Hypertension Profile

What is hypertension?

Hypertension is a chronic disease of the cardiovascular system. It manifests when the blood pressure is higher than the normal range. Blood pressure is the pressure exerted by the blood on the walls of the arteries- the major blood vessels of our body which deliver oxygenated blood to the various organs.

The measurement of blood pressure has two elements-diastolic blood pressure and systolic blood pressure. The pressure exerted by blood on the walls of the arteries when the heart is contracting is called systolic blood pressure and the pressure exerted when the heart is in a state of rest is known as diastolic blood pressure. A person is labeled to be hypertensive when on 2 different occasions, his systolic blood pressure is ≥140 mmHg and diastolic pressure is ≥90 mmHg.

What is meant by the term ‘hypertension profile’?

A ‘hypertension profile’ is a battery of blood tests which are carried out in a person suffering from hypertension in order to assess the etiology and effects of this chronic disease on the person’s various organs. The tests commonly performed are-

– Fasting blood sugar (FBS).
– Serum urea.
– Serum creatinine.
– Serum electrolytes.
– Lipid profile (including Total cholesterol, HDL cholesterol, LDL cholesterol, Serum Triglycerides).

Why has my physician asked me to undergo a hypertension profile?

A hypertension profile test is carried out in a person suffering from hypertension in order to-

-Detect end-organ damage- The kidneys and heart are the two organ systems most severely affected by undiagnosed or untreated hypertension.
– Assess the risk probability of developing a cardiac disease.
– Ascertain the cause of hypertension.
– Set up baseline levels for subsequent therapeutic modalities.
– Chart out the treatment plan for hypertension and the end-organ damage if diagnosed.

What are the risk factors for developing hypertension?

The risk factors for developing hypertension can be divided into 2 broad categories.
Modifiable risk factors
– Unhealthy dietary habits- These contain eating oily foods, including trans fats in the diet, consuming too much sodium salts and too little potassium in daily food.
– Sedentary lifestyle.
– Smoking tobacco.
– Excessive consumption of alcohol.
– High level of stress in life.
 
Non-modifiable risk factors
– Age over 65 years.
– Female gender-More pronounced as the age advances (>55). Male gender is more prone below the age of 55 years.
– A family history of hypertension.
– Chronic diseases including diabetes, renal disorders, sleep apnea.
– Race- Africans are at a higher risk of developing hypertension than the general population.

What are the symptoms of hypertension?

Hypertension is mostly asymptomatic and therefore largely under-diagnosed. The disease is aptly referred to as the ‘silent killer’. The symptoms of hypertension manifest when the condition is moderate to severe. The clinical presentation may include-

– Early morning headaches
– Nausea
– Vomiting
– Listlessness
– Dizziness
– Disorientation
– Loss of balance
– Anxiety
– Irregular heartbeat
– Chest pain
– Vision impairment
– Epistaxis (nose bleed)
– Muscle tremors
– Flushing
– Blood spots in eyes

What can be the complications of untreated hypertension?

Uncontrolled hypertension can lead to damage of multiple organs- the heart, kidneys, brain, and eyes bearing the major brunt. The complications can be-

Cardiovascular disorders– These range from pain in the chest (angina) to heart failure. The major reason is the blockage or narrowing of cardiac blood vessels due to atherosclerosis. Ballooning of blood vessels (aneurysm) is also a complication.

Stroke (cerebrovascular accident)– This is due to the narrowing or rupture of an artery supplying blood to the brain.

Hypertensive nephropathy– Kidney damage including renal failure can be a dreaded complication.

Hypertensive retinopathy– This can result in loss of vision.

Loss of memory (dementia)– The narrowing of arteries supplying vital areas of the brain can lead to dementia (Vascular dementia).

How should I prepare for a hypertension profile test?

No specific preparations are required. Inform your physician regarding your medical history and the medicines you may be consuming at the time of the test. Inform your physician if you suffer from a drug allergy. Your physician needs to be told if you suffer from a bleeding disorder or are on blood thinners.

Do I need to fast before undergoing a hypertension profile test?

Yes, you need to fast for 8-12 hours before undergoing this test.

What are the risks involved?

A hypertension profile test is a safe, risk-free and easy to perform the test. But as it is a blood test, it does carry a few risks. The test involves inserting a needle in one of your veins on the arm to withdraw a sample of blood. This might lead to a sensation of a prick or a sting. It can also lead to bruising, bleeding, the formation of a hematoma or an infection at the site of the invasion. Consult your physician if you witness any sign of infection-pus or abscess at the site of prick. When a needle is inserted in your vein, you may also feel dizziness and the sight of blood may unnerve you. It is advisable to look away during this procedure if you are faint-hearted.

Can I undergo a hypertension profile test if I am pregnant?

You can safely undergo a hypertension profile test as this is a safe, easy to perform and risk-free procedure. Pregnant females are at an increased risk of suffering from hypertension and the associated complications.

How is the hypertension profile test performed?

A hypertension profile test is performed as an outpatient procedure. It is a safe, minimally invasive and quick test. No sedation is given. The test can be carried out in a doctor’s office or at a diagnostic center. If you are already admitted to a hospital, this test will be carried out in a hospital setting itself.

The test involves the following simple steps-

– A technician will apply a tourniquet proximally to the site chosen for venipuncture. This makes the veins more prominent, allowing easier access. The area is cleaned with a disinfectant.

– A sterile needle is used to puncture the vein and draw about 5 ml of blood. The pressure is applied to the vein with sterile gauze after the needle is withdrawn.

– A tourniquet is released. The blood sample is collected in a vial. A small bandage is applied over the site from where blood has been drawn.

How long does it take for the test to be performed?

The procedure lasts only 10-15 minutes.

When can I get the results of my hypertension profile test?

You can get the results of the test the very same day.

What do the results of my test convey?

As discussed earlier, the aim of performing a hypertension profile is to assess the etiology, degree of end-organ damage inflicted and chart out a judicious treatment plan.

Fasting blood sugar (FBS)- Fasting blood sugar levels (normal value-100mg/dl) are generally found to be raised in hypertensives, predisposing them to the risk of developing diabetes mellitus.

Serum urea– Due to end-organ damage inflicted by the raised blood pressure on kidneys, the serum urea levels (normal value-5 to 20 mg/dl) can be significantly increased in the hypertensives. The increase is significant with advancing age and chronicity of hypertension. An alternative explanation could be that the altered renal function has led to the genesis of hypertension.

Serum creatinine– High blood pressure is one of the leading causes of renal impairment. The values of serum creatinine (normal value-60 to 110 micromoles per liter) can thus be elevated in the hypertensives-the duration of hypertension playing a vital role. The more the chronicity, the more the damage. The non-functioning kidneys can also be a reason for hypertension to originate in the first place.

Serum electrolytes– Increased level of sodium (normal value-135-145 mmol/L) in the diet is one of the major factors contributing to the genesis of hypertension. In hypertensives, most of the sodium is accumulated in intracellularly. Therefore, blood levels are low. The same is the case with calcium (normal value- 2-2.6 mmol/L) in hypertensive subjects.

A decrease in calcium levels is a significant factor in the origin of hypertension. Serum potassium (normal value- 3.5-5 mmol/L) has a similar scenario. According to some studies, lower levels of serum chloride (normal value-95-105 mmol/L.) are associated with increased mortality in patients with hypertension.

Lipid profile including total cholesterol, HDL cholesterol, LDL cholesterol, Serum Triglycerides– Dyslipidemia is associated with a significant increase in the risk of suffering from cardiovascular and cerebrovascular disorders with a high degree of morbidity and mortality.

What is the global burden of hypertension?

In the last three decades, the number of people suffering from hypertension has gone up globally and so has the associated morbidity and mortality. In a survey conducted in 2010, 1.4 billion people had hypertension globally, accounting for 18 million deaths annually. Cardiovascular disorders were the primary cause of death.

Hypertension is a global public health concern and is largely a preventable disease. It is a silent but giant killer. Interventions as simple as adopting a healthy lifestyle can mitigate the damage that this chronic insidious ailment can inflict.

The endeavor of clinicians worldwide is to keep hypertension under check by trying to keep the systolic blood pressure under 140 mmHg. Early diagnosis and judicious treatment are the cornerstones of keeping this disease in check.