Two Commonly Asked Questions About Hypertension

Hypertension (high blood pressure) is a common health problem and one of the leading cause of morbidity and mortality, throughout the world. Hypertension leads to various cardiovascular complications (such as atherosclerosis, angina, heart attack, stroke, peripheral vascular diseases etc.), which ultimately lead to morbidity and mortality. As hypertension is a common health problem, it is only natural that many people will have various questions regarding the disease, which is leading cause of death.

Question 1: I have blood pressure of 134/88 mm Hg, and my doctor says it is not hypertension, am I at risk?

Systolic blood pressure of 140 mm Hg or more and diastolic blood pressure of 90 mm Hg or more is considered as hypertension. Yes, your doctor is right in telling you that you do not have hypertension, as it is below the defined limit. However, your condition is termed as pre-hypertension and you are at risk of developing hypertension, if you do not take precautions, such as lifestyle changes (such as increasing physical activity and doing regular aerobic exercise), reducing body weight to normal if you are obese or overweight, restriction of salt (sodium) intake and increase in potassium intake etc.

Some recent studies have shown that even at systolic blood pressure of 120 mm Hg, the risk of mortality and morbidity from hypertension related complications increases (in compare to normal subjects). The higher the systolic pressure goes, the greater is the risk. Hence, ideally, even if you have systolic blood pressure of above 120 mm Hg, you should be cautious and take precautionary measures to keep blood pressure under control, to prevent risk of hypertension related morbidity and mortality. Hence, if your BP is 134/88 mm Hg, you need to take preventive measures, such as lifestyle modification, weight reduction, salt restriction etc.

Question 2: which is more important, systolic blood pressure or diastolic blood pressure?

Ideally you should not worry about which is more important, systolic blood pressure or diastolic blood pressure and regard both as enemy to your good health. Both has its importance, and they should not be compared. Systolic BP is due to pressure of pumping out of blood from heart against resistance (peripheral resistance) and diastolic BP is due to filling pressure (when blood enters heart).

Hence, increase in systolic BP indicates that heart has to pump blood against higher resistance (peripheral resistance), which means heart has to work extra hard to pump equal amount of blood (in compare to an individual with normal BP) and with every beat heart is doing extra work. The heart may become enlarged as a result, especially left ventricle, which is directly pumping blood out to the periphery. And, increase in diastolic BP indicates that heart has to work extra hard for pumping in (sucking in) blood or venous return, which indicates heart may be failing. Because returning of venous blood to heart becomes difficult and heart has to work extra and may fail if situation continues for long, which is known as CHF or congestive heart failure. Hence, systolic blood pressure and diastolic BP should not be compared, as increase in any of the pressure is not good for heart.

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