The number of hypertension patients is increasing. This is due not only to the increase of elderly persons but also to the fear of hypertention among people. Recently, more people began to consult with their home doctors about hypertention before they get into serious conditons.
Hypertension Is a Silent Killer
The complication of hypertension progresses slowly though there is not subjective symptoms. Occasionally, the patients who suffer from hypertension can be seen among workaholic middle-aged men, who are heavy drinkers and seldom exercise. They often say as follows: “Since I am accustomed to hypertension, I don't have to get a treatment. It' no big deal.” Unfortunately, such persons become cerebral apoplexy, angina pectoris, and myocardial infarct in their fifties. If you do not treat hypertension for a long period of time, it would into serious diseases. Therefore, hypertension is called a silent killer.
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The Standards of Hypertention
The standards of the WHO in 1978 is generally used to diagnose whether a person is hypertension or not. Please use a sphygmomameter to see whether your blood pressure is normal.
| normal blood pressure | if your systolic blood pressure is below than 140mmHg and diastolic blood pressure is less than 90mmHg |
| borderline hypertension | if your systolic blood pressure is 140〜159mmHg and／or diastolic blood pressure is 90〜94mmHg |
| hypertension | if your systolic blood pressure is over 160 mmHg or diastolic blood pressure is over 90 mmHg |
Is your blood pressure normal？
The Variety and the Causes of Hypertention
T. Essential Hypertention
90% of hypertention are essential hypertention, So, essential hypertension means hypertension with no causes. However, it is commonly known that inheritance and the living habitude are main causes which are related with hypertention.
A. About Inheritance
Various studies clearly exemplify that inheritance is one of the factors that causes hypertension. Frequently, children biologically inherit hypertension from their parents. This suggests that having a hypertensive treatment and improving your life style is helpless, meaningless and useless because hypertension is biologically determined. In other words, you must recombine your genes in order to cure hypertension, which sounds impossible.
B. About the Living Habitude
Besides inherritance, the living habitude is one of the factors that causes hypertension. One case shows that many residents who dwell in the district where people take a lot of salt often become hypertension compared with those who live in the area where people do not take much salt. Moreover, the another case illustrates that persons who drink heavily(ie. over 360 ml of Japanese Sake ) tend to become hypertension. So, cutting alcohol and salt will prevent you from suffering hypertension.
Furthermore, one study pointed out interesting data. The study examined many over-weighted hypertensive patients. It found out that the patients' blood pressure fell when the patients' weight decreased and that the blood pressure got lower when they did the exercise continuously. Theses reasons are adequate to reveal the fact that hypertension is called “a living habitude disease.” In fact, it is impossible to recombine genes to cure hypertension. However, changing your living habitude is one of the possible ways to cure hypertension.
U. Secondary Hypertention
It is hypertention which the cause is not become clear. If the causes of hypertension are removed,a patient could be cured. It is said that the kidney disease and the disorder of the hormone could be the causes. 10% of the causes with the hypertention is categorized into these.. You have a possibility of becoming hypertention from following factors：your parents are hypertention；you like salty food；you are overweighted；and you hardly do exercise.
The Risk Factors of Hypertention
There are many risk factors of hypertension：alcohol, cigarettes, diabetes, lack of exercise, overweight and salt.
The Symptoms of Hypertention
The hypertention patients hardly have subjective symptoms： the symptoms of individual patients differentiate in many ways.
For instance, there are persons who feel the symptoms of hypertention although their blood pressure is not very high. On the other hand, some patiens don't feel the symptom even if their blood pressure is very high.
Many hypertension patients with claim the following symptoms：back headache(the heavy feeling of one's head which is lighter than a headache), palpitation(heartbeat), shoulder, stiffness, tinnitus, vertigo, and shortness of breath. However, there are no specific symptoms.
Everybody do have some kinds of posibilities of becoming hypertension.
Be careful, or it will be too late.
The Approaching Complication
Hypertention is the condition that the internal pressure of the artery is always high . Due to the resistance of the pressure, the wall of artery becomes hard and thick, and the load of heart becomes harder, eventually they cause various complications.
●Cerebral Apoplexy(cerebral hemorrhage, cerebral infarction)
●Heart Disease(angina pectoris, myocardial infarction, heart failure)
●Renal Failure
◆What's “The Quartet of Death”
It is rarely not that the hypertention patients complicate with diabetes, hyperlipemia, and overweigh.
For the patient who has these four diseases, the risk of becoming angina pectoris and myocardial infarction is high. Those complications are called “The Quartet Of Death”or“Symdrome X,” and we need special attentions to those symptoms.
For example, one case reports that if a man who is over 60 years old and whose systolic blood pressure is over 160mmHg and total cholesterol is over 300mg／dl, 4 or more out of 10 people would become angina pectoris or myocardial infarction within 10 years.
In order to find out the complication of hypertension, it is of importance to measure your blood pressure and realise how high it is. Furthermore, it is more signifcant to know the exact period of time of being hypertension. To all of you who are not consulting with your home doctor since you are not in a serious condition, I strongly warn you that you are in danger of leading to complication.
Before Beginning to Take the Medicine
Before you start to take antihypertensive medicines, it is more important to improve your daily habitude and life style. In other words, you need to exclude hypertension risk factors since hypertension is a long standing disease, a disease you must get a permanent treatment. Therefore, you must find the best treatment which suits your life style because it is meaningless to treat it contemporary.
●It is said that about 30% of patients' blood pressure fall, if they limit the amount of salt.(This is called “salt dependent hypertension”) Since salt greatly relates to other diseases, it is of importance to limit salt.
At present, the intake quantity of salt of Japanese is the average of 12~13g in a day. However the ideal amount is 7~8g each day.
As a first step, try to take in half the amount of soy sause, Japanese pickles, and umeboshis.
Leave the soup of noodles. It would be more preferable if you stop eating instant food and dining out constantly.
It is impossible and meaningless to limit the intake of salt (2〜3g)extremely.
The key goal is to reduce the intake of salt within each meals.
●The blood pressure drops right after you begin to drink liquor. But, the blood pressure of a person who is drinking habitually becomes higher than that of the one who is not drinking habitually.
One research clearly indicates that the blood pressure of the hypertention patient who has a drinking habit falls if he stops drinking.
Followings are adults' preferable amounts of liquor at one time：about 280 ml of Japanese sake and about 1L of beer.
●Though overweighted persons are not always diagnosed hypertension,it is true that most of them do suffer from hypertension. On the contrary, average weighted persons tend not to become hypertension.
Furthermore, obesity leads to various unexpectable diseases. Therefor, overweighted persons who are diagnosed hypertension should attempt to reduce their weight.
The Standard Weight(KG)＝The Height(M)×The Height(M)×22
If you suffer from hypertension and the measure goes over 15%, I strongly recommend you to start a diet.
●Of all the effective ways to drop the blood pressure, the best way which could be easily managed by individuals is working out. It is an ideal therapy.
The exercise is effective not only for hyperteotion but also, for diabetes, hyperlipemia and obesity.
The exercise therapy will be explained later.
●Nicotine shrinks vessels. As a result, it makes the blood pressure goes high and promotes arteriosclerosis. Therefore, the person with hypertention should stop smoking immediately.
●The others
Stress also raises your blood pressure. Irregular life styles, lack of sleep, irritation, and tiredness cause to feel stress. You should find some good ways to reduce your stress. Finding these tasks is of significance since this will prevent you from becoming hypertension. It seems and sounds very easy, but it is not. Remember, we face many fusses which make us irritate：quarrels with your assistants, bosses, colleagues at work and/or with husband or wife at home；traffic jams and noises； routine works etc. Unfortunately, it is impossible for us to ignore this irritation.
But, wait. Why don't we try not to feel stress by concentrating on other activities which you spiritually enjoy. Let's start to care about our mentality, too. Perhaps, this mental treatment might cure hypertension.
In addition to reducing your stress, you must take care of your body physically. When you go out or take a bath on a cold day, be sure not to cool your body so quickly. Coldness shrinks your vessels and causes to raise your blood pressure since the heart tries to send blood to the tip of your fingers and toes. Also, constipation can cause hypertension, because your blood pressure raises when you put a lot of efforts to cure constipasion. So, eat many fibers and try not to be constipated.
The Standards When you Begin to Take Medicines
It is said that the blood pressure of 20〜30% of the hypertention patients get lower, when they practice “the improvement of the living habitude” (Non Medicinal Therapy)
“Non Medicinal Therapy” is the basis of the hypertention therapy. If the blood pressure don't get lower by “Non Medicinal Therapy” sufficiently, we need to start “Medicinal Therapy”
However, there is no clear standards when to begin to take medicines.
Since it is safe that the period hypertesion lasting is short, you should begin to take medicines within hypertension is slight.
As one standard (from THE JOURNAL OF THE JAPAN MEDICAL ASSOCIATION VOL,116 NO,10 P166)
●Advanced hypertention：if your blood pressure is above 180／110mmHg, you should begin to take medicines immediately.
●Slight or middle hypertention：if your blood pressure is 140〜179／90〜109mmHg, you should do “the improvement of the living habitude” (The Non Medicinal Therapy) first. When the blood pressure doesn't fall enough, even if you have done this for 2~3mouths, you should begin to take medicine.
●If you have the complication and the risk factors, for example the diabetes. And if you have the heart disease, the cerebral apoplexy in your relative.(And if in your relative there are the heart disease, the cerebral apoplexy) You should begin to take medicines, if your blood pressure is more than 140/90mmHg.
●The comparative young patient (less than 30~40 years old) must begin to take medicines positively.
●It needs carefulless to give medicines for the old patient ( 80 years old or older).
The Ideal Blood Pressure
●One's ideal blood pressure should be kept below the measure of 140~150mmHg at systolic and 90mmHg at diastolic.
●If you are aged, or if you complicated with ischemic heart disease or cerebral infarction, it is necessary to take care not to get your blood presssure too low.
The Exercise Therapy for Hypertention
In recent years, many researchers have proved the remarkable usefulness of the exercise therapy, a therapy which is also available for various diseases. Furthermore, medical doctors begin to use the therapy to cure hypertension.
●The Effects of the Exercise Therapy
When you do a light exercise constantly, the pressor substance decreases and depressor substance increases and this will lead the blood pressure to fall gradually. And it is known that a light exercise descrease a load of heart.
When you take medicines, your blood pressure will get higher suddenly, if you stop taking medicines. However, when you do the exercise therapy, your blood pressure will not get higher right away, even if you stop doing the exercise.
Since, the exercise therapy cures hyperlipermia, diabetes, obesity and hypertention, it is the most efficient and important method.
By doing the execise therapy, it is said that the systolic pressure falls to 11mmHg, the diastolic pressure falls to 6mmHg on average.
Therefore, the blood pressure of the borderline hypertention can be expected to falls in some degree by doing the exercise therapy.
●The patient who are allowed to do the exercise therapy
The patient whose systolic perssure is equal to or less than 160mmHg；diastolic pressure is equal to or below 105mmHg.
The patient, who was the advanced hypertention, is able to do the exercise if you are taking medicine and your blood pressure is between the range indicated above.
●The patient who are not allowed to do the exercise therapy
It is dangerous for the patient who has an extremely high blood pressure, angina pectoris, heart failure, the renal failure and the retinal disease, to do this therapy.
Anyway, it is necessary to consult with a doctor beforehand.
●What kinds of exercises should you do?
An aerobic exercise is“an exercise that conditions the heart and lungs by increasing efficient intake of oxygen by body.” This includes walking quickly, swimming, walking in the water.
I believe that walking quickly is the best and easiest way to continue everyday.
On the other hand, a non-aerobic exercise, such as the muscle training, is inefficient, since it raises the blood pressure.
●How much should you exercise?
You should exercise as much as 200~300Kcal at one time. In order to achieve this goal, you need to do aerobic exercises for an hour. Let's do the exercise no less than 1 hour and three or four times in a week. An exercise which gets a pulse 100~120 per a minute is effective.
If you do a walking exercise, you need to take 8000~10000 steps a day.
Attentions for Those who Take Hypotensive Medicines
In recent yaers, researchers and medical doctors put a lot of efforts to improve efficient and safe medicine to cure hypertension. However, there is no medicine with no side effects.
Before you start to take medicines, please consult with your home doctor about your medical history, allergic history and the medicine you take at present.
After you begin to take medicines, if you have any troubles, please consult with your home doctor.
It is significant to take medical examinations periodically in order to check side effects.
It is very dangerous to stop, to cut down or to increase the medicine by self judgment. If you feel any necessity, consult with your home doctor immediately. You nead not to hesitate even though you don't have an appointment.
One case illustrates that persons who take hypotensive medicines irregularly by their judgments tend to become cerebral apoplexy or heart disease compared with those who do not have any treatment at all.
Last
It is very important for patients to have a trustful home doctor, to be consulted, and not to judge their situations by themselves.