PATIENT ENQUIRY

High Blood Pressure


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What Is?
What is High Blood Pressure
How to Treat High Blood Pressure
Natural Treatments for High Blood Pressure

What is high blood pressure?

High blood pressure or hypertension is a chronic disease wherein the arterial blood pressure is higher than normal. As a result, the heart has to pump harder than usual to circulate blood through the arteries and capillaries, which stresses the arterial walls and speeds up plaque formation.

Blood pressure (BP) is defined by two measurements that reflect the peak of heart muscle contraction, called systolic BP, and the relaxed phase of cardiac contraction, called diastolic BP.

The causes of hypertension are both biomedical and lifestyle oriented. While emotional or physical stress raises blood pressure transiently, diet, alcohol intake, tobacco smoking, and levels of physical activity affect longer-term blood pressure levels. The risk of disease increases as the level of blood pressure increases. A person with hypertension who smokes has a three-fold increased risk for heart attack and stroke.

Irrespective of the cause, persistently elevated blood pressure is a substantial causative factor in the development and progression of atheromatous plaque in the arteries, also called arteriosclerosis. High blood pressure is a major risk factor for coronary heart disease, stroke, heart failure, peripheral vascular disease, and chronic renal failure. Hypertension also results in end-organ damage and can lead to chronic renal failure, retinal damage of the eye, and brain atrophy.

A doctor or nurse can use a sphygmomanometer to measure arterial blood pressure, which is expressed in terms of systolic pressure over diastolic pressure measured in millimetres of mercury (mmHg), for example 110/60.

The normal range is from 100 to 140 mmHg for systolic BP and 60 to 90 mmHg for diastolic BP. Therefore, hypertension is diagnosed if the systolic BP persistently exceeds 140 mmHg or the diastolic BP persistently exceeds 90 mmHg.

High blood pressure is classified as either primary hypertension (essential hyper¬tension), which occurs in 90 to 95% of people with hypertension, or secondary hypertension, which occurs in 5 to 10% of people with hypertension. Secondary hypertension results because of another disease condition, such as chronic renal disease, diabetes, Cushing’s disease or other endocrine disorders.

Secon¬dary hypertension generally presents as a symptom of the primary disease process. However, primary hypertension is typically an asymptomatic disease, until substantial vascular or renal damage has occurred. Primary hypertension is often detected during a routine physical examination when a different medical problem is suspected, or as part of a physical ‘check-up’.

Symptoms associated with high blood pressure

Symptoms associated with high blood pressure

Early symptoms that may be associated with hypertension include:

  • Recurrent headache – generally occipital pain that radiates to the frontal zone, throbbing in quality, present on wakening but influenced by upright posture and stress
  • Recurrent nose bleeds (epistaxis) – associated with moderate to severe hypertension
  • Nocturia – increased frequency of urination due to reduced renal concentrating capacity

If a person suffers with a severe headache, nausea or vomiting, bad headache, confusion, changes in vision, or nosebleeds he or she may have a severe and dangerous form of high blood pressure called malignant hypertension.

Late symptoms occur due to end-organ damage and include symptoms and signs related to cardiovascular disease, cerebrovascular ischaemia and oedema, retinal vascular damage, and renal damage.

Uncontrolled hypertension enhances the arterial functional and pathological changes associated with aging. Over time, atherosclerotic plaques build up along the internal layers of the aorta and other arteries thereby disrupting the wall structure, promoting arterial wall fibrosis and calcification, which accelerates hypertension.

In smaller arteries, arterial wall growth and remodelling is accentuated resulting in media wall thickening, which leads to increased peripheral arterial resistance and increased blood pressure.

Secondary effects, due to impaired circulation control and response, occur in the coronary, cerebral, renal and peripheral arteries leading to ischaemic, hypoxic changes, and tissue metabolic changes. Chief among these are myocardial overload, which leads to cardiac hypertrophy, and pressure-induced changes in the filtering system of the kidneys, leading to slow but progressive loss of glomerular filtration.

Australian facts and statistics for high blood pressure

In Australia, approximately 32% of men over 25 years of age and 27% of women over 25 years of age take medication to regulate arterial blood pressure. A 2005 health study found that hypertension is the most common problem managed by general practitioners and accounted for 6% of all problems under general practice management.

What causes high blood pressure?

What causes high blood pressure?

Essential hypertension is a medical disorder caused by complex interactions between inherited and lifestyle factors.

Some of the factors that contribute to high blood pressure include:

  • Hereditary factors
  • Obesity
  • Lack of exercise
  • A diet high in salt
  • Excess alcohol intake
  • Kidney disease.

The effects of high blood pressure on the arteries are worsened by:

  • Cigarette smoking
  • High levels of saturated fat in the diet
  • High blood cholesterol
  • Diabetes.

Certain drugs can cause hypertension or reduce the efficacy of hypertension medication. Ask your doctor or pharmacist about a more suitable alternative. Medications that affect blood pressure include:

  • The combined contraceptive pill
  • Non-steroidal anti-inflammatory drugs
  • Some nasal drops and sprays
  • Some cough medicines, eye drops, and appetite suppressants.

Genetic inheritance is estimated to contribute only 20-30% to blood pressure variance. This means that having a relative with hypertension leads to a low to moderate risk for hypertension. The incidence of hypertension rises with advancing age, because arteries become more rigid as part of the aging process.

Ethnicity influences the risk of hypertension. In the United States, adult Afro-Americans exhibit a substantially greater prevalence of essential hypertension compared with Caucasians. In the UK, African and Asian communities have the same prevalence of essential hypertension as Caucasians.

In Australia, Aboriginal people returning from an urban to a rural lifestyle exhibit a dramatic fall in blood pressure, associated with decreased weight, improved glucose tolerance, improved blood lipid profiles, and reduced alcohol intake.

Multiple nutritional disturbances can cause essential hypertension. The following dietary scenarios increase a person’s risk for hypertension:

  • High in saturated fat, refined carbohydrate, and alcohol
  • Low in fibre
  • High in salt and low potassium intake
  • Low calcium and magnesium intake
  • Copper deficiency
  • Low antioxidant intake (ascorbate and Vitamin E)
  • Impaired essential fatty balance.

Environmental factors have been reported to influence the development of hypertension. Rural communities show a lower prevalence of essential hypertension compared with urban communities nearby. This difference is attributed to a variety of life-style factors, including lower physical activity and greater life-stress for urban communities, due to higher population density and competition for space.

Other environmental factors that may contribute to hypertension are: lower antioxidant levels (such as ascorbate and Vitamin E) secondary to urban atmospheric pollution, and higher levels of smoking, obesity, alcohol, and prescription and illicit drug use, in order to reduce stress levels and cope with life’s challenges.

Prevalence of high blood pressure

Prevalence of high blood pressure

A marked variation in the prevalence of essential hypertension exists between different countries and between sub-populations within a country. Developed nations show a higher prevalence compared with developing nations, and urban populations show a higher prevalence compared with rural populations.

In developed countries, approximately 50% of people between 60 to 70 years of age have hypertension. Hardening of the arterial walls is a common factor in the aging process and leads to high arterial pressure.

A high-normal blood pressure in a young adult is a good predictor of hypertension later in life. A young adult whose blood pressure lies in the upper range of normal will usually develop hypertension in later years. Individuals with a higher risk for hypertension can be identified as young adults and corrective lifestyle, dietary, and nutritional measures implemented, in order to reduce the chances of significant, future hypertension.

You can play a vital role in managing blood pressure levels and overall health and well-being. Early, simple steps towards a healthier lifestyle choices can improve your chances of enjoying a long, productive life.

How is high blood pressure diagnosed?

How is high blood pressure diagnosed?

A doctor will use a sphygmomanometer to measure a person’s blood pressure several times before confirming a diagnosis of high blood pressure, because blood pressure can vary throughout the day.

A blood pressure reading of 120/80 mmHg is normal and only needs review once a year, or when symptoms appear.

A person with high blood pressure, diabetes, heart disease, or kidney disease requires more frequent blood pressure checks. A person can learn to take blood pressure measurements at home, where appropriate.

Other diagnostic tests for a person suspected of having high blood pressure may include:

  • Blood test to assess cholesterol levels and urinalysis
  • ECG or echocardiogram for heart disease
  • Renal ultrasound or Doppler ultrasound to exclude renal artery narrowing (stenosis).
What are the risk factors for high blood pressure?

What are the risk factors for high blood pressure?

Hypertension and prehypertension are connected to a cluster of risk factors, including abdominal obesity, hyperinsulinemia, insulin resistance, and vascular dysfunction. Several lifestyle options are known to help lower blood pressure and improve other cardiovascular risk factors, but the positive benefits across the population are limited because of inadequate uptake and commitment to lifestyle changes, such as eating healthier foods and giving up bad habits.

Factors that may increase a person’s risk for high blood pressure include:

  • Age – the risk of high blood pressure increases with age
  • Ethnicity – high blood pressure is more common in African-Americans and Aboriginal Australians
  • Family history – high blood pressure tends to run in families
  • Obesity – a high body mass index requires more blood to your tissues and as blood volume increases so does blood pressure.
  • Physically inactive – people who don’t exercise have higher blood pressure and an increased the risk of obesity
  • Smoking – the chemicals released raise blood pressure temporarily and damage artery walls long-term, which leads to high blood pressure
  • Excess dietary salt – too much salt leads to fluid retention, which can increase blood pressure
  • Low dietary potassium – too little potassium leads to an accumulation of sodium, which can increase blood pressure
  • Low vitamin D – may affect an enzyme produced by the kidneys that regulates blood pressure
  • Excess alcohol – can damage the heart and increase blood pressure
  • High stress – can cause a temporary but significant increase in blood pressure
  • High cholesterol, diabetes, kidney disease, and sleep apnoea all can increase blood pressure levels.
How can hypertension be prevented?

How can hypertension be prevented?

Physical exercise
Schedule 30 minutes of moderate-intensity physical activity on at least five days of the week, in periods of at least 10 minutes or longer to promote circulation and fitness. You don’t have to overdo things. Any energetic activity that doesn’t make you breathless, such as brisk walking or cycling, will provide a significant benefit and reduce the risk of hypertension, and in turn kidney and heart disease, and stroke.

Ask your doctor about increasing the intensity of exercise or any new exercise regime, and make sure any increase in intensity is gradual.

Healthy eating
A balanced, nutritious diet is essential in managing high blood pressure and reducing the risk of heart disease and stroke. A person who eats a variety of foods from each of the five food groups will benefit from a lowered risk of hypertension.

Try to include every day:

  • Vegetables
  • Whole grains
  • Lean meats
  • Oily fish
  • Fruit
  • Reduced-fat, low-fat or no-fat dairy products
  • Monounsaturated or polyunsaturated vegetable and seed oils
  • Nuts, seeds, and legumes.

Conventional medical treatments doctors use to treat high blood pressure

Antihypertensive medications

Hypertension is a leading risk factor for preventable cardiovascular disease, with over one in five adults affected worldwide.

In most cases, a person with high blood pressure will need to take antihypertensive medication to keep blood pressure within the normal range. Antihypertensive medication is often gradually increased to determine the best combination and dose to achieve the best blood pressure control. More than one medication is usually needed. Fortunately any side effects are in most cases minimal.

A medical doctor will need to carefully manage antihypertensive medication and check blood pressure regularly to assess the effectiveness of medication. A person taking hypertension medication should not stop or alter medication doses without first discussing this intension with a doctor.

Antihypertensive medication can lower and manage high blood pressure but can’t cure the cause of hypertension. While the dose prescribed may vary over time, in most cases medication needs to be taken for the duration of life.

Many classes of antihypertensive medications have been developed to regulate blood pressure, including thiazide diuretics, ACE inhibitors, calcium channel blockers, beta blockers, and angiotensin II receptor antagonists.

Drug therapy is justified for a person with high pressure at high risk of heart attack and stoke. However, drug therapy should not obviate changes to a healthier lifestyle, including a more nutritious diet and regular exercise.

All classes of antihypertensive drugs have similar efficacy, but some work better than others, depending on individual response. The target blood pressure range might take time to reach and usually more than one drug is required to reach the target.

Secondary hypertension results because of the effects of another medical disorder or medication, so the primary cause requires treatment as well. Secondary hypertension may be due to:

  • Chronic kidney disease
  • Disorders of the adrenal gland, such as a pheochromocytoma tumour or Cushing syndrome
  • Hyperparathyroidism
  • Pregnancy or preeclampsia
  • Medications such as birth control pills, diet pills, some cold medicines, and migraine medicines
  • Renal artery stenosis – narrowing of the artery to the kidney
Medications prescribed to treat hypertension

Medications prescribed to treat hypertension

Drug therapy remains a critical step in preventing and controlling high blood pressure. Doctors have several different types of mediations to choose from to treat hypertension, and usually a combination is trialled and doses refined over time to optimise patient outcomes.

For uncomplicated hypertension, the following classes of antihypertensive agents are equally effective for first-line use, both in initial and maintenance therapy

Angiotensin-converting enzyme (ACE) inhibitors prevent the body making angiotensin II, which causes blood vessels to narrow (vasoconstriction) and raises blood pressure.

Angiotensin II receptor blockers (ARBs) prevent the body from responding to the chemical angiotensin II, which causes blood vessels to narrow and raises blood pressure.

Calcium channel blockers, also called calcium antagonists, disrupt the movement of the mineral calcium through calcium channels. Cardiac output and peripheral arterial resistance determine blood pressure.
Calcium channel blockers affect blood pressure in three ways. First, the smooth muscle layer in the arterial wall relaxes enough to increase the diameter of arteries, which lowers blood pressure without any risk of rupture. Second, the heart muscles (the myocardium) relax just enough to reduce the heart work load and blood pressure, without sacrificing heart function. Third, calcium channel blockers slow the electrical activity within the heart and reduce the heart beat rate, which reduces blood pressure.

Diuretics act on the kidneys to promote the excretion of salt and fluid from the blood in the form of urine, and are often used as the first line of therapy for high blood pressure. If the volume of body fluid is decreased the volume of blood will decrease, which in turn lowers blood pressure.

Antiadrenergic agents, such as beta-blockers and alpha-blockers, affect the sympathetic nervous system by inhibiting the signals of epinephrine and norepinephrine, in order to reduce the number of nerve impulses that occur in the heart. They are used to treat hypertension, and also anxiety, panic disorder, and post-traumatic stress syndrome.

Alpha-blockers, also called alpha-adrenergic antagonists, prevent norepinephrine (noradrenaline) from constricting blood vessels and are used to treat high blood pressure, prostate enlargement and Raynaud’s disease. The relaxation of arteries leads to a slightly wider vessel diameter and lower blood pressure.

Beta-blockers block the action of adrenaline and noradrenaline in the heart. While the pumping action of the heart remains unchanged the heart rate is lowered, the heart muscles require less oxygenated blood, and blood pressure is lowered. Beta-blockers are also used for angina, fast heartbeat and migraine prevention.

Centrally acting antiadrenergic drugs usually are prescribed along with a diuretic when other anti-hypertensive drugs have failed. They lower blood pressure by inhibiting the stimulation of the alpha-adrenergic receptors and decrease sympathetic stimulation to the blood vessels and heart.

Centrally acting antiadrenergic drugs block the release and action of catecholamines (epinephrine, norepinephrine, dopamine), which are hormones the body releases in response to stress. This class of antihypertensive drug has more side effects compared with other types.

Direct vasodilators are used when various multidrug regimens have failed to deliver adequate blood pressure control and should only be prescribed by a hypertension specialist after other antihypertensive treatments have been trialled.

Renin inhibitors are drugs that inhibit the binding of rennin to angiotensinogen – the first step of the rennin-angiotensin-aldosterone system – and prevent the conversion of antiotenongen to angiotensin I and II. As a result, blood vessels relax and dilate (vasodilation), which enables blood to flow more easily through arteries and lowers blood pressure.

Combination medications must be used for effective blood pressure control in hypertensive patients. Fortunately, using a combination of drugs does not exacerbate side effects any higher than using either drug on its own.

Always take medicines according to your doctor’s instructions and do not stop taking them abruptly as this can cause problems.

A person with hypertension should have monthly consultations with a medical doctor after starting drug therapy, until an ideal blood pressure is reached. Diuretics, ACE inhibitors, and ARBs can affect creatinine levels, potassium levels and other electrolytes, and so twice-yearly or yearly blood tests are needed, in order to exclude adverse effects.

Self-help measures for a person with high blood pressure

Self-help measures for a person with high blood pressure

Persistent, uncontrolled hypertension can lead to serious health problems. A person will be more at risk if he or she smokes, is overweight, socially isolated, or physically inactive, or has diabetes, high blood cholesterol, or depression.

Lifestyle changes are very important to help manage high blood pressure and lower the risk of cardiovascular disease. The following recommendations can help control blood pressure:

  • Reduce excess body weight
  • Be physically active
  • Drink alcohol in moderation
  • Quit smoking
  • Reduce stress
  • Decrease dietary salt intake
  • Increase your potassium intake by eating a wide variety of fruit, vegetables, plain unsalted nuts, and legumes.

Physical exercise
Schedule 30 minutes of moderate-intensity physical activity on at least five days of the week, in periods of at least 10 minutes or longer to promote circulation and fitness. You don’t have to overdo things. Any energetic activity that doesn’t make you breathless, such as brisk walking or cycling, will provide a significant benefit and reduce the risk of hypertension, and in turn kidney and heart disease, and stroke.

Meditation and yoga
Stress has been associated with greater cardiovascular risk and stress management such as relaxation therapy can help lower blood pressure. A study of 56 prehypertensive men and women who underwent eight combined meditation and yoga sessions showed significant reduction in systolic blood pressure compared with a second group who attended eight muscle relaxation sessions of a similar duration.

Ask your doctor about any new exercise regime or increasing the intensity, and make sure any increase in intensity is gradual.

Healthy eating
A balanced, nutritious diet is essential in managing high blood pressure and reducing the risk of heart disease and stroke. A person who eats a variety of foods from each of the five food groups will benefit from a lowered risk of hypertension.
Try to include every day:

  • Vegetables
  • Whole grains
  • Lean meats
  • Oily fish
  • Fruit
  • Reduced-fat, low-fat, or no-fat dairy products
  • Monounsaturated or polyunsaturated vegetable and seed oils
  • Nuts, seeds, and legumes.

Reducing the amount of salt in the diet will aid the management of hypertension and could even help prevent hypertension.

  • Choose low-salt or reduced-salt food whenever possible
  • Don’t add salt to food when cooking or before eating
  • Flavour meals with herbs and spices instead of salt
  • Avoid high-salt foods, such as potato crisps or chips, salted nuts, commercial sauces, processed meat, and takeaway foods.

Guidelines by the National Heart Foundation of Australia1 recommend that doctors caring for patients with hypertension should routinely provide advice on smoking, nutrition, alcohol use, physical activity and body weight.

Nutritional medicine treatment for high blood pressure

High blood pressure is a pervasive and devastating health threat to the aging population. Around 30% of the aging population don’t realize their blood pressure levels are above normal. For the nutritional medicine practitioner treating high blood pressure, there are several points of special note.

The most commonly advised nutritional therapeutic inter vention for essential hypertension is to restrict sodium intake and increase potassium intake. This advice is based on the positive association between blood pressure and salt intake and the negative association between blood pressure and potassium intake reported by intercultural epidemiological studies.

However, the most comprehensive and largest of these studies, the Intersalt Study, assessed 10,000 people across 52 different countries and demonstrated only a weak relationship between salt intake and blood pressure, which was partly attributable to variations in body-weight and alcohol intake.

Multiple studies within single countries report little or no correlation between salt intake and blood pressure and people with established essential hyper-tension exhibit no significant variation in salt or potassium intake from normotensive people. In addition, intervention studies have demonstrated that clinically achievable salt restriction in hypertensive patients produces only mild and variable blood pressure reduction that is of questionable clinical significance.

A person can control blood pressure, reduce the risk of heart disease and stroke, and improve the effectiveness of antihypertensive medication by implementing a number of lifestyle changes. In fact, a person with mild hypertension might be able to regulate normal blood pressure simply by making healthier lifestyle choices.

According to the Stroke Foundation, “two out of five people can successfully lower their blood pressure by making adjustments to their lifestyle”. Eating a high-fibre, low-fat, and low-salt diet, exercising regularly, limiting alcohol, maintaining an optimal weight, and quitting smoking have all been shown assist with blood pressure control.

The goals of nutritional medicine treatment of high blood pressure are to prevent hypertension and to control blood pressure in people who have hypertension.

Nutrients and foods that help prevent high blood pressure

Nutrients and foods that help prevent high blood pressure

Potassium
Eating foods rich in potassium will help protect some people from developing high blood pressure. You probably can get enough potassium from your diet, so a supplement isn’t necessary. Many fruits, vegetables, dairy foods, and fish are good sources of potassium.

Calcium and Vitamin D
Research has shown that populations with adequate calcium intake have a lower risk of high blood pressure, so eating an adequate amount of calcium is important. Dairy products such as low-fat milk, yogurt, and cheese are good sources of calcium.

Drinking low-fat milk and milk products will provide both calcium and vitamin D, which are two nutrients that work together to reduce blood pressure. Getting enough calcium and vitamin D is also essential to building strong, dense bones. Vitamin D plays an important role in protecting your bones and enhances the body’s ability to absorb calcium.

Magnesium and potassium
A diet low in magnesium can cause blood pressure to rise. But doctors don’t recommend taking extra magnesium to help prevent high blood pressure. The amount a person derives from eating a healthy diet is usually enough. Magnesium is found in whole grains, green leafy vegetables, nuts, seeds, and dry peas and beans.

Spinach, a popular green salad delight, is low in calories, high in fibre, and packed with potassium, folate, and magnesium, which help lower and control blood pressure levels.

Rich in magnesium, unsalted sunflower seeds can be added to salads and vegetable dishes for an additional nut flavour. Because sunflower seess are high in salt remember to avoid adding any additional salt to meals.

Beans are a cost-effective addition to any diet because of their nutritional benefits and versatility. Black, white, navy, lima, pinto, adzuki, and kidney beans contain soluble fibre, magnesium, and potassium – all of which help lower blood pressure.

Soybeans are another excellent source of potassium and magnesium. Edamame soybeans eaten straight out of the pod are a popular, healthy Japanese snack.

Potatoes contain the minerals magnesium and potassium, which regulate blood pressure. An optimal level of these minerals can help regulate blood pressure. When potassium levels in the body are low, the body retains extra sodium, which raises blood pressure. A potassium-rich diet helps the body to excrete excess sodium. Bananas also provides potassium and are a great choice for snacks when you are out and about.

Fish oils
Essential fatty acids, such as omega-3 fatty acids, are found in mackerel and salmon. These fish oils may help reduce high blood pressure, but their role in preventing hypertension remains unclear.

Garlic
There has been some evidence to suggest garlic’s effect in lowering blood pressure, in addition to improving cholesterol and reducing some cancers.

Dark chocolate
While still undergoing much debate, the concept that eating chocolate could prevent or control hypertension is appealing to chocolate producers and fanciers alike. Several medical studies have found that dark chocolate has a beneficial effect on insulin action and endothelial function.

Researchers in Zurich have proposed that cocoa flavanols and their metabolites, especially epicatechin, lower blood pressure, improve vascular function and insulin sensitivity, are reduce platelet reactivity.

Platelets and leukocytes contribute to arterial thrombosis and to inflammatory processes, and cocoa flavanols have been shown to inhibit platelet aggregation and activation, which thins the blood in a way similar to aspirin. Cocoa flavanols also inhibit leucocyte (white blood cells) activation, which contribute to chronic inflammation.

Co-enzyme Q10

Australian researchers performed a meta analysis of 12 clinical trials that investigated using coenzyme Q10 to treat 362 hypertensive patients. They found that coenzyme Q10 has the potential to lower systolic blood pressure by up to 17 mmHG without significant side effects.

US researchers observed the effects of taking coenzyme Q10 in 109 patients who had essential hypertension for at least one year. Results showed “A definite and gradual improvement in functional status was observed with the concomitant need to gradually decrease antihypertensive drug therapy within the first one to six months”. Patients experienced significantly improved systolic and diastolic blood pressure and half the patients were able to stop taking one to three antihypertensive drugs within four months of starting coenzyme Q10.

Dietary Approaches to Stop Hypertension – DASH eating plan

Dietary Approaches to Stop Hypertension – DASH eating plan

United States researchers supported by the National Heart, Lung, and Blood Institute found that following an eating plan low in salt, saturated fat, cholesterol, red meat, sugar, and total fats that includes fruits, vegetables, low-fat dairy products, whole grains, fish, poultry, and nuts can lower blood pressure. The research led to the development of the Dietary Approaches to Stop Hypertension – DASH eating plan, which is rich in potassium, magnesium, calcium, protein, and fibre.

The DASH eating plan includes heart healthy guidelines to limit saturated fat and cholesterol and focuses on increasing intake of minerals (like potassium, calcium, and magnesium) and nutrient-rich foods, as recommended by the Institute of Medicine.

Glossary

Glossary

Atheromatous plaque – name given to a focal abnormal build-up of cholesterol and other fat-like substances along an artery wall, which may be isolated or extensive

Arteriosclerosis – the process of thickening of walls of medium and large arteries, which leads to hardening and loss of elasticity

Atherosclerosis – a specific form of arteriosclerosis chacterised by a build up of calcium, cholesterol, and triglyceride along internal arterial walls.

Angiotensin Converting Enzyme (ACE) Inhibitors – a medication used to treat high blood pressure by preventing the body making angiotensin II, a chemical that causes blood vessels to narrow and raises blood pressure. ACE inhibitors are also used to treat congestive heart failure, to protect the kidneys in people with diabetes, and to treat people after a heart attack

Arteriosclerosis or atherosclerosis – the build-up of fatty deposits within the arteries, eventually may cause a blockage of blood flow or stiffening of the artery walls.

Beta-blockers – block the effects of adrenaline in various parts of the body including the heart. As a result, the heart doesn’t have to work as hard and blood pressure is lowered.

Calcium channel blockers – slows the movement of calcium into the cells of the heart and the walls of the arteries. As a result the arteries are relaxed and dilate, which reduces the pressure in the blood vessels and makes it easier for the heart to pump blood.

Caucasians race – white-skinned, non-Mongolian population

DASH Diet – Dietary Approaches to Stop Hypertension encourages more daily servings of fruits, vegetables, and whole grain foods aimed at reducing blood pressure, in conjunction with antihypertensive medication.
Diuretic – act on the kidneys to remove excess salt and fluid from the blood through the excretion of urine.

Epistaxis – nose bleeds

Glomerular filtration – process of blood filtration by the kidneys to remove wastes such as urea and ammonium, which are diverted to the urinary bladder.

Hypertensive emergency – a severe elevation in blood pressure that can lead to organ damage, heart attack, kidney damage, arterial rupture, and hemorrhagic stroke.

Hypertensive retinopathy – damage to the blood vessels in the retina (back of the eye) caused by high blood pressure.

Hypertensive urgency – progressive or impending organ damage caused by high blood pressure.

Hypertrophic cardiomyopathy – enlarged and thickened heart muscles, which can lead to abnormal heart rhythm and a failure to pump adequate blood throughout the body.

Myocardium – muscles of the heart responsible for continuous heart contractions

Vasodilation – widening of blood vessels

Vasoconstriction – narrowing of blood vessels