TYPES OF HYPERTENSION
THE TYPES OF HYPERTENSION (HIGH BLOOD PRESSURE)
Before we look at the different types of Hypertension, it's worth mentioning the difference between 'having Blood Pressure' and 'having Hypertension'
Everyone has blood pressure. Without pressure, the blood pumping from your heart wouldn't reach your brain and all the organs in your body, when the brain is permanently starved of oxygenated blood, people have around four minutes to live before the brain starts to die.
Blood pressure is measured by two numbers. The accepted blood pressure has a range between 90mmHg/60mmHg and 120mmHg/80mmHg. The first number (120) is called Systolic, it's the measurement of pressure from your heart to maintain a healthy body, the second number (80) is called Diastolic it's the measurement of pressure when your heart is at rest, most times this is shortened to 90/60 & 120/80.
More about blood pressure in other sections.
Caffeine will raise your blood pressure
Blood pressure can increase for various reasons. If you drink a few cups of coffee the caffeine will raise your blood pressure, if you receive some bad news your blood pressure may increase, if you go in the gym and exercise your blood pressure will increase.
The increase in blood pressure is a normal reaction and is not necessarily any cause for concern. In a healthy body your blood pressure will drop after these events to an accepted level.
The increases mentioned above may be caused by adrenaline or moments of stress, more information on adrenaline is in section 26, more on stress in section 19.
Blood pressure goes up and down during the day
People who have blood pressure within the accepted range will still find their blood pressure goes up and down during the day.
However, some people may find their blood pressure is higher in the morning. Lifestyle can have an impact on blood pressure when we wake up, this can be due to the brain releasing hormones into the blood stream while we sleep.
Normally blood pressure returns to accepted levels during the day. It’s the increase in blood pressure and other factors while we sleep and wake in the morning that can cause of a heart attack, it’s been established you’re up to five times more likely to have a heart attack in the morning.
There’s more information about the heart and sleep in sections 6, 21, 25, 20.
Blood pressure becomes a problem when the pressure stays elevated for long periods of time, the medical term for this is called Isolated Systolic Hypertension. So, when you're told you have hypertension it can mean you need to change your life style or take medication.
There are many things that can be a cause of hypertension, I have covered this subject in greater detail in this section, and in the members section.
Apart from high blood pressure some people have low blood pressure, this is called hypotension. This subject and other terms used to define types of hypertension are detailed below.
WHITE COAT HYPERTENSION
WHITE COAT HYPERTENSION is when your blood pressure is taken in a Doctor's Surgery or similar conditions, causing the readings to be inaccurate or misleading. I've seen this scenario first hand. A good friend of mine was in my office and asked about the website I'm writing. He asked if he could check his blood pressure, the readings were 182mmHg/98mmHg with a pulse of 126bpm - he was horrified,
I suggested he should get it checked again. I had a call around an hour later to say he checked it at a local chemist, and it was only 129mmHg/81mmHg with a pulse of 76bpm. He has since checked it again to find it was a similar acceptable reading.
There are different thoughts on this situation. Some Doctors suggest that this should be treated, on the basis that during a typical day the person may also get stressed at work, an argument at home, or similar situation. Other Doctors have the opinion that high readings taken in the surgery could be misleading and possibly lead to people taking unnecessary medication.
It may be an option to purchase a home blood pressure monitor and take readings under different conditions. However, any readings should be discussed with your own doctor before you make any life style decisions.
MASKED HYPERTENSION is a condition totally the opposite to White Coat Hypertension where a reading taken in the Doctors surgery is within normal accepted range and on the face of it requires no treatment. However, if the same person takes their blood pressure at home or place of work etc. the readings can be a lot higher.
This leaves the problem with people who have this condition, thinking that the blood pressure reading in the surgery indicates their blood pressure was controlled. where they will be living with hypertension that may be damaging their heart and other organs.
What is the answer?
Maybe you have a friend who has a home blood measure machine. If you have any concern you should discuss it with your doctor or health professional.
ESSENTIAL HYPERTENSION, also referred to as Primary Hypertension, has no known causes and affects a large proportion of the adult population, and is known to slowly increase blood pressure over many years. I am told there is no cure for Primary Hypertension, however there are things you can do to lower your blood pressure.
Sadly there is no single change that would bring about lower blood pressure, you are unique and require a treatment plan solely dedicated to you. This could include some medication and lifestyle changes. I have put together suggestions, some of which I've tried myself in the members section, but don't necessarily go there straight away, there is plenty of information in other sections on my website that may assist you.
RESISTANT HYPERTENSION is when people have high blood pressure that doesn't respond to medication. Blood pressure that remains high can be a cause of a stroke, and other cardiac complications.
Doctors then look at what can be the cause, sometimes there is an underlying medical condition, possible kidney problems, even hormones can be the culprit of high blood pressure. In addition, your doctor may ask about how well you sleep, a condition known as Sleep Apnea (More about sleep in section 25) can cause blood pressure problems. Other causes such as obesity and smoking may contribute.
I've often heard people saying `I'm stressed out.' This may cause a temporary increase,but if you're continually stressed, it may be something that needs to be managed (More on stress in section 19).
PULMONARY HYPERTENSION relates to the blood pressure measured between your heart and your lungs. The pressure can't be measured in the normal way by putting a cuff around your arm.
If your doctor has cause to check the pressure between heart and lungs, he may suggest you have an echo cardiogram or a medical procedure to insert a probe into your heart. Your doctor will be able to explain if this procedure is relevant to a long term raised blood pressure.
(There is also a new machine, like an electronic blood pressure monitor, this is explained in section 15).
HYPOTENSION: Low Blood Pressure is the opposite to hypertension, people who have a low blood pressure are said to have hypotension, and this term is applied when people have a blood pressure of 90mmHg/60mmHg (90 being systolic pressure, 60 being diastolic pressure).
I have a family member that has hypotension, I've seen first hand where standing in heat for a period, can cause a person to faint.
There are many conditions that can cause low blood pressure. As mentioned, symptoms can include fainting, feeling dizzy, an accident where you lose blood, heart disease that causes a slower than normal pulse, dehydration, the early stages of pregnancy.
Some blood pressure drugs can also lower your blood pressure too far.
Diabetes can lower your blood pressure, especially when suddenly standing up.
Hormone levels are also known to cause low blood pressure; and a blood test can possibly confirm this.
Treatment is available, however this varies from person to person, so you should speak with your doctor who could suggest a course of treatment. Low pressure can affect anyone, no matter what age or gender.
PRE-ECLAMPSIA is divided into two separate groups:
Normotensive is the term used where a pregnant woman who has normal blood pressure may develop pre-eclampsia in the later stages of pregnancy (around 20 weeks from gestation).
The second group covers women who have chronic hypertension, edema and a protein in the urine which has implications on the kidneys (this is medically referred to as proteinuria).
Complications with a pregnancy can be caused by any blood pressure disorder that affects the organs, which in turn supplies blood from the mother to the placenta. As well as chronic hypertension mentioned above, there are several factors that can make someone susceptible to this condition, eg Being over 35 years old, blood pressure problems with a previous pregnancy, having a body mass index BMI in excess of 39 (a healthy BMI number is said to be between 18 and 25).
Checking blood pressure is part of all assessments during a pregnancy, and an obstetrician and midwife continually monitor if blood pressure is high in the later stages of a pregnancy, generally from 20 weeks.
As pre-eclampsia can complicate any pregnancy, any concerns should be discussed with your doctor, obstetrician, midwife, health specialist as soon as possible, to identify options to control blood pressure.
RENOVASCULAR HYPERTENSION affects the kidneys. When the arteries taking blood to the kidneys become restricted due to plaque, it reduces blood supply to the kidneys, which in turn makes the kidneys believe blood pressure is low. To compensate, the kidneys send a message to the brain to release hormones, which tells the body to retain more salt. As you will see, the body then raises blood pressure to ensure the kidneys keep working correctly.
The problem is caused by plaque building up in the arteries taking blood to the kidneys, this can be referred to as atherosclerosis or hardening of the arteries. A similar situation can cause heart attacks when plaque builds up in the arteries around the heart. Cholesterol and life style play a part in the damage.
These conditions and others are covered in the members section suggesting ways to minimise or possibly avoid these dangerous conditions.
PORTAL HYPERTENSION is caused when blood coming from the Pancreas, Intestine and Stomach all merge together, blood then flows through the portal vein into the liver. However if the flow of blood through the liver is restricted, pressure increases causing blood pressure to rise. One of the main causes of this condition is Cirrhosis, the scaring left by this condition is a by-product of the liver trying to heal itself.
There are several tests to identify this condition, one being a blood test looking at white cells and platelets. There are further tests and examinations that a doctor will carry out should they suspect this condition.
MALIGNANT HYPERTENSION is a serious condition when high blood pressure causes "Target Organ Damage".
Damage occurs in the body's main organs that are supplied with blood through the body's circulatory system, due to uncontrolled blood pressure conditions. These organs include the kidneys, brain, heart, eyes, liver, due to uncontrolled blood pressure.
Another cause is the use of illegal drugs, cocaine being a main contender.
The loss of blood due to an accident or other complications that reduce the body's volume of blood may also cause organ damage, medically this is referred to as Hypovolemia.
Malignant hypertension is a very complex subject that needs to be explained in greater detail by a qualified medical practitioner, but I have provided more information in the members section.
REBOUND HYPERTENSION may occur for many reasons.
It can simply mean that a person taking medication for hypertension has made their own decision to change or stop the medication prescribed,or they may think that as their blood pressure has improved, they don't need the medication any longer, or they may be experiencing unpleasant side effects and decided to stop.
The side effects of suddenly stopping blood pressure medication can be extremely dangerous and may lead to resistant hypertension.
A number of specific medications can cause dangerous side effects if stopped suddenly. When blood pressure or other drugs need to be stopped, the doctor will explain how the daily dose will be gradually tapered off.
In general, it is safer to maintain the dose prescribed and if there are reasons a person needs to stop they should discuss this with their doctor or health professional before doing anything.
ACCELERATED HYPERTENSION If not diagnosed or treated, this can be a very serious condition which can be life threatening. As the name implies this condition causes a sudden and quick rise in blood pressure causing possible damage to organs such as the kidneys, brain, liver, blood vessels. It has been said that it has some similarities to malignant hypertension, however it's not quite the same.
It's possible a person's blood pressure reading could rapidly rise to 210mmHg/135mmHg. A very high diastolic figure up to 135 or higher indicates the person needs urgent medical treatment to gradually reduce their blood pressure, followed by tests to determine the cause. As mentioned before this is a complex condition.
OCULAR HYPERTENSION you may be interested to know has nothing to do with blood pressure, Ocular Hypertension is when the pressure of the Vitreous Gel
Vitreous gel fills the space between the lens and the retina of the eyeball of humans. Often referred to as the vitreous humour.
inside the eye is above accepted levels. I've mentioned it as there is a separate condition that relates to the back of the eye.
Vitreous gel fills the space between the lens and the retina of the eyeball of humans. Often referred to as the vitreous humour.