It is important to understand what is hypertension or high blood pressure. Hypertension is “the pressure exerted by the blood on its vessel wall, due to the volume of blood and speed of the blood flow”.
It is actually difficult to determine a cut-off blood pressure (both systolic blood pressure and diastolic blood pressure) above which it can be considered hypertension. That is why, ideally we should consider a blood pressure, above which it put risk of hypertension related medical complications/complications in a significant number of people. In another simple word a blood pressure level above which one is at risk of developing complications (such as cardiovascular, renal, cerebral or brain and other complications) that are seen with individuals with hypertension.
Several studies have shown that systolic blood pressure of more than 115-120 mm of Hg and diastolic blood pressure of more than 80 mm of Hg, increases the risk of hypertensive complications in significant number of people. Therefore, ideally systolic blood pressure should be below 120 mm of Hg. The risks of cardiovascular and other complications of hypertension double with every 20 mm Hg increase in systolic pressure and 10 mm Hg increase in diastolic pressure. Read more…
High blood pressure has profound and serious affects on heart as well as in the vascular system. Hypertension is a risk factor for atherosclerosis (thickening of arteries, mainly due to deposition of cholesterol and other materials on the walls of blood vessels). Hypertension is also risk factor for heart failure, coronary artery disease (CAD), peripheral arterial disease (PAD), stroke, as well as kidney diseases such as renal/kidney failure.
How high blood pressure causes changes in heart?
If you are a patient of high blood pressure (hypertension), the most likely cause of your death is due to heart disease (congestive heart failure, heart attack or myocardial infarction). Hypertension causes structural and functional adaptations which leads to hypertrophy (enlargement) of left ventricle of heart (left ventricle is responsible of pumping of oxygen rich blood to various tissues and body parts), diastolic dysfunction (problem with filling of heart or diastole), congestive heart failure (CHF), as well as abnormalities of blood flow mainly due to changes in the coronary arteries (atherosclerosis) and micro-vascular disease. Read more…
During pregnancy marked physiological changes occurs and for successful and happy outcome of pregnancy the female body has to undergo successful physiological adaptation. If the adaptation process is not perfect or appropriate medical disorders may occur during pregnancy. Some of the medical disorders are fairly common during pregnancy and increase in blood pressure is one such common medical problem during pregnancy.
During pregnancy the cardiac output (which the quantity of blood heart has to pump every minute) increases by approximately 40% and the heart rate or pulse rate increases by approximately 10 beats per minute mainly during the last three months of pregnancy. But despite the increase in heart rate the increase in cardiac output is mainly due to increase in stroke volume, which is the amount of blood heart pumps out in every heart beat.
During second trimester of pregnancy there is reduction in the vascular resistance and there is reduction in blood pressure in normal pregnant women. Blood pressure is the result of cardiac output and degree of vascular resistance and if there is reduction in the vascular resistance, blood pressure falls. That is the reason blood pressure of 140/90 mm of Hg is considered very high during pregnancy (mainly during second trimester), whereas the same pressure is considered only the beginning of high blood pressure in general population. High perinatal (4 weeks before delivery to 4 weeks after delivery is the perinatal period) mortality and morbidity is associated even at blood pressure of 140/90 mm of Hg.
The diagnosis of hypertension (high blood pressure) is different in pregnant women in compare to general population. Blood pressure in a pregnant woman should be checked in sitting position, because if blood pressure is taken in lateral recumbent position, as is the practice in general, blood pressure may be lower than in sitting position. The diagnosis of high blood pressure in pregnant woman requires measurement of at least two elevated blood pressure of at least 6 hours apart. Blood pressure of 140/90 mm of Hg is considered very high blood pressure during pregnancy as generally blood pressure is low during pregnancy due to reduction in vascular resistance. 140/90 mm of Hg is considered only mild hypertension in a normal subject, but in pregnant women the same pressure is considered very high blood pressure.
High blood pressure in pregnancy may cause intrauterine growth retardation, increased perinatal mortality etc. Pregnant women with hypertension are also at risk of development of medical problems like preeclampsia and abruptio placenta. To prevent the complications of hypertension, women with chronic hypertension should be thoroughly evaluated for to identify the remediable causes of hypertension and also to prevent adverse effects of anti hypertensive drugs during pregnancy. Read more…