Hypertension is elevated pressure in the arteries which take the blood to the vital organs. Normal blood pressure is 120/80 or below. Pre-hypertension is considered between 120/80 and 139/89. Hypertension is considred 140/90 and above. The blood pressure is measured by a blood pressure cuff  or sphygmomanometer, which is usually placed on the upper left arm. Some persons may have  falsely elevated blood pressure readings only when taken in the clinic setting but normal blood pressures in their home environment. This is a condition called white coat hypertension. These patients are advised to regularly monitor their blood pressure at home.

The top number, the systolic blood pressure, corresponds to the pressure in the arteries as the heart contracts and pumps blood forward into the arteries. The bottom number, the diastolic pressure, represents the pressure in the arteries as the heart relaxes after the contraction. The diastolic pressure reflects the lowest pressure to which the arteries are exposed.

Elevation of the systolic and /or diastolic blood pressure increases the risk of developing heart disease, kidney disease, eye damage, stroke,  and atherosclerosis  which is hardening of the arteries. This type of damage is called end organ damage.

Hypertension is usually symptomless, however sometimes a person may experience headaches, dizzyness, neck stiffness, blurred vision and a sensation of hearing their pulse easily. The danger of hypertension is that there is usually no warning of  ongoing end organ damage until late in the disease because of the absence of symptoms. This delays the onset of medical attention and increases the risk of complications already present at initial presentation. It is therefore important to have your blood pressure checked regularly in the absence of symptoms.

The management of hypertension is dependent on the degree of elevation of the blood pressure, the presence of any end organ damage at that lavel of hypertension, and any additional risk factors. A person not at immediate high risk will initially be given a lifestyle program with regular blood pressure monitoring. The lifestyle program will involve a healthy low fat, low salt diet, 30minutes of cardiovascular exercise, three to four times per week, a weight loss program, a smoking cessation program, and a stress management program.

If lifestyle measures are not effective, the person has very elevated blood pressures or end organ damage then medication is used. There are several classes of antihypertensives which can be used. Sometimes combinations are used to enhance the hypotensive effect while minimising possible side effects seen with high dose monotherapy. It is important to attend your doctor’s visits regularly to monitor your hypertension as well as screen for end organ damage. Prevention is most important, so for non hypertensives, annual physical examinations are strongly advised.