Hypertension is defined as sustained elevation of Blood Pressure (BP) that is >140/90 mmHg. Elevated BP is associated with many unwanted complications of which many are not reversible. Complications of Hypertension are divided into two broad categories. There are Microvascular complications and Macrovascular complications of Hypertension. The organs that High BP damage are called Target organs: these are Kidneys, Heart, Brain and eyes.
Microvascular complications refer to the damage of the small vessels and capillaries in the Target organs. Macrovascular complications on the other hand refer to damage of bigger blood vessels in the Target Organs or elsewhere in the body. Every year a Person with Hypertension is checked if any of the target organs have been damaged. The damage is slow and may take years to progress depending on how high is the BP and genetic vulnerability of an individual. The higher the blood pressure, the faster the damage occurs and the higher the risk for major Macrovascular complication. The bad thing about Hypertension is that a person does not know they have it until it is found incidentally or significant damage has occurred.
The goal of treating Hypertension is to keep BP below 140/90 , this prevent damage of the small blood vessels from starting or progressing.
1. Kidney Damage
High BP causes damage in the kidneys by slowly mainly damaging the capillaries (Microvascular) in the Nephron. This leads to Kidneys becoming leaky to Proteins, glucose and Electrolytes and other important body substances. As the time goes the kidney function deteriorates and the Person suffers Chronic Kidney Disease (CKD). CKD is not curable and gets worse with time. Another sad thing is CKD worsens Hypertension and makes it difficult to control in a Positive feedback loop.
2. Eye Damage
Hypertension damage eyes in two main areas. It causes damage to the small vessels of the Retina (The inner layer of the eyes which receives light and form images), this leads to irreversible condition called Hypertensive Retinopathy. Another complication of Hypertension is increased risk of developing cataract. Cataract is Opacity that happens on the lens of the eyes making it difficult to see. It can be removed by surgery and Artificial lens in inserted on the affected eye to restore vision. Both these conditions are not painful and usually take a few months to years to develop.
3. Brain Complications of Hypertension
The brain is also affected by high BP. The main complication is Stroke, also called Cerebrovascular Accident (CVA). Here a large vessel, due to very high pressure inside it, Ruptures and causes bleeding inside the brain (a Macrovascular complication). This is followed by brain damage on the affected area and loss of function on one side of the body or even Death. It is said that about 50% of people with CVA Die during the attack. Hypertensive Encephalopathy is another complication caused by a very high BP, Usually >180/110. The person is usually confused or may have seizures. It requires urgent treatment before it causes other complications.
4. Heart Damage
The function of the Heart is to pump blood to the lungs and rest of the body in order to transport Nutrients, Oxygen and waste. When the BP is too high the heart struggles to pump effectively and result in Heart Failure, a condition called Hypertensive Heart Disease (HHD). High BP is also associated with increased risk of Myocardial infarction (Heart attack).
Conclusion
Hypertension is a serious Medical condition that needs to be treated as soon as it is discovered. The good news is that it can be controlled with Diet changes and reduction of weight and other lifestyle changes.
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