous vegetables and low in saturated fats. Limit your intake of processed and packaged foods, which contain extra sugar and salt and unhealthy fats. A heart-healthy diet emphasizes food that includes fruits, vegetables, whole grains, and lean protein like fish. Examples of eating plans that can help control blood pressure are the DASH diet (Dietary Approaches to Stop Hypertension) and the Mediterranean diet.
    • Limit your intake of salt and alcoholic beverages. In the kitchen, replacing regular salt with sodium-free or lower-sodium alternatives can benefit.
    • Potassium in the diet can help reduce the effects of sodium (salt) on blood pressure. The best sources of potassium are Dried fruits (raisins, apricots) Beans, lentils Spinach, broccoli Oranges, orange juice, Coconut water, Tomatoes
  • Stay physically active. Regular exercise has multiple benefits, it helps you shed extra weight, reduces stress, and strengthens your cardiovascular system (heart and blood vessels). Aim for 150 minutes of moderate physical activity weekly. Look for aerobic routines that will challenge your lungs and heart. Try things like brisk walking, cycling, swimming, or dancing.

Strength training also can help reduce blood pressure. Try to include strength training exercises in your workout schedule. Speak to a healthcare provider about developing an exercise program.

  • Maintain a healthy weight. Being obese or overweight increases your risk of developing high blood pressure. A fall in blood pressure usually follows weight loss, as the heart does not have to work so hard to pump blood around the body.

A well-balanced diet with calorie intake that matches the individual’s needs (size, gender, and activity level) will help. Having a healthy diet and staying physically active will help you maintain an ideal weight and thus reduce the risk of hypertension.

  • Manage stress. Stress is common in people of all age groups and managing it is important for your overall health. Pursuing a hobby, listening to music, practicing yoga, meditation, or deep breathing can help in managing stress or other emotional disorders. Try to find other ways to unwind and cope better with your stress levels.

Getting enough sleep is important to your overall health and heart. Your blood pressure goes down when you get some sleep. Most folks need at least 7 hours of high-quality sleep each night. That means you fall asleep within 30 minutes, don’t wake up more than once, and fall back to sleep quickly when you do.

  • Keep Tabs on Your Blood Pressure Check your blood pressure regularly to make sure it doesn’t get too high. High blood pressure usually doesn’t have any symptoms. So, measuring your Blood Pressure is the perfect way to tell if diet, exercise, and other lifestyle modifications are working. You can use a home monitor to check it, or you can visit your doctor.
  • Quit smoking and limit your alcohol intake: Smoking & drinking too much alcohol raises blood pressure and reduces the effectiveness of blood pressure medications. Limiting both can help lower blood pressure. Quitting both can also reduce the risk of heart disease and improve overall health, possibly leading to a longer life.

If you suffer from high blood pressure, your lifestyle choices can play a vital role in treating it. You may be able to cure your hypertension simply by changing your lifestyle. Simply changing what you eat, and drink can bring down systolic blood pressure by as much as 11 points, according to some estimates.

The advantages of lifestyle modification include significant drug cost reduction and improvement in conditions such as diabetes, hypercholesterolemia, and other cardiovascular diseases. These days people are increasingly educating themselves about the side effects of drugs. More people are willing to make lifestyle changes, including diet and exercise.


If you don’t treat high blood pressure, it can put you at risk for developing serious illnesses later in life such as heart attack, kidney failure and stroke. Living a healthy lifestyle by eating healthy foods, watching your weight, and getting regular exercise is also a great way to help manage your blood pressure.

If you’d like to learn more about hypertension and what you can do on your own to control your blood pressure, our team of doctors at CareFirst  is happy to help.

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