The most prevalent non-communicable, lifestyle-preventable disease in the world, hypertension, is to blame for serious cardiovascular diseases like myocardial infarction (heart attack), heart failure, stroke, and kidney failure. Along with raising mortality and morbidity, hypertension also burdens the patient, their family, and the healthcare system financially. Previously a condition of the wealthy, obese, and old, hypertension today affects people of all socioeconomic classes and ages. In fact, there is enough data to conclude that young individuals are becoming more likely to have hypertension.
The risk of complications increases if the person has other co-morbidities like diabetes, high cholesterol (Dyslipidaemia), and a family history of cardiovascular disease. According to the most recent data from the WHO, 1.28 billion people between the ages of 30 and 79 have hypertension. Despite the fact that only 20% of people with hypertension reach the target blood pressure levels even after starting medication, and despite the fact that 46% of people with hypertension are unaware that they have the condition, hypertension continues to be a leading cause of early mortality worldwide.
Mental health & hypertension
Development of the self, the community, and the economy all depend on mental health. A link exists between hypertension and mental health. Stressful circumstances like anxiety and depression increase the likelihood of developing hypertension and its problems on the one hand, while on the other hand, complications from hypertension cause cognitive impairment and a loss in quality of life. Stress triggers the production of numerous hormones that raise heart rate, damage blood vessels, or constriction that results in hypertension, while the precise mechanism by which stress causes hypertension is not fully known. The risk of hypertension is increased when stress is combined with behavioural issues such as extensive alcohol or caffeine use, smoking, inactivity, and improper food consumption. Blood vessel damage from high blood pressure raises the risk of atherosclerosis, a condition where there is less blood flow to the organs.
Over time, this decrease in blood flow to the brain cells damages the cells, leading to a variety of mental disorders including memory loss (dementia), depression, and other cognitive impairments. Healthy eating habits, regular exercise, and medication are just a few examples of lifestyle changes that help lower blood pressure and prevent stress.
Navigating hypertension treatment
There are two types of treatment for hypertension: pharmaceutical and nonpharmacological. Regardless of the use of pharmaceuticals, non-pharmacological methods like lifestyle change will be the cornerstone of the treatment. Blood pressure can be managed with healthy eating habits, reduced salt and fat intake, frequent exercise, including yoga and meditation, abstinence from alcohol, tobacco, and caffeine. For the treatment of hypertension, a wide range of medications is available, including centrally acting medications such as alpha-blockers, beta-blockers, ACE inhibitors, Ang II receptor blockers, calcium channel blockers, etc. Most medications are safe for use in therapy, and unfavourable reactions or side effects are typically not anticipated. Prior to beginning medicine, one should also take into account the patient’s age, the degree of their hypertension, and any co-morbid conditions they may have, such as diabetes, high cholesterol, heart disease, asthma, and consequences such as heart disease and kidney disease. Patients who have asthma or heart blockages should not use certain antihypertensive drugs such as beta blockers. Leg or pedal edoema is a common side effect of medications like calcium channel blockers but is accepted. Drug withdrawal may be necessary if medications like Angiotensin-converting enzyme inhibitors occasionally produce dry cough. A medication with several advantages is favoured over one with just an antihypertensive impact.
(The author is a Bengaluru-based senior consulting physician.)