Hypertension is a condition in which blood pressure in the arteries is persistently elevated. High BP is also a major risk factor for stroke, heart diseases. Lifestyle changes and medications can lower blood pressure and the risk of health conditions. At Medicircle, we are presenting World Hypertension Day Awareness Series wherein we are featuring eminent Cardiologists to create awareness amongst the general population about their preventive action.

Dr. Vanita Arora is the first female electrophysiologist in India. Dr. Vanita is a pioneer female cardiac electrophysiologist in the country. She has received many awards like Rising Star in Cardiology, Woman Doctor Entrepreneur of the Year 2018 along with several other outstanding achievements in her medical career spanning more than two decades, and is currently the Director and Head of Cardiac Electrophysiology Lab and provides services at Max Healthcare Super Speciality Hospital. She has been a distinguished faculty member in several National and reputed international meetings. She is elected secretary of IHS.

Causes of Hypertension 

Dr. Vanita Arora says, “ Starting from basics, what causes hypertension? If you ask this to any layperson, he would say stress is the main cause of hypertension. But talking in medical terms, there are two types of hypertension 

Primary  Secondary 

Aging causes the arteries to thicken. The arteries supplying the blood to other parts of the body become thickened. This causes the lumen to narrow which results in further thickening causing restriction to the flow of the blood. In layman's terms, it's easy to explain the pumping action of the water. The water pipes are laid down in our houses. If the pipe lumen is small, the water will flow with increased pressure. The same goes with the blood flow in arteries. So, this is what happens with age once people start aging, the arteries become thickened. This is the reason behind blood pressure. 

Reversible and Irreversible causes of hypertension

Dr. Arora says, “There are some causes which can be prevented and reversible such as : 

Family history of hypertension  Kidney diseases like pheochromocytoma (tumor of kidney)

In the case of pheochromocytoma, if the tumor is taken care of, the blood pressure reverses back to normal. This results in the opening up of the narrowed renal arteries which solves the problem of hypertension. An angioplasty can be done in this case where a stent is put and the blood pressure comes to normal. To control your blood pressure, you must see your cardiologist. It is important to further analyze it and reverse the cause of hypertension. If you do not have a reversible cause of hypertension, then it is important to take medical therapy and reverse it. 

Diet for hypertension: LOW SALT diet V/s NO SALT diet 

Dr. Arora informs, “Diet is a very important part of hypertension. A balanced diet is key to control hypertension. One should increase the intake of healthy food with green vegetables. Salt intake is very important to control. If you are suffering from hypertension, then you do not need to totally give up on salt. You need to take a LOW SALT diet instead of a NO SALT diet. Avoid the extra salt in the diet. So you need to make sure that the food consumed in the house must be with low salt and there should be no top salt added especially in curd, salads, or pickles. Namkeen like bhujia, bakery products, and pickles contain salt as a preservative. So avoid these foods if you have hypertension.

Losing weight is important for hypertensive patients 

Dr. Arora states, “If you are overweight, you need to lose weight. Emphasize lifestyle. Take a walk. If you cannot run or walk, go to the gym or climb stairs instead of lift. We are in a pandemic confined to our homes. There are a lot of restrictions and limitations. But we must take care of our lifestyle. If you are overweight, losing weight is very important.”

Side effects of the Blood pressure medications 

Dr. Arora informs, “ A tablet of paracetamol also has side effects. However, the medicines for blood pressure are very safe. Safety cannot be 100 % in the world. Blood pressure medicines do not have any major side effects. But, you have to be careful with some patients, especially those who are over 70 years old. Those who are 70 years above may have reduced renal function due to aging. If you have reduced renal function, some kinds of drugs may damage the kidneys further. If you have a pre-existing slow heart rate, there might be some electrical disturbance in the conduction system. This can lead to further slow heart rate in case you are consuming blood pressure medications. So, doctors must be careful while using the blood for the patients. It is important to check the background of the patient. So, do not be scared if you have been taking blood pressure medicines for a long time. Once you start taking the blood pressure medicines, it is for a long time. There is nothing called tolerance of blood pressure medication. If you are well settled with a blood pressure drug, you should not change it.” 

COVID 19 and hypertension connection 

Dr. Arora says, “COVID is a big risk and a very tricky virus. COVID has caused a lot of stress. Blood pressure is increasing because of stress. People are confirmed at home which has resulted in depression, anxiety, and stress. So many of the patients are coming with overshooting blood pressure. Some patients are scared to go to the hospital because they may turn COVID positive. They delay their hospital visits and this results in more problems. So it is a very tricky situation. So I would suggest that please do not stress out. Anxiety is not good. Do not step towards depression. If anything like this is happening, please seek help from your cardiologist or psychotherapist to vent out your feelings, and you will be able to help yourself and your family.”

(Edited by Dr.Rati Parwani)