Hypertension is called “the silent killer” because it rarely causes symptoms. Experts believe that up to one-third of people with high blood pressure don't know they have it. Some people with hypertension experience occasional headaches; however, headaches are very common and can be caused by various other factors. You are not likely to notice any symptoms until your hypertension becomes severe, which typically takes years. It is important to have your blood pressure checked, even if you don't have any symptoms. If untreated, slowly rising blood pressure can damage your brain, heart, kidneys, or arteries, and could lead to heart attacks, strokes, or kidney failure.
The rare, life-threatening form of hypertension—malignant hypertension—has recognizable symptoms that require immediate treatment Table 01. Symptoms of malignant hypertension may include blurred vision, headache, confusion, anxiety, drowsiness, fatigue, nausea, vomiting, chest pain, shortness of breath, cough, decreased urinary output, and weakness or numbness of the arms, legs, face, or other areas.
Table 1. Symptoms of Malignant Hypertension
Blurred vision Headache Confusion Anxiety Drowsiness Fatigue Nausea Vomiting Chest pain Shortness of breath Cough Decreased urinary output Weakness or numbness of the arms, legs, face, or other areas
Your age and gender influence your risk of developing hypertension. Primary hypertension usually develops between the ages of 35 and 55. If it develops much earlier or later, another underlying medical condition is usually involved. In men, the risk of developing hypertension begins to rise sharply at age 45; for women, the risk escalates at about age 55. Men are more likely than women to have hypertension until age 55, when the ratio reverses. In both sexes, the risk increases with age.
Ethnicity plays a role in your risk for hypertension. African-Americans are at a higher risk for hypertension than people of other ethnicities. In African-Americans, high blood pressure develops earlier, is more severe, and is more likely to damage the organs, leading to conditions such as stroke or renal failure. The rate of hypertension is an estimated 35% among African-Americans, compared with 25% for the U.S. population as a whole. About 20% of the deaths among African-Americans are related to hypertension, a rate that is double that for whites. It is unclear why rates of hypertension are so high among African-Americans, but it is unlikely that the cause is strictly genetic. Some studies have shown that rates of chronic high blood pressure are much lower among rural Africans than in Americans of African descent, suggesting that the prevalence of hypertension may be heavily influenced by a modern, urban lifestyle.
The rate of hypertension among Hispanics is approximately the same as that of white Americans, although some statistics indicate that the rate is higher among Mexican-Americans.
Among Asian-Americans, the rate of high blood pressure is generally lower than that among whites.
Individuals with type 2 diabetes are twice as likely to develop high blood pressure as those who do not have diabetes. About 60% to 65% of individuals with diabetes also have hypertension. Not only is hypertension more common in people suffering from diabetes, but when the two co-exist the risks for uncontrolled blood pressure are more profound. Because of the high risks associated with having both diabetes and hypertension, experts recommend that people with both type 2 diabetes and hypertension maintain a lower blood pressure level (135/80) than what is suggested for individuals who only have hypertension (140/90).
Smoking increases your blood pressure and risk for coronary heart disease. The nicotine that you inhale when you smoke is toxic, and leads to narrowed blood vessels and increased blood pressure. Nicotine also encourages clot formation, which can lead to stroke.
Obesity is a risk factor for hypertension Figure 03. One-third to one-half of all people with hypertension are overweight; even moderate obesity increases your risk of developing high blood pressure. Blood pressure rises as you gain weight and drops if you lose weight.
Figure 03. Body mass index (BMI)
A diet high in salt can increase your blood pressure as you age. You should reduce your salt intake, even if your blood pressure is only moderately above the normal level.
Some scientists believe that primary hypertension is inherited in 30% to 60% of cases. If one or more members of your family have a history of hypertension, you should have your blood pressure checked regularly and take steps to lower your risk.
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