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Blood pressure is the pressure of blood circulating against the walls of the vessels. Normal blood pressure in an adult is 120 millimeters of mercury systolic and 80 millimeters of mercury diastolic. Blood pressure is of two types - High blood pressure - Low blood pressure High Blood Pressure Definition High blood pressure can be defined as the condition in which the force exerted by the blood circulating on your arteries is so high that it may cause health problems like several heart conditions. It means that more your heart pumps the blood the narrower the arteries and higher the blood pressure. Blood pressure is generally determined by the amount of blood your heart pumps and the amount of resistance to blood flow in the arteries Symptoms of High Blood Pressure Majority of people suffering from high blood pressure does not have any significant signs or symptoms even if the blood pressure level has reached at an alarming level. The symptoms of high blood pressure in men and women are quite similar. Although a few people suffering from high blood pressure will have symptoms like headaches, shortness of breath, nosebleeds etc. but these symptoms are not very significant and may not occur until the blood pressure has reached life threatening level Some inconclusive symptoms of high blood pressure which are not always caused by high blood pressure are as follows- - Blood spot in the eyes- some people may have blood spots in the eyes but it is not necessary that they are caused by high blood pressure but doctors check these symptoms in order to identify the nerve damage - Facial flushing- facial flushing generally occurs when the blood vessels in the face becomes wider or dilate. It can occur unpredictably or due to certain conditions like exposure to sun, cold weather, spicy food, emotional stress, consumption of alcohol etc. - Dizziness is generally not caused by high blood pressure but dizziness should not be ignored as sudden dizziness, loss of coordination or balance difficulty in walking are all the signs of a stroke and high blood pressure is one of the major reason for causes of heart stroke High Blood Pressure Causes The causes of high blood pressure is divided into 2 categories - Essential high blood pressure - Secondary high blood pressure Although there are no identifiable causes for essential high blood pressure but there is a strong linkage with some risk factors which results in developing the condition The causes mentioned below are the risk factors associated with essential high blood pressure but some of them are also associated with secondary high blood pressure - Age- as a person gets older there are more chances of him getting affected by high blood pressure - Family history- if any of your close family members are suffering from hypertension then according to the researchers you have a significantly higher chances of getting affected by hypertension. - Temperature- temperature also plays an important role in hypertension. According to researchers the level of blood pressure was lower when it was warmer and was higher when it was cold. - Ethnicity- researchers have found evidence that people with south Asian or African ancestry are more likely to get affected more as compared to people with Caucasian or Amerindian ancestry - Obesity- people who are overweight are more likely to get affected by the disease as compared to people with normal weight - Gender- in general high blood pressure is more common in adult men than adult women but after the age of 60 both men and women are exposed to the risk of getting affected by hypertension equally - Lack of physical labour- lack of physical exercise or physical inactivity increases the risk of getting affected by hypertension so that’s why it is very important to exercise daily and maintain body weight as increasing body weight is one of the major reasons of getting affected by no’s of diseases. - Smoking- smoking causes our blood vessels to get narrower thus increasing the blood pressure rapidly also it reduces the amount of oxygen so in order to compensate that our heart needs to pump more blood thus increasing the blood pressure. - Alcohol intake –doctors have found that people who consume alcohol have higher systolic blood pressure as compared to people who do not consume alcohol. The researchers have found out that the people who consume alcohol have about 7 millimetre higher systolic blood pressure as compared to the people who do not drink - High salt consumption- people who consume a lot of salt in there food are more likely to have higher blood pressure than people who have lesser consumption of salt - Fatty diet- according to several health professionals the people who consume food full of fat are more likely to get affected by hypertension as compared to other people. Basically it does not depends upon the quantity of fat you are consuming but which type of fat you are consuming for e.g. fats which comes from fruits nuts etc. are good fats but saturated fats and trans fats which comes from animal source food are not good for health. - Stress- mental stress is also one of the major reasons of developing high blood pressure, doctors have found out that long term stress is majorly responsible for getting affected by high blood pressure - Diabetes- people suffering from diabetes are at a higher risk of getting affected by high blood pressure. If blood sugar is controlled by insulin or any other methods then it reduces the risk of getting affected by high blood pressure in long term. - Psoriasis- it is a condition of immune system that appears on the skin in the form of red thick scaly patches. Researchers carried out a study on 78000 women suffering from psoriasis have a higher risk of getting affected by high blood pressure - Pregnancy- pregnant women are more likely to get affected by high blood pressure as compared to the women’s who are not pregnant Some of the complications faced by the people due to high blood pressure are - High blood pressure can sometimes cause thickening of the arteries which results in nos of heart related problems like heart stroke or other complications - Very high blood pressure can cause blood vessels to swell causing aneurysm which when ruptured can be life threating - Very high blood pressure can cause blood vessels in your eyes to swell or thickened up which results in vision problems - Very high blood pressure can affects a person’s ability to remember or learn i.e. a person is not able to understand the concepts easily Symptoms of High Blood Pressure During Pregnancy There are actually different types of blood pressure which prevail during pregnancy They are divided into 4 categories. - Gestational hypertension- women who suffer from gestational high blood pressure that develops after 20 weeks of pregnancy. Researchers believe that women who suffer from gestational high blood pressure can eventually develop preeclampsia. - Chronic hypertension- chronic high blood pressure is generally present before pregnancy or develops before 20 weeks of pregnancy but high blood pressure generally doesn’t show any signs or symptoms, therefore, it is difficult to identify when it started - Chronic hypertension along with superimposed preeclampsia- this is a condition in which women suffering from chronic high blood pressure develops other blood pressure related complications like protein in the urine etc. - Preeclampsia- preeclampsia is a condition which prevails after 20 weeks of pregnancy and is linked with damage of other organs like brain, liver, kidneys etc. preeclampsia can be life threatening for both the mother and the baby if left untreated Some of the risks imposed by high blood pressure during pregnancy are as follows- - Blood flow to the placenta is decreased- due to high blood pressure the blood flow to the placenta is decreased which results in that your baby will receive less oxygen and nutrients which relates several complications like premature birth, breathing complications and chances of getting affected easily - Placental abruption- due to preeclampsia a condition which develops after 20 weeks of pregnancy can cause your placenta to separate itself from the inner walls of the uterus. Sometimes it can cause complications such as heavy bleeding which is life threatening for both the mother and child - Slow growth of the baby- sometimes high blood pressure results in slow or restricted growth of your baby - Injury to organs- high blood pressure can result in damaging your different organs like lungs, liver, brain, kidney etc. if this condition gets worse it can be life threatening and damage your major organs - Premature delivery- sometimes high blood pressure results in premature delivery of the baby which can further impose complications like getting affected by the infections very easily - Heart diseases- having preeclampsia can increase the risk of getting affected by various heart disease, like heart stroke, heart attack or various other complications. Some of the signs and symptoms of preeclampsia besides high blood pressure are as follows- - Excess protein in the urine or other related renal problems - Nausea or vomiting - Liver function disrupted - Shortness of breath - Levels of platelets decrease - Upper abdominal pain generally on the side of the ribs - Changes in vision or sometimes loss of vision - Sudden weigh gained or swelling in your face and hands can also be the signs of preeclampsia Some of the methods by which you can reduce the risk of the complications caused by high blood pressure are- - Visit your doctor or health care clinic on a regular basis during your pregnancy - Take your medication as prescribed it will help you to control your blood pressure - Stay active- remain active don’t be lazy and lethargic and follow your doctors advice on physical mobility - Know what’s of limits- avoid smoking or consumption of alcohol or intake of illicit drugs which can cause severe complications High Blood Pressure Diet Some of the foods that will help you to control your blood pressure are as follows- - Green leafy vegetables which are rich in potassium should be consumed as potassium because potassium helps in reducing sodium level in your kidneys through your urine which in turns lower your blood pressure - Some of the vegetables which are rich in potassium are as follows - Kale - Romaine lettuce - Turnip greens - Collard greens - Spinach etc. - Berries- these fruits are especially rich in flavonoids thus researchers have found out that consuming these compounds lower the chances of getting affected by high blood pressure or control it if you are already suffering from it - Beetroot- beetroots are rich in nitric oxide which helps in lowering blood pressure by opening your blood vessels - Skimmed milk- skimmed milk is rich in calcium and low in fat which is the appropriately correct diet for lowering blood pressure. If you don’t like skimmed milk than you can also choose yogurt it also helps in reducing blood pressure - Oat meals- oatmeals are excellent source for high fiber and low fat thus it helps in reducing the blood pressure - Bananas- eating bananas can reduce your blood pressure as bananas are a rich source of potassium - Salmon or fish with omega-3s should be consumed to lower the blood pressure and on the other hand fish are also rich in vitamin d which helps in lowering the blood pressure - Garlic and herbs- garlic is rich in nitric oxide which helps in lowering blood pressure - Dark chocolate- researchers have found out that eating 100 gms of dark chocolate every day reduces the risk of getting affected by cardiovascular diseases thus it helps in reducing blood pressure - Pistachios- pistachios are very healthy and help in reducing or lowering the blood pressure - Olive oil- olive oil contains polyphenols which helps in lowering the blood pressure - Pomegranate is another fruit which helps in lowering blood pressure for a short tem High Blood Pressure Chart/Range High Blood Pressure- Causes, Symptoms
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डा. कमल शर्मा लम्साल फिजिसियन तथा मुटुरोग विशेषज्ञ, सिभिल अस्पताल शरीरका सम्पूर्ण अंगमा रक्तसञ्चार गर्नका लागि मुटुले निरन्तर पम्पको काम गरिरहेको हुन्छ । मुटु खुम्चिँदा शरीरका विभिन्न अंगमा शुद्ध रगतको सञ्चार हुन्छ । मुटु फुक्दा शरीरका विभिन्न अंगबाट आएको अशुद्ध रगत मुटुमा जम्मा हुन्छ । मुटुमा यसरी जम्मा हुन आएको रगत अर्कोपटक मुटु खुम्चिँदा रक्तनलीहरुमार्फत अगाडि बढ्छ । चिकित्सकीय भाषामा मुटु खुम्चिने प्रक्रियालाई सिस्टोल र फुक्ने प्रक्रियालाई डायस्टोल भनिन्छ । समग्रमा मुटुमा हुने सिस्टोलिक र डायस्टोलको निरन्तर प्रक्रियाले समस्त शरीरमा रक्तप्रवाह गराइरहन्छ । रक्तनलीमार्फत रक्तसञ्चार हुँदा उत्पन्न हुने विशेष किसिमको दबाबलाई नै रक्तचाप भनिन्छ । मुटु खुम्चिएको समयमा मुटुबाट वेगसाथ निस्केको रगतले रक्तनलीमा दिएको चापलाई सिस्टोलिक रक्तचाप भनिन्छ भने मुटु एकैचोटी धड्किसकेपछि फुकेको अवस्थाको चापलाई डायस्टोलिक रक्तचाप भनिन्छ । साधारणतया स्वस्थ व्यक्तिको रक्तचाप औसतमा १२०÷८० मिमि हुन्छ । माथिको अंकलाई सिस्टोलिक रक्तचाप तथा तलको अंकलाई डायस्टोलिक रक्तचाप भनिन्छ । सामान्यतया सिस्टोलिक वा माथिको प्रेसर १२० मि.मि. र डायल्टोलिक वा तलको ८० मि.मि. सम्म हुनु सबैभन्दा राम्रो हो । उच्च रक्तचाप साइलेन्ट किलर उच्च रक्तचापलाई मेडिकल भाषामा हाइपरटेन्सन भनिन्छ । जसको शाब्दिक अर्थ मुटु तथा रक्तनलीहरुमा दबाब बढ्नु हो । विश्वस्वास्थ्य संगठनले उच्च रक्तचापलाई सुषुप्त हत्यारा अर्थात् साइलेन्ट किलरको संज्ञा दिएको छ । उच्च रक्तचापले तत्कालै कुनै ठूलै असर पार्ने सम्भावना कम भए पनि लामो समयको अन्तरालपछि मानिसलाई बिस्तारै रोगी बनाउँदै मृत्युशै्यामा पु¥याइरहेको हुन्छ । उमेर बढ्दै जाँदा उच्च रक्तचापको खतरा पनि क्रमिक रुपले बढ्दै जान्छ । उच्च रक्तचाप महिला पुरुष दुवैमा हुन्छ । सामान्य भाषामा भन्दा माथिको प्रेसर १४० वा सोभन्दा बढी र तलको ९० वा सोभन्दा बढी हुनुलाई उच्च रक्तचाप भनिन्छ । उच्च रक्तचापका लक्षण सामान्यतया उच्च रक्तचापका बिरामीमा कुनै लक्षण नदेखिन पनि सक्छन् । कुनै व्यक्तिमा एक वा बढी लक्षण हुन्छन् भने कोहीमा केही पनि लक्षण नहुन सक्छ । कसैलाई अत्यधिक रक्तचाप तथा त्यसको जटिलताले बेहोस नै हुन सक्ने भएकाले लक्षणमा एकैनाशको निश्चितता हुँदैन । उच्च रक्तचापका मुख्य लक्षणमा विशेषगरी टाउकोको पछाडिको भागमा दुख्ने, वाकवाकी लाग्ने तथा बान्ता हुने हुन्छ । रिंगटा लागेर हुत्तिने, शरीरले हलुंगोपना महसुस गर्ने, आँखाको दृष्टिमा परिवर्तन भई धमिलो देख्ने लक्षण हुन्छ । कुनै काम नगरे पनि थकाइको महसुस हुने र कमजोरी अनुभव हुन्छ । श्वास लिन गाह्रो हुने, मुटुको ढुकढुकी अनियमित हुने,थोरै परिश्रम गर्दा पनि धेरै पसिना आउने उच्च रक्तचापको लक्षण हुन् । यौन चाहना कम हुने, नाथ्री फुटेर नाकबाट रगत आउने, खुट्टा तथा अनुहार सुन्निने, रातो हुने लगायतको उच्च रक्तचापका लक्षण हुन्छन् । रक्तचाप धेरै नै बढी भएपछि रक्तनलीहरु बढी तन्किएर फुट्न सक्छ । मस्तिष्कभित्रको रक्तनली फुटे पक्षघात हुन्छ । मुटुको रक्तनली बन्द भए हृदयाघात हुन्छ । आँखाको रक्तनली फुटे अन्धोपन तथा मिर्गौलाको रक्तनलीमा घात भएर मिर्गौलाले काम नगर्ने हुन्छ । कहिलेकाहीँ बढी प्रेसर भएको व्यक्ति बेहोस हुने, हातखुट्टा नचल्ने, पिसाब कम हुने तथा हृदयाघात भएको अवस्थामा अस्पतालको आकस्मिक कक्षमा पुग्ने अवस्था हुन्छ । त्यसैले उच्च रक्तचापका लक्षण पनि रक्तचापको तह तथा यसले विभिन्न अंगमा गरेको असरको आधारमा देखा पर्छन् । रक्तचाप बढी भैरहेका धेरै बिरामीमा केही पनि लक्षण नहुन सक्छ । लक्षण नदेखिँदा पनि रक्तचाप हुने भएकाले रक्तचाप छैन होला भन्ठानेर बिरामीले औषधी नखाँदा जोखिम हुन्छ । ढिला भैसकेपछि औषधि खाँदा ज्यानको समेत जोखिम हुन्छ । टिनेजरमा रक्तचाप टिनेजरमा पनि रक्तचापको समस्या हुन सक्छ । कम उमेरमा रक्तचाप परीक्षण गर्नका लागि विशेष किसिमको सानो मेसिनको प्रयोग गर्नुपर्छ । वयस्क व्यक्तिका लागि प्रयोग गरिने मेसिनले टिनेजरको रक्तचाप नाप्दा सहि मापन नहुन सक्छ । कम उमेरमा देखिने उच्च रक्तचाप परीक्षण गर्ने यन्त्र फरक किसिमको भए पनि नाप्ने तरिका भने उस्तै हुन्छ । को व्यक्तिका लागि कति रक्तचाप ठिक हो भन्ने कुरा बच्चा तथा टिनेजरको उमेर,उचाइ, लिंगअनुसारका विशेष किसिमका चार्ट हेरेर पत्ता लगाउन सकिन्छ । वयस्क व्यक्तिका लागि ठिक मानिने रक्तचाप टिनेजर तथा बच्चाका लागि बढी हुन सक्छ । रक्तचापको सही मापन गर्न २४ घण्टासम्म घरमै यन्त्र जडान गरी हेर्नुपर्ने हुन सक्छ । अस्पतालमा रक्तचाप परीक्षण गर्दा मनोवैज्ञानिक अवस्थाले उचित मापन फरक पर्न सक्छ । स्वाथ्यकर्मीको अगाडि कतिपय बालबालिका तथा टिनेजर तर्सिन सक्छन्, जसको असरले रक्तचाप सामान्यभन्दा केही बढी देखिन सक्छ । केही अनुसन्धानले अमेरिकी बालबालिका तथा टिनेजरमा ४ प्रतिशतमा उच्च रक्तचाप देखिएको छ भने नेपालमा सो उमेरमा हुने उच्च रक्तचापबारे अझैसम्म अध्ययन हुन सकेको छैन । विभिन्न हर्मोनसम्बन्धी रोगहरु तथा मिर्गौलासँग सम्बन्धित हुने विभिन्न प्रकारका रोगले रक्तचाप बढाउन सक्ने हुनाले बालबालिका तथा टिनेजरलाई यस्तो रोग छ कि छैन भनेर परीक्षण गर्नमा बढी केन्द्रित हुनुपर्छ । बालबालिका तथा टिनेजरको तौल बढी वा बुबा–आमामा उच्च रक्तचाप छ भने जेनेटिक कारणअनुसार कम उमेरमै उच्च रक्तचाप देखिने सम्भावना हुन्छ । कम उमेरदेखि नै मुटुलगायतका सबै अंगलाई बढी दबाब पर्ने हुनाले हृदयाघात, मस्तिष्कघात लगायतका जटिलता युवावस्थामै देखिन सक्छन् । भ्रम र उपचार कम उमेरमा रक्तचाप बढ्ने केही निश्चित कारण हुन सक्ने भएकाले आवश्यक परीक्षण गरी सम्बन्धित कारण पत्ता लगाएर उपचार गरेमा जीवनभर औषधि सेवन गर्नुपर्ने नहुन सक्छ । त्यस्तै मुटुसँगै जोडिएको मुख्य रगतको नली एर्वोटामा जालो बसेर पनि उच्च रक्तचाप हुन सक्छ । जसलाई खुर्केर फाल्ने वा स्टेन्ट राखेर उपचार गर्न सकिन्छ । रक्तचाप कम भयो भने पनि जोखिम हुन्छ । माथिको सिस्टोलिक रक्तचाप ९० भन्दा कम हुनु हुँदैन । ब्लड प्रेसर कम हुँदा किड्नी फेल हुनुका साथै मस्तिष्कमा हुने रक्तप्रवाह घट्छ । रक्तचाप कम हुनबाट बच्न प्रशस्त पानी पिउनु पर्छ । नुनको मात्रा मिलाएर खानु पर्छ । रक्सी सेवन गर्नु हुँदैन । रक्तचापलाई सन्तुलित राख्नु सन्तुलित भोजन गर्नुका साथै शारीरिक व्यायाम गर्नुपर्छ । प्रायः सबै प्रकारका रोगको अन्तिम अवस्थातिर रक्तचाप कम हुन सक्छ, यस्तो अवस्थामा मुख्य रोगको सघन तरिकाले उपचार गरेमा रक्तचाप सन्तुलनमा आउन मद्दत गर्छ । कतिपय टिनेजरले धूमपान तथा मद्यपान सेवनले गर्दा पनि रक्तचापको जोखिम हुन्छ । आहारविहारले पनि रक्तचाप सन्तुलनमा नआए चिकित्सकको सल्लाह लिन जरुरी हुन्छ । रक्तचापको औषधि खाँदा चिकित्सकको सल्लाहमा खानु पर्छ । ठिक भयो भनेर जथाभावी ह्वात्त औषधि छोड्दा ज्यानको जोखिम पनि हुन सक्ने भएकाले चिकित्सकको परामर्शविना औषधि छोड्नु हुँदैन । कतिपय औषधि एक्कासि छोड्दा रक्तचाप अति नै बढी भएर ज्यानको जोखिम हुन सक्छ । मिर्गाैला, थाइराइडलगायतका रोगका कारणले रक्तचाप बढेको छ भने सो कारणको उपचार भैसकेपछि उच्च रक्तचापको औषधि नचाहिन पनि सक्छ । उच्च रक्तचापको औषधिको सेवनले मिर्गौलालगायतको शरीरका अंगमा असर हुन्छ भन्ने कतिपयको भ्रम छ । औषधिले मिर्गौलालई खराबी गर्नु नभई बचाउँछ । तर चिकित्सकको सल्लाहमा खानु पर्छ । रक्तचाप बढ्यो भन्दैमा नुन पूरै रोक्ने नभई कम मात्रामा सेवन गर्नुपर्छ । नुन पूरै रोक्दा नकारात्मक असर हुन सक्छ । त्यसैले खानपानमा ध्यान दिनु पर्छ, जथाभावी खानपान गर्नु हुँदैन । बेला–बेलामा स्वास्थ्य जाँच गराउनु पर्छ । प्रस्तुति ः उपेन्द्र खड्का