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  • Writer's pictureChristopher Zambakari

Just the ‘Essentials’ on: Essential (Primary) Hypertension

Updated: May 16, 2023

Desert Haven Home Care and Apollo Residential Assisted Living provide residents with high-quality supervision and treatment reflective of what we believe should be the three cornerstones of managed care for seniors: meaningful, patient-centered care, service and advocacy. Our staff and professional healthcare practitioners are knowledgeable and respected servants, familiar with the latest evidence-based research and outcomes. As we continue to provide our residents with best-quality care, service and advocacy, we are sharing with you through our websites these timely and topical insights into issues that impact our elderly loved ones. And, while essential hypertension can be a serious health challenge, there are steps that can be taken to reduce risks and to slow its progress, which are discussed below.

Just the ‘Essentials’ on: Essential (Primary) Hypertension

What is essential hypertension?


High blood pressure without an obvious secondary cause is called essential hypertension. It is also termed primary hypertension. Blood pressure is the force exerted by your blood against your blood vessels when the heart pumps blood throughout the body. When the force of the blood is greater than normal, it creates the condition of hypertension.


Most cases of hypertension are cases of essential hypertension.[1] Individuals having essential hypertension do not exhibit identifiable causes such as kidney disease. Secondary hypertension is the other type of hypertension, and this is when an obvious cause of the high blood pressure can be identified. Such causes include renovascular disease, renal failure, pheochromocytoma, aldosteronism and others.


Are there risk factors associated with essential hypertension?


Research shows that genetic factors play an important role in essential hypertension.[2] Apart from genetics, these are some of the factors that can increase your risk of developing essential hypertension:

● Stress

● Diet

● Aging

● Sedentary lifestyle

● Increased salt intake

● Obesity

● Race or ethnicity


What are the signs and symptoms of essential hypertension?


People may not notice any signs or symptoms of essential hypertension. Essential hypertension is often discovered quite by accident – often during a regular medical checkup. Essential hypertension can occur at any age. However, it mostly affects middle-age populations.


Symptoms of high blood pressure include:


● Headache.

● Blurred vision.

● Dizziness.


It is important to note, as stated above, that these symptoms appear typically only at exceptionally high levels of blood pressure.


How will I know if I have essential hypertension?


Having your blood pressure checked regularly is the best way to screen for essential hypertension. Your blood pressure can go up or down throughout the day. It also changes during exercise, rest, stress or at a time when you are experiencing a physically painful condition. Occasional high blood pressure doesn’t mean you are experiencing essential hypertension. Diagnosis of essential hypertension cannot be confirmed until your blood pressure shows two to three high readings at different times.


The standard blood pressure reading is 120/80 mmHg. The first number denotes systolic pressure, which shows the amount of force being exerted on the vessel walls when the heart pumps blood. The second number means diastolic pressure, which depicts the amount of force being exerted on the vessel walls between beats of the heart. Blood pressure between 120 and 139 is normal, but not optimum. Hypertension occurs when systolic pressure rises to 140 or more. Diastolic blood pressure readings between 80 and 89 are considered normal, but not optimum. A diastolic blood pressure of 90 or more indicates hypertension. These values are used as a general guide. However, the thresholds for healthy and hypertensive blood pressure criteria can vary between countries.


Blood pressure of 140/90 mmHg or more requires medical treatment. High blood pressure can cause your blood vessels to leak or burst.[3] This is what leads to stroke. High blood pressure is one of the main causes of strokes.


Essential hypertension diagnosis


Essential hypertension is diagnosed by taking multiple blood pressure readings over time. These measurements are taken using a blood pressure monitor – a sphygmomanometer or an aneroid device.


Measuring blood pressure is the basic part of a regular checkup. It is normally carried out as a part of a normal medical examination. Certain conditions such as anger, stress or exercise can temporarily raise blood pressure. Therefore, it is important to take multiple readings at different times. Sometimes, doctors may even advise you to take at least one or two blood pressure readings at home.[4] Doctors do this to minimize the stress factor associated with a clinic or hospital setting. Consistently high blood pressure on multiple occasions would most likely confirm the diagnosis of essential hypertension.


Treatment of essential hypertension


Treating essential hypertension and any other hypertension condition begins with lifestyle modifications. Doctors may recommend many lifestyle changes to manage high blood pressure[5]. These lifestyle changes usually are:


  • Consuming a healthy diet not containing too many fats.

  • Eating fresh fruits and vegetables.

  • Exercising regularly.

  • Reducing body weight.

  • Adopting certain stress-relieving strategies such as meditation, yoga, etc.

  • Minimizing alcohol consumption.

  • Quitting smoking.

  • Reduction of salts in the diet.

  • Minimizing consumption of processed food or cheeses.


If lifestyle changes do not lower blood pressure levels, your doctor will assess your condition and formulate a personalized treatment plan. This treatment plan may consist of certain medications in specific doses. Commonly prescribed antihypertensive medications are:


  • Beta-blockers,[6] such as propranolol.

  • Diuretics, such as thiazide diuretics.

  • Calcium channel blockers, such as amlodipine.[7]

  • Angiotensin-converting enzyme (ACE) inhibitors, such as captopril.

  • Angiotensin II receptor blockers (ARBs), such as losartan.

  • Renin inhibitors, such as aliskiren.


These medications are highly effective in managing blood pressure. A combination of lifestyle changes and specially prescribed medicines can contribute to a healthier life free from the worry of high blood pressure and its consequences.


Essential hypertension prognosis


There is a good chance people with essential hypertension will realize lower blood pressure by adopting healthier lifestyles and following the advice of medical professionals. Lifestyle modifications are not quick fixes, but rather require a long-term commitment. With a healthier lifestyle often comes the reduction of medications or even the removal of such prescriptions. However, many patients with essential hypertension have to use medicine regularly during the course of their lives.


What complications can arise if essential hypertension is not managed?


Left untreated, essential hypertension can lead to many serious complications. One of the major problems that arises is the consistently high force being exerted on the blood vessels throughout the body. These Some of the serious complications arising from essential hypertension are:


  • Stroke.

  • Atherosclerosis.

  • Heart failure.

  • Heart attack.

  • Blindness.

  • Kidney .

  • Nerve damage.

  • Anxiety.[8]


Meanwhile, essential hypertension in pregnant women can be more dangerous.[9] It can cause the following complications:


  • Preeclampsia

  • Intrauterine growth restriction.

  • Premature birth.

  • Stillbirth.

  • Placental abruption.


The importance of patient advocacy


Tulane University’s School of Public Health and Tropical Medicine notes, “Healthcare advocates give patients and their families direct, customized assistance in navigating the healthcare system.”[10] Patient advocacy, therefore is a critical ingredient in managed-care assisted living environments like Desert Haven Home Care and Apollo Residential Assisted Living; it is a cornerstone of our pledge to our residents, their families and loved ones: Care. Service. Advocacy.


Patient advocacy and the positive, necessary role it can play in rehabilitation and quality of life matters, is often overlooked.

The many layers in today’s healthcare system have created a real need for several types of healthcare advocacy, although such advocacy and the positive, necessary role it can play in rehabilitation and quality of life matters, is often overlooked. In fact, a Harvard Business Review analysis found that 52 percent of patients in the U.S. cannot navigate the healthcare system’s complexity without help.[11] Without the worries of fighting your way through the healthcare system, you are able to focus more completely on your well-being and your management and treatment necessities, knowing that an advocate is working on your behalf with your medical team, healthcare agencies and companies; monitoring and confirming medication needs, arranging for targeted care that addresses specific challenges; and more.


Takeaway:


If you feel like you have high blood pressure, it’s time to visit your doctor. Apart from this, you should maintain a routine for regular medical checkups. If you have been diagnosed with essential hypertension, it is important you pursue a healthier lifestyle and follow the advice of your doctor.



Disclaimer


The material presented on this blog does not constitute medical advice. We encourage you to consult your primary care physician. The statements on this blog are not intended to diagnose, treat, cure or prevent any disease. Always consult your personal physician for specific medical advice. If you or your loved one is considering the benefits of quality assisted living, please contact us at 602-670-9326, or email us at info@deserthavenaz.com.


About the authors

Dr. Christopher Zambakari, B.S., MBA, M.I.S., LP.D.

Dr. Zambakari is the owner and operator of Desert Haven Home Care in Phoenix and Apollo Assisted Living in Glendale. A recognized leader in managed-care assisted living advocacy on behalf of the elderly, Zambakari provides experienced direction and oversight to ensure the care facilities provide the highest levels of customized care, administered by respectful licensed medical and caregiving professionals.


Nathalia Zambakari, Board Certified AGACNP-BC

Nathalia Zambakari is a board-certified Acute Care Nurse Practitioner and a licensed medical professional responsible for short-term care patients suffering from severe conditions. As part of the Desert Haven/Apollo care team, she reviews the medical records of incoming residents, helping the professional staff to manage patient regimens. She leads evidence-based caregiver education to ensure the best care possible for the Desert Haven and Apollo residential communities’ residents.



[1] Bolívar JJ. “Essential hypertension: an approach to its etiology and neurogenic pathophysiology.” Int J Hypertens. 2013;2013:547809. doi:10.1155/2013/547809 [2] Natekar A, Olds RL, Lau MW, Min K, Imoto K, Slavin TP. “Elevated blood pressure: Our family's fault? The genetics of essential hypertension.” World J Cardiol. 2014;6(5):327-337. doi:10.4330/wjc.v6.i5.327 [3] Ciszek B, Cieślicki K, Krajewski P, Piechnik SK. Critical pressure for arterial wall rupture in major human cerebral arteries. Stroke. 2013;44(11):3226-3228. doi:10.1161/STROKEAHA.113.002370 [4] Ogedegbe G, Pickering T. “Principles and techniques of blood pressure measurement.” Cardiol Clin. 2010;28(4):571-586. doi:10.1016/j.ccl.2010.07.006. [5] Nicoll R, Henein MY. “Hypertension and lifestyle modification: how useful are the guidelines?” Br J Gen Pract. 2010;60(581):879-880. doi:10.3399/bjgp10X544014. [6] Stumpe KO, Overlack O. “Diuretics, beta-blockers or both as treatment for essential hypertension.” Br J Clin Pharmacol. 1979;7 Suppl 2(Suppl 2):189S-197S. doi:10.1111/j.1365-2125.1979.tb04690.x. [7] Fares H, DiNicolantonio JJ, O'Keefe JH, Lavie CJ. “Amlodipine in hypertension: a first-line agent with efficacy for improving blood pressure and patient outcomes.” Open Heart. 2016;3(2):e000473. Published 2016 Sep 28. doi:10.1136/openhrt-2016-000473. [8] Pan Y, Cai W, Cheng Q, Dong W, An T, Yan J. “Association between anxiety and hypertension: a systematic review and meta-analysis of epidemiological studies.” Neuropsychiatr Dis Treat. 2015;11:1121-1130. Published 2015 Apr 22. doi:10.2147/NDT.S77710. [9] Lindheimer MD. “Hypertension in pregnancy.” Hypertension. 1993;22(1):127-137. doi:10.1161/01.hyp.22.1.127. [10] Tulane University School of Public Health and Tropical Medicine. "Why Healthcare Advocacy is Important." March 1, 2021. https://publichealth.tulane.edu/blog/healthcare-advocacy/ (accessed June 21, 2021). [11] Ibid

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