What is Hypertension?

Hypertension, also known as Cardiovascular Disease (CVD), is characterised by an excessive supply of blood in the vessels. Either the flow of blood is too high, putting pressure in the arterial walls or the blood flow faces resistance in the smaller arteries of the body.
 

How is it Measured?

Ideally, blood pressure should be below 120/80. Here, the upper number is called the Systolic Pressure i.e. when the heart contracts and the lower number is called the Diastolic Pressure i.e. when the wall relaxes in-between beats. (Just so that you know! Blood pressure is measured in the unit millimetres of mercury (mmHg)).
 
Thus, by definition hypertension can be defined as a condition of consistently having a systolic blood pressure of 140 or more and a diastolic blood pressure of 90 or higher. Of the two figures, systolic pressure plays a greater role in the diagnosis of hypertension.
 
Based on the systolic/diastolic pressure values, Hypertension can be classified as:
- Prehypertension:
     • Systolic 120-139
     • Diastolic 80-89
- Stage one hypertension:
     • Systolic 140-159
     • Diastolic 90-99
- Stage two hypertension:
     • Systolic 160+
     • Diastolic 100+
 

What are its implications on health?

Hypertension can be a risk factor for disorders such as kidney failure. Additionally, if left untreated, hypertension can have an adverse effect on cognitive functioning such as memory, attention, learning, mental flexibility, abstract thinking and other cognitive skills.
 

What is the relationship between Stress and Hypertension?

The relationship between stress and hypertension is well established, where stress has been shown to contribute substantially to hypertension and increases the risk of developing cardiovascular diseases (CVD). Stress has also been implicated in raising the Systolic blood pressure (the upper figure) and also reducing the supply of oxygen to the heart muscle.
 
It also elevates adrenaline levels (the fight-or-flight hormone) and persistent higher levels of adrenaline in the body (due to stress), can increase the risk of anxiety and depression (yes! In addition to heart diseases).
 
How stress impacts heart functioning can be illustrated by a study where just a 5-minute exposure to small audiences (a stressful situation) can bring measurable changes in the blood pressure levels of patients with existing coronary heart diseases. Additionally, the patients who were most reactive to this stressful situation, were three times more likely to die in the next 5 to 6 years (let’s pay some heed!)
 
Thus, repeated exposure to stress can cause consistent increased levels of blood pressure, which in the long run can take the shape of hypertension. Additionally, stress also increases the risk of having a heart attack, especially work-related stress or similar situations which are highly demanding but the person has little control over them.
 
The key reasons contributing to higher stress levels are very varied and can range form socio-economic factors such as lifestyle, neighbourhood and exposure to violence and discrimination to personal factors such as family issues, job strain, financial problem, etc.
 
It must be highlighted, that your ‘response to stress’ plays an important role in the development of hypertension. The hypertensives are more reactive in their response to stressful situations and this may cause hypertension to progress. Consequently, their higher blood pressure levels recover slower, after their response to a stressful situation as compared to people who do not have hypertension or have no family history of hypertension.
 
Hypertension then may be characterised both by greater reactivity to stress and by slower recovery
and working on your reactions to stressors can play a key role in your heart health.
 

How can Hypertension be treated?

There are many lifestyle changes that can help in controlling hypertension:
• Low sodium Diet
• Reduction of alcohol intake
• Weight reduction in overweight patients 
• Exercise
• Caffeine reduction
• Drug treatment such as diuretics 
• Psychological Interventions such as relaxation, meditation, deep breathing, imagery, self-calming talks, time management and therapy.