Admission Blood Pressure And Outcome
If it is accepted that hypertension increases the risk of cardiovascular complications of anesthesia, is this the result of the presence of hypertensive heart disease or does it relate closely to the level of blood pressure at the time of admission for surgery? In 1979, Goldman and Caldera19 examined patients with arterial hypertension who were included in their risk index.12 No significant differences were found between patients who were hypertensive at the time of surgery and those who were normotensive, treated with diuretics, or hypertensive but relatively well controlled . The absence of difference may be ascribed to two factors: the study did not have the statistical power to confirm or refute an association between hypertension and outcome, and very few patients had blood pressures that could be classified as stage 3 hypertension. Indeed, only 5 of 196 patients had a diastolic blood pressure higher than 111 mmHg.19 Other studies20,21 also suffered a lack of statistical power. One study showed a clear association between hypertension and perioperative myocardial re-infarction.22 Hypertension has also been shown to play a role in the risk of complications after coronary artery surgery.23
With the increase in blood pressure there is an increased incidence of electrocardiographic abnormalities.27,28 In hypertensive patients, there is evidence of an association between quality of blood pressure control and the occurrence of silent postoperative myocardial ischemia .29
Facts About Hypertension In The United States
In 2017, the American College of Cardiology and the American Heart Association published new guidelines for hypertension management and defined high hypertension as a blood pressure at or above 130/80 mm Hg. Stage 2 hypertension is defined as a blood pressure at or above 140/90 mm Hg. 1
|or||90 mm Hg|
- Having hypertension puts you at risk for heart disease;and stroke, which are leading causes of death in the United States.2
- In 2018, nearly half a million deaths in the United States included hypertension as a primary or contributing cause.2
- Nearly half of adults in the United States have hypertension defined as a systolic blood pressure 130 mm Hg or a diastolic blood pressure 80 mm Hg or are taking medication for hypertension.3
- Only about 1 in 4 adults with hypertension have their condition under control.3
- About half of adults with uncontrolled hypertension have a blood pressure of 140/90 mm Hg or higher. This includes 37 million U.S. adults. 3
- About 30 million adults who are recommended to take medication may need it to be prescribed and to start taking it. Almost two out of three of this group have a blood pressure of 140/90 mm Hg or higher.3
- High blood pressure was a primary or contributing cause of death for more than 494,873 people in the United States in 2018.2
- High blood pressure costs the United States about $131 billion each year, averaged over 12 years from 2003 to 2014.4
Eating More Fruit And Vegetables And Less Fat
People who have high blood pressure or people at high risk of developing high blood pressure should eat as little saturated and total fat as possible.
Instead, experts recommend:
- fish rich in omega-3 twice a week
- nontropical vegetable oils, for example, olive oil
- skinless poultry and fish
- low fat dairy products
It is important to avoid trans fats, hydrogenated vegetable oils, and animal fats, as well as large portion sizes.
Some fats, such as those in oily fish and olive oil, have protective effects on the heart. However, these are still fats. While they are typically healthful, people with a risk of hypertension should still include them in their total fat intake.
Also Check: Veterinary Blood Pressure Cuff Size Chart
Thickening And Enlargement Of The Heart
High blood pressure makes it difficult for your heart to pump blood. Like other muscles in your body, regular hard work causes your heart muscles to thicken and grow. This alters the way the heart functions. These changes usually happen in the main pumping chamber of the heart, the left ventricle. The condition is known as left ventricular hypertrophy .
CHD can cause LVH and vice versa. When you have CHD, your heart must work harder. If LVH enlarges your heart, it can compress the coronary arteries.
Hypertensive Heart Disease Diagnosis
In determining if the person has hypertensive heart disease, the person needs to undergo tests such as:
Physical and Medical History Exam
What the physician does here is that he or she asks questions to the patient related to the condition as well as doing the necessary physical exam which is the IPPA or the Inspection, Palpation, Percussion and Auscultation.
It is the usage of high frequency sound waves and creates an image of the systems in the persons body.
A cardiac ultrasound showing left ventricular hypertrophy
It is an imaging method which uses the x-rays in creating the cross sectional portion of the persons body.
EKG or Electrocardiogram
It is an exam that records the hearts electrical activity.
It is otherwise known as echocardiogram which also uses sound waves to create of a picture of a heart in motion.
Coronary Angiography Exam
It is a kind of exam which uses a contrast material or a special dye in combination with the x-ray for a clearer picture of blood circulation in the patients heart. In doing this test, the person needs to be tested for allergies prior to the test.
TEE or Transesophageal Echocardiography
It is a test that uses an ultrasound device which passes through the patients esophagus to create of an image of the musculature of the heart and its parts. Here, there is a need to use a transducer which directs the waves of the ultrasound, reflects it and translates the heart image.
Chest X Ray
Don’t Miss: Does Claritin D Raise Blood Pressure
Lifestyle And Home Remedies
Lifestyle changes can help you control and prevent high blood pressure, even if youre taking blood pressure medication. Heres what you can do:
Although diet and exercise are the most appropriate tactics to lower your blood pressure, some supplements also may help lower it. However, more research is needed to determine the potential benefits. These include:
- Fiber, such as blond psyllium and wheat bran
- Minerals, such as magnesium, calcium and potassium
- Folic acid
- Supplements or products that increase nitric oxide or widen blood vessels , such as cocoa, coenzyme Q10, L-arginine or garlic
- Omega-3 fatty acids, found in fatty fish, high-dose fish oil supplements or flaxseed
Some research is studying whether vitamin D can reduce blood pressure, but more research is needed.
While its best to include these supplements in your diet as foods, you can also take supplement pills or capsules. Talk to your doctor before adding any of these supplements to your blood pressure treatment. Some supplements can interact with medications, causing harmful side effects, such as an increased bleeding risk that could be fatal.
You can also practice relaxation techniques, such as deep breathing or meditation, to help you relax and reduce your stress level. These practices may temporarily reduce your blood pressure.
Testing And Diagnosis: When To See The Doctor
Your doctor will review your medical history, conduct a physical exam, and run lab tests to check your kidneys, sodium, potassium, and blood count.
One or more of the following tests may be used to help determine the cause of your symptoms:
- Electrocardiogram monitors and records your hearts electrical activity. Your doctor will attach patches to your chest, legs, and arms. The results will be visible on a screen, and your doctor will interpret them.
- Echocardiogram takes a detailed picture of your heart using ultrasound.
- Coronary angiography examines the flow of blood through your coronary arteries. A thin tube called a catheter is inserted through your groin or an artery in your arm and up into the heart.
- Exercise stress test looks at how exercise affects your heart. You may be asked to pedal an exercise bike or walk on a treadmill.
- Nuclear stress test examines the flow of blood into the heart. The test is usually conducted while youre resting and exercising.
Treatment for hypertensive heart disease depends on the seriousness of your illness, your age, and your medical history.
Also Check: What Size Blood Pressure Cuff Do I Need
Can You Prevent Hypertensive Heart Disease
Yes! There are several ways you can help prevent hypertensive heart disease. The best way is to get a regular physical exam and monitor your blood pressure. If you need to lower your blood pressure you can do that in several ways, including:
- eating healthy;
- monitoring stress levels and making sure they don’t get too high;
- maintaining a healthy weight
- getting enough sleep;
- stopping smoking as smoking puts you at a higher risk for heart disease and high blood pressure;
- drinking alcohol in moderation as excessive alcohol consumption is bad for blood pressure;
Maintaining a healthy lifestyle, in general, is the best way to prevent hypertensive heart disease, and these tips provide a simple guideline for doing it. Please consult with your doctor about other ways to maintain a healthy lifestyle and help prevent hypertensive heart disease and other ailments.;
Can Hypertension Be Cured
The fourth industrial revolution enabled the field of medicine to improve health conditions. You may have expected that chronic illnesses now have a cure. Unfortunately, hypertension has no cure, but you can manage it with medication.
Now that you know the risk factors for hypertension, you can do these to lower your BP with natural means:
- Exercise. It is crucial for your health and can help lower BP.
- Improve your diet. Experts recommend a diet rich in fresh produce and whole grains.
- Maintain a healthy weight. Maintaining your weight reduces the strain on your heart.
- Limit your sodium intake. Look for low or no salt foods to lower intake.
- Avoid stress. You can reduce stress by meditating, engaging in a relaxing activity, or exercising.
- Drink with caution. Limit your alcohol consumption.
- Quit smoking. Benefits include better lung health and a lower risk of heart disease.
Lifestyle changes can help lower your BP and cut the risk of heart disease. Your doctor may also prescribe BP medication. These are antihypertensive drugs. Antihypertensive oral medicines include:
- ACE inhibitors
- Centrally-acting antihypertensive drugs
The goal of treatment is to normalize your BP. Your doctor may prescribe a medication with few or no adverse effects. This treatment works well.
If medication can only regulate your BP, youll need to take it forever. Its usual to need many medications to control BP. Take the drug as prescribed. Otherwise, youll risk a stroke or heart attack.
You May Like: How To Calibrate Blood Pressure Monitor Omron
Hypertensive Heart Disease Prevention
Diagnosing high blood pressure early can help prevent heart disease, stroke, eye problems, and chronic kidney disease.
All adults over the age of 18 should have their blood pressure checked every year. More frequent measurement may be needed for those with a history of high blood pressure readings or those with risk factors for high blood pressure.
Hypertensive Heart Disease Causes
In the presence of high blood pressure, there will be an increase in the pressure of the persons blood vessels. When this happens, the heart pumps harder to be able to deliver the right amount of blood all over the body despite the presence of the high blood pressure. At first, the heart will be able to compensate but in the long run, the heart will eventually give in and it will lead to the thickening of the musculature of the heart. Without the right treatment, there is a possibility that the person will develop a congestive heart failure.
Aside from that, high blood pressure will make the heart undergo ischemic episodes due to the thickening of the musculature and the increased need of oxygen via the red blood cells or through blood circulation. In short, having a high blood pressure will lead to blood vessel walls thickening which, when it reaches the worst point, it will lead to atherosclerosis which is a medical term that means an increase in the deposit of cholesterol in ones blood vessels which will eventually cause a high risk of stroke as well as heart attacks.
In sum, those who are at high risk for this disease condition are as follows:
- Hypertensive persons
- Persons who have high blood cholesterol level
- Persons who smoke a lot
- Persons who are living an inactive lifestyle
- Persons who have higer than the average acceptable BMI or Body Mass Index
Read Also: Is Vinegar Good For High Blood Pressure
Does Coffee Lower Blood Pressure
There is an ongoing debate on how caffeine affects blood pressure. Previous studies show conflicting results about this subject. But coffee has shown properties that both elevate and lower blood pressure.
Caffeine can elevate your blood pressure, even if you dont have hypertension. This sudden rise in blood pressure is unknown. Caffeines effect on blood pressure varies by individual.
Caffeine may inhibit a hormone that widens arteries. Other researchers believe caffeine stimulates the adrenal glands, raising blood pressure.
Also, avoid caffeine before activities that raise your blood pressure. Examples of such are exercising, weightlifting, or intense physical labor.
Greek researchers in 2010 claim otherwise. They said that coffee improves the elasticity of blood vessels. The vascular systems of those who drank one to two cups of coffee were better than those who drank less or more.
More researchers need to look into these findings to confirm these. But you can be sure that drinking coffee in moderation will not harm you.
What Is The Best Drink For Hypertension
Therapies for HTN are not curative. You have to continue them forever to manage the disease. If you have HTN, you can add healthy drinks to your diet to help manage your BP.
There is no available source on the internet that singles out any drink as the best. If you want to manage your HTN, you might want to try these drinks:
- Apple cider vinegar. It flushes the body of salt and poisons. The rennin enzyme lowers blood pressure.
- Lemon water. Lemon water is a cell cleanser. It also softens arteries, reducing the pressure within them.
- Methi water. The fiber in methi or fenugreek water helps lower the pressure.
- Chia seeds infused water. Chia seeds have a lot of omega-3 fatty acids. They help thin the blood and reduce its pressure.
- Tomato juice. Japanese researchers reported in 2019 that it could improve systolic and diastolic pressure.
- Beet juice. A study from 2016 found out that raw beet juice lowered BP.
- Prune juice. Researchers reported that people who eat prunes daily had reduced BP.
- Pomegranate juice. People who drank pomegranate juice had lower systolic and diastolic pressure.
- Berry juice. A literature review in 2020 said that cranberry or cherry juice might help lower BP.
- Skim milk. Experts concluded that drinking low-fat milk yields a lower risk of hypertension.
- Tea. Green tea was effective in reducing blood pressure in a 2014 study.
Recommended Reading: Does Spicy Food Cause High Blood Pressure
What Is Atherosclerosis
Atherosclerosisalso known as atherosclerotic cardiovascular diseaseis a condition that involves a build-up of deposits that form plaques in the wall of the arteries. This build-up can eventually constrict or occlude the artery and reduce blood flow.
There are often no symptoms of atherosclerosis until an artery has become so narrow or obstructed that it can no longer supply adequate blood to organs and tissues. When this occurs in the heart, the subsequent shortage of adequate blood flow and oxygen can lead to a heart attack.
Chronic elevation of blood pressure can speed up the process of developing atherosclerosis.
When Do I Code I11 9
Hypertension and hypertensive heart disease: I11. The combination of hypertension and hypertensive heart disease is currently coded using the ICD-9 402. xx series of codes. As noted earlier, each category is currently divided into malignant, benign, and unspecified essential hypertension with or without heart failure.
Also Check: Do Onions Lower Blood Pressure
Risk Factors For Hypertensive Heart Disease
High blood pressure has many risk factors, including:
Sometimes pregnancy contributes to high blood pressure, as well.
Although high blood pressure is most common in adults, children may be at risk, too. For some children, high blood pressure is caused by problems with the kidneys or heart. But for a growing number of kids, poor lifestyle habits, such as an unhealthy diet, obesity and lack of exercise, contribute to high blood pressure.
High Blood Pressure Diagnosis
A person is diagnosed with hypertension when their blood pressure measures over 129 mmHg systolic and over 80 mmHg diastolic .
High blood pressure readings must be consistent over time, because the blood pressure normally fluctuates up and down with activity and other factors. Therefore, there are specific preset parameters indicating how many times a high blood pressure reading must be to qualify for a diagnosis of high blood pressure.
There are two categories of hypertension.
- Stage 1:;Systolic pressure of 130 mm Hg to 139 mm Hg or a diastolic pressure of 80 mm Hg to 89 mm Hg.
- Stage 2: Systolic pressure over 140 mm Hg or a diastolic pressure over 90 mm Hg.;
Having untreated high blood pressure of 140/90 increases the risk of getting atherosclerosis two- to three-fold.
Rates Of High Blood Pressure Control Vary By Sex And Race
Uncontrolled high blood pressure is common; however, certain groups of people are more likely to have control over their high blood pressure than others.
- A greater percent of men have high blood pressure than women .3
- High blood pressure is more common in non-Hispanic black adults than in non-Hispanic white adults , non-Hispanic Asian adults , or Hispanic adults .3
- Among those recommended to take blood pressure medication, blood pressure control is higher among non-Hispanic white adults than in non-Hispanic black adults , non-Hispanic Asian adults , or Hispanic adults .3
Treatment Of Left Ventricular Diastolic Dysfunction
Certain classes of antihypertensivesACE inhibitors, beta blockers, and nondihydropyridine calcium channel blockershave been shown to improve echocardiographic parameters in symptomatic and asymptomatic diastolic dysfunction and the symptomatology of heart failure. Candesartan, an angiotensin receptor blocker , has been shown to decrease hospitalization in patients with diastolic heart failure.
Use diuretics and nitrates with caution in patients with heart failure due to diastolic dysfunction. These drugs may cause severe hypotension by inappropriately decreasing the preload, which is required for adequate LV filling pressures. If diuretics are indicated, delicate titration is necessary. Hydralazine has been shown to cause severe hypotension in patients with heart failure due to diastolic dysfunction.
By increasing the intracellular calcium level, digoxin can worsen LV stiffness. However, a large, randomized trial has not shown any increase in mortality rate.
You May Like: Spicy Food And Blood Pressure