Features September 2015 Issue

Understand and Prevent Health Complications from Hypertension

Poorly controlled high blood pressure can affect your brain, kidneys and eyes, as well as your blood vessels and heart.

Image: Thinkstock

Getting your high blood pressure under control can do much more than ease the strain on your heart and blood vessels. By not managing hypertension, you run the risk of heart failure, heart disease, stroke, kidney disease, as well as problems related to vision and brain function.

Unfortunately, many people with high blood pressure are unaware of the many potential health complications that can stem from their condition. “Hypertension is generally referred to as the ‘silent killer,’ as no obvious symptoms may be evident until the damage due to hypertension has progressed,” says Cleveland Clinic nephrologist and hypertension expert George Thomas, MD.

While the primary goal of blood pressure control is to reduce the risk of events such as heart attack and stroke, managing hypertension is also necessary to avoid circulation problems throughout the body.

Hypertension, kidneys and eyes

The kidneys play a crucial role in maintaining a healthy circulatory system. The kidneys filter nearly 150 quarts of blood each day, removing wastes, toxins and extra fluid from the bloodstream.

But high blood pressure, over time, can injure the kidneys and make them less effective at filtering blood. Hypertension is actually the second-leading cause of kidney failure in the U.S. after diabetes.

“High blood pressure can be a cause or a consequence of kidney disease,” Dr. Thomas says. “High blood pressure can cause changes in the structure and functioning of the small blood vessels in the kidneys, as well as scarring of the filtering units in the kidneys. This, in turn, affects the filtration function of the kidneys, and if blood pressure remains uncontrolled or poorly controlled, leads to progressive deterioration of kidney function.”

Damage to the tiny blood vessels in the eyes can also result from high blood pressure. This condition is called hypertensive retinopathy.

“Hypertension can cause changes in blood vessels in the eyes,” Dr. Thomas explains. “These changes can range from a narrowing of the blood vessels in the eyes in the early phases, to bleeding spots and swelling of the optic disk within the retina in more severe cases.”

Blood vessel health

Blood pressure is defined as the pressure blood exerts against the inside walls of the arteries. Higher blood pressure then exerts more of a strain on the arteries. This can sometimes result in an aneurysm, which is a bulge in the wall of a blood vessel.

Aneursyms can develop in any blood vessel, but Dr. Thomas says one of the highest-risk areas is the abdominal aorta, a large artery that helps supply blood to most of the body.

“Hypertension also predisposes people to have aortic dissection, a tear in the aorta, which can be life threatening,” he adds.

Better brain health

There’s a strong connection between the heart and brain. A healthy heart and normal blood pressure can help ensure that oxygen-rich blood circulates throughout the brain. But if hypertension causes injury to arteries carrying blood to the brain, the result can be a stroke.

Uncontrolled high blood pressure is also associated with memory problems and difficulty thinking. Dr. Thomas says a large study, SPRINT (Systolic Blood Pressure Intervention Trial), is examining whether getting your systolic blood pressure below 140 mm Hg reduces the risk of cognitive decline, as well as cardiovascular and kidney diseases.

Image: Thinkstock

Home monitoring can help manage your blood pressure.

Know your numbers

Current guidelines define hypertension as a systolic (the top number in your blood pressure reading) pressure of 140 to 159 mm Hg or a diastolic pressure (bottom number) of 90 to 99 mm Hg. Prehypertension is classified as a systolic pressure of 120 to 139 or a diastolic pressure of 80 to 89. Prehypertension is an important diagnosis, because it can be a warning that full hypertension may be in your future if you don’t take steps now to get your blood pressure down to a healthier level.

These numbers, however, need to be looked at on an individual basis, Dr. Thomas says. Older people, for example, may be fine with a higher blood pressure. Individuals with heart disease or diabetes may be advised to reach lower blood pressure levels.

Getting your blood pressure checked at your doctor appointments is important. But you should also consider using a home blood pressure monitor. Even if you’re in good health and have had no elevated blood pressure measurements, it’s worth the time and nominal expense of keeping track of your blood pressure at home.

“Changes in blood vessels begin early in the hypertensive process,” Dr. Thomas says. “These changes progress with persistently high blood pressures. It’s important to know your blood pressure numbers so that hypertension can be diagnosed and managed prior to progressive damage.”

Once you know what your blood pressure should be, it’s up to you to make the necessary lifestyle changes, follow through with doctor appointments, and take your antihypertensive medications faithfully to help keep your blood pressure under control. The better your blood pressure is managed, the greater the chances of preserving the health of your eyes, kidneys, brain, blood vessels and heart.

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