HYPERTENSION

Hypertension is a major health problem worldwide. Its attendant morbidity and

mortality complications have a great impact on patient’s quality of life and survival.
Optimizing blood pressure control has been shown to improve overall health outcomes. In
addition to pharmacological therapies, non pharmacological approach such as dietary
modification plays an important role in controlling blood pressure. Many dietary components
such as sodium, potassium, calcium, and magnesium have been studied substantially in the past
decades. In adults aged 18 years and older, hypertension is defined as a systolic blood pressure
(SBP) equal or more than 140mmHg and/or diastolic blood pressure (DBP) equal or more than
90mmHg. It is one of the most common diseases that lead to office visits or hospitalizations
and a major risk factor for stroke, congestive heart failure (CHF), myocardial infarction (MI),
peripheral vascular disease, and overall mortality. Therapeutic options include diet and lifestyle
changes (including weight loss, smoking cessation, and increased physical activity),
antihypertensive drugs, and surgery in special situations. The relationship between sodium
intake and blood pressure changes has been a topic of discussion for decades. Hypertension is
predominantly observed in societies with average sodiumchloride intake >100mmol/day and
very rarein populations consuming <50mmol/day. Patients with an increase in potassium intake
of 1000mg/day had a 0.9mmHg lower SBP and a 0.8mmHg lower DBP. The relationship
between calcium intake and hypertension is a complex and difficult one to isolate largely
because of the interaction with other nutrients in the diets and difficulty in reliably collecting
calcium intake data and important unmeasured confounding variables. magnesium intake only
resulted in a small overall reduction in blood pressure, a mean of −0.6mmHg (95% CI, −2.2 to
1.0mmHg) for SBP and −0.8mm Hg (95% CI, −1.9 to 0.4mmHg) for DBP. Blood pressure was
measured in the non-dominant arm to the nearest 2 mm Hg using a mercury
sphygmomanometer with a cuff of the appropriate size following standard recommended
procedures.
Hypertensive disorders of pregnancy remain leading causes of maternal and perinatal
morbidity and mortality. Hypertension disorders of pregnancy remain a major health issue for
women and their infants in the United States. Preeclampsia, either alone a or superimposed on
preexisting (chronic) hypertension, presents the major risk. Although appropriate prenatal care,
with observation of women for signs of preeclampsia and then delivery to terminate the disoder,
has reduced the number and extent of poor outcomes, serious maternal-fetal morbidity and
mortality still occur. Although the task force has modified some of the component of the
classification, this basic, precise, and practical classification was used, which considers
hypertension during pregnancy in only four categories : 1) preeclampsia-eclampsia, 2) chronic
hypertension (of any cause), 3) chronic hypertension with superimposed preeclampsia, and 4)
gestational hypertension. Chronic hypertension (hypertension predating pregnancy), present
hypertension with systolic BP of 160 mmHg or higher or diastolic BP of 105 mmHg or higher.
Postpartum hypertension it is important to remember that preeclampsia with severe systemic
organ involvement and seizures can first develop in the postpartum period. Because early
hospital discharge from the hospital to be aware of symptoms (eg, severe headache, visual
disturbances, or epigatric pain) that should be reported to a health care provider.
Hypertension was observed to be prevalent in 37.1% of the studied population with an
insignificant gender difference. Rate of occurrence of hypertensives was found to be
significantly higher in type 2 diabetes (51.9%), obese subjects (45.2%), long-term smokers
(49%) and alcohol addicts (48%) than control groups. The risk of development of diabetes was
significantly higher in hypertensives than normotensive. However, when creatinine and blood
urea nitrogen were included in the model, the significance was nul-lified. The incidence of
Type 2 Diabetes (T2D) is increasing globally from 2.8% in 2000 to 4.4% in 2030.
Approximately 70% of diabetics are hyper-tensives, as diabetics are prone to HTN twice more
likely than normoglycemic individuals. The decrease in mean systolic blood pressure by 10
mm/Hg reduces the risks of devel-oping complications in diabetes by 12%, mortality by 15%,
myocardial infraction by 11% and microvascular complications by 13% among diabetics
respectively. The high prevalence rate of T2D and HTN is major con-cerns in Mysore
population. HTN plays a key role in the progression of T2D and is associated with vascular
com-plications. Among hypertensives, BMI, Glycemic index, lipid profile and kidney
dysfunction, markers are poten-tial predictors of T2D. The assessment of nephropathic markers
besides analyzing metabolic components and blood pressure management is better approaches
to pre-vent the risk of development of T2D in hypertensives.
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