Hypertension

The National Heart, Lung and Blood institute has estimated that half of the people with high blood pressure are unaware of the condition. Hypertension is a silent killer because it is often symptom free. High blood pressure is the major cause for heart failure, stroke and kidney failure. Hypertension is defined as persistent levels of blood pressure in which the systolic pressure is above 140 mm Hg and the diastolic pressure is above 90 mm Hg.

Hypertension is a lifetime condition. About 20% of the adult population develop hypertension; Out of which more than 90% of them have essential or primary hypertension, that has no medical cause. The rest of them develop secondary hypertension where there is blood pressure elevation with specific cause like narrowing of the renal arteries, organ dysfunction, certain medications, tumors and pregnancy.

Blood pressure is classified into 4 stages for adults aged 18 years and older. They are
Stage 1 (mild) - systolic 140-159 and diastolic 90-99
Stage 2 (moderate) - systolic 160-179 and diastolic 100-109
Stage 3 (severe) - systolic 180-209 and diastolic 110-119
Stage 4 (very severe) - systolic >210 and diastolic >120

A person with hypertension is usually symptom free until some vessel damage occurs. Physical examination may reveal no abnormalities, but some changes may be noted in retina, such as hemorrhages, exudates, narrowed arterioles and papilledema. The manifestations are related to the organ systems served by the involved vessels.

A thorough history, physical examination (retina), lab studies (electrocardiography, renogram, intravenous pyelogram, renal arteriogram, renal function studies, renin levels,protein in the urine, blood urea nitrogen) are performed to confirm the diagnosis.

Blood pressure can be kept under control by nonpharmacological methods, including weight reduction, restriction of alcohol, sodium and tobacco, exercise and relaxation. The antihypertensive drugs are selected by the doctor depending upon the effectiveness, chance of acceptance by the person and fewer side effects.

The medication therapy for hypertension includes diuretics, adrenergic inhibitors, vasodilators, angiotensin-converting enzyme (ACE) inhibitor and calcium antagonist. There are three major divisions under diuretics namely thiazide diuretics, loop diuretics and potassium sparing diuretics. These are used in combination with other antihypertensive drugs. Reserpine, methyldopa, propranolol, prazosin hydrochloride, clonidine hydrochloride, metoprolol, nadolol, guanethidine, labetalol hydrochloride and phentolamine mesylate are some of adrenergic inhibitors used in regular treatment. The major action of these adrenergic inhibitors is to block or prevent the release of norepinephrine from adrenergic receptors.

Hydralazine hydrochloride, minoxidil, sodium nitroprusside and nitroglycerin diazoxide are a few vasodilators used to decrease peripheral resistance and cause peripheral vasodilation by relaxing smooth muscles. Captopril, a ACE inhibitor prevents conversion of angiotensin 1 to angiotensin 2 and thereby decreases the blood pressure. Diltiazem hydrochloride, nifedipine and verapamil are calcium antagonist that inhibits calcium ion influx across membranes and reduce cardiac afterload.

Hypertension is a lifetime condition and so should the treatment be. Treatment should not be discontinued abruptly.

Foods good for your heart

Heart diseases are mainly caused by cholesterol or fat content in our body. Cholesterol level in blood is one of the important determinant of heart disease. Cholesterol or fat blocks the blood vessels that supply blood to the heart which leads to increased work load leading to heart disease. Cholesterol is accumulated in our body from the food we take. Let's now see about a few foods that lower the risk of heart disease.

Almonds: Almonds have good cholesterol and they give you satiety. Hence almonds can be used in salads and desserts instead of other nuts and cheese. Almonds can be soaked over night and made in to a paste with little water and can be eaten with milk. Though they are rich in calories, taking a handful will not increase your weight or cholesterol levels. They are proved to reduce the LDL cholesterol.

Fish and fish oil: Fish is the richest source of omega-3 fatty acids and has less saturated fat. Opting fish instead of red meat from lamb or beef will reduce cholesterol. Eating baked or grilled fish instead of fried ones will have significant difference. Two servings of any fish like mackerel, whale, lake trout, herring, sardines, seal meat, albacore tuna and salmon, a week is the best food that reduces the risk of heart disease.

Fish oils made out of cod, tuna, mackerel or salmon is good for frying any fish or meat compared to other oils. They are good for heart because of their triglyceride lowering effect.

Soluble fibers: Soluble fiber has the capacity to reduce low-density lipoprotein and also decrease the absorption of cholesterol in the intestines. Soluble fiber is rich in foods like apples, barley, brussels sprouts, oats, pears, psyllium, kidney beans and prunes. Any recipe made out of the above mentioned soluble fibers is capable of bringing down bad cholesterol.

Low sodium diet: Restricting sodium intake after a certain age is always good. Those prone to heart diseases can limit their sodium intake to 1.6 grams per day. A salt intake of 4 grams per day is acceptable. Any foods rich in salt like canned foods, pizza, frozen dinners, pickle, pappads or chips should be avoided.

Restricting oil: Most oils are rich in bad cholesterol. Eating baked and grilled foods are good for health. For cooking, oils like olive oil, flaxseed oil, soybean oil, canola oil and fish oil can be used. These increase your levels of HDL cholesterol and decrease blood pressure.

Walnuts: This is another food that can decrease the risk of heart disease. It has the same effect as almonds.

Pomegranate and cranberry-grape juices help to increase HDL and decrease LDL cholesterol. Pomegranate has nitric acid content in it which reduces plaque formation in the arteries.

Soy: Soybeans are rich in protein but they are believed to control obesity and lower LDL cholesterol. They are also rich in vitamins and minerals.

Olives, blue berries, black berries, strawberries, avocados, spinach, carrots, artichokes, broccoli and cauliflower are good to keep your heart healthy.

Lean meat and chicken has less fat compared to organ meat and meat with skin, thereby decreasing the risk of heart disease.

Ginger and garlic also lower cholesterol. Garlic boiled and taken with milk every morning clears the blood vessels and prevents clot formation.

Food along with exercise and healthy lifestyle can definitely reduce the risk of your heart disease. So eat healthy and lower your risk of heart disease.