When dealing with high blood pressure (HBP or as we call it —hypertension) the most common question that arises in one’s mind is— Is high blood pressure a big deal? Well, it is —-Because it is putting stress your heart and your arteries, even if you don’t feel any different. This extra or added stress can raise your chances for several complications that can seriously hurt important organs like your heart and brain. HBP is a silent killer that can quietly damage your body for years before you can recognize any symptoms. If left undetected (or uncontrolled), it can lead to many disabilities, a poor quality of life or even a fatal heart attack.
Let us discuss about some of the complications that may arise due to uncontrolled or poorly controlled high blood pressure.
1. Damage to the arteries :
Normally, arteries are the blood vessels that carry blood from the heart to the rest of the body. They have a smooth inner lining and are flexible, strong and elastic s as to push blood through your body. Hypertension gradually increases the pressure of blood flowing through your arteries and may result in
a. Damaged and narrowed arteries : The extra force of blood can damage the cells on the inside walls of the arteries where fats (from our diet) may start depositing to form plaques or clogs. This reduces the elasticity and flexibility of the arteries—-and narrows them—thus further limiting the blood flow through them to body. These plaques or clogs can even block arteries. b. Aneurysm: When blood continues to flow through a narrowed artery, the constant pressure can cause a section of its wall to enlarge and form a bulge (aneurysm). An aneurysm can potentially rupture and cause life-threatening internal bleeding.
2. Damage to the heart :
a. Coronary artery disease: this occurs when the arteries that supply blood to your heart muscles get narrowed. When blood can’t flow freely to your heart, you can experience chest pain (angina), a heart attack or irregular heart rhythms (arrhythmias). b.Enlarged left heart: High blood pressure forces your heart to work harder than normal in order to pump blood to the rest of your body. This causes the left heart chamber (ventricle) to thicken or stiffen (—a condition called as left ventricular hypertrophy). This reduces the ventricle’s ability to pump blood to your body and increases the risk of heart attack, heart failure and sudden cardiac death.
c.Heart failure. Over time, the strain on the heart caused by high blood pressure can cause the heart muscle to weaken and work less efficiently. In due course, the heart begins to wear out and may fail to function leading to heart failure.
3. Damage to the brain :
Just like any other body part, our brain too depends on the blood supply to work properly and survive. Depending on what part of your brain is affected by HBP, you could have problems with language, vision, movement, or anything else your brain controls. It could be temporary if the blood flow is restored, or the damage may be permanent if the cells die. High blood pressure can cause several problems, such as:
a. Stroke: When an artery in the brain tears, leaks, or gets clogged, it can stop blood from getting to brain cells. This part of your brain is deprived of oxygen and nutrients, causing brain cells to die. This results in a stroke. b. Transient ischemic attack (TIA ): This is often called a mini-stroke, This is a brief, temporary disruption of blood supply to your brain caused by blood clots or plaques. A transient ischemic attack is often a warning that you’re at risk of a full-blown stroke. c. Dementia: This is a brain disease resulting in problems with thinking, speaking, reasoning, memory, vision and movement which arises due to a lessened blood supply to the brain. It is also called as vascular dementia. d. Mental Difficulties: the changes in understanding and memory that result from blocked blood flow to the brain when high blood pressure damages arteries.
4. Damage to the kidneys :
The function of kidneys is to filter excess fluid and waste from the blood. High blood pressure can damage the blood vessels inside and those leading to the kidneys, causing several types of kidney diseases (called as –nephropathy). If a person has diabetes in addition to high blood pressure, then it can worsen the damage. Some types of kidney damage occurring due to HBP include:
a. Kidney failure: High blood pressure is one of the most common causes of kidney failure as damage to the fine network of arteries inside and in those leading to kidneys can affect the filtration capacity of kidneys. As a result of this, dangerous levels of fluid and waste can accumulate in the body that may ultimately require dialysis or kidney transplantation. b. Kidney scarring (glomerulosclerosis): Glomeruli are tiny clusters of blood vessels within your kidneys where the filtration of fluid and waste from your blood takes place. Glomerulosclerosis refers to scarring or damage to these fine vessels which can leave your kidneys unable to filter waste effectively, ultimately leading to kidney failure. c. Kidney artery aneurysm: Just like any artery, a bulge in the wall of a blood vessel leading to the kidney is known as a kidney (renal) artery aneurysm. These can rupture to cause serious internal bleeding.
5. Damage to eyes :
The blood vessels that supply blood to eyes are very fine and delicate which can be damaged by high blood pressure. This can cause:
a. Retinopathy: When HBP damages the vessels supplying blood to the retina, it causes eye damage known as retinopathy. This condition can lead to bleeding in the eye, blurred vision and complete loss of vision. If you also have both diabetes and high blood pressure, you’re at an even greater risk. b. Fluid buildup under the retina (choroidopathy): It occurs when fluid accumulates under the retina because of a leaky blood vessel. This can result in distorted vision or in some cases scarring that impairs vision. c. Nerve damage (optic neuropathy). When a blocked blood flow in the eye damages the optic nerves. It can kill the nerve cells which may cause bleeding within the eye or vision loss.
6. Sexual dysfunction :
High blood pressure can damage the lining of blood vessels in the genital organs in both men and women limiting the flow of blood through them. The decreased blood flow, especially among men who are not treating their high blood pressure makes it difficult to achieve and maintain erections — a condition often referred to as erectile dysfunction. In women, this leads to a decrease in sexual desire or arousal, vaginal dryness, or difficulty achieving orgasm.
7. Other complications of high blood pressure
High blood pressure can also affect other areas of the body, leading to problems like:
a. Peripheral artery disease (PAD): narrowing or blockage of arteries due to HBP away from heart, especially in the lower part of the body, can cause pain or cramping in the legs, arms, stomach and head. This makes you feel fatigued or tired easily. b. Bone loss: High blood pressure can increase the amount of calcium eliminated in urine. This may lead to loss of bone density (osteoporosis), which in turn can lead to broken bones. The risk is especially increased in older women. c. Obstructive sleep apnea: is a condition in which the throat muscles relax leading to loud snoring. This commonly occurs in more than half of the people with high blood pressure. Also, a disturbed sleep resulting from sleep apnea can raise the blood pressure.
8. Hypertensive Crisis
Sometimes blood pressure rises so quickly and severely that it becomes a medical emergency requiring immediate treatment and hospitalization. In such cases the blood pressure readings suddenly exceed 180/120 mm Hg which can cause :
- Memory loss, personality changes, trouble concentrating, irritability or loss of consciousness
- Stroke
- Severe damage to your body’s main artery
- Chest pain
- Heart attack
- Sudden impaired pumping of the heart, leading to fluid backup in the lungs resulting in shortness of breath (pulmonary edema)
- Sudden loss of kidney function
- Complications in pregnant women (preeclampsia or eclampsia)
9. High blood pressure and metabolic syndrome (insulin resistance syndrome)
Metabolic syndrome refers to a cluster of risk factors, including high blood pressure, that raises the risk of heart disease, diabetes, stroke and other health problems. It is diagnosed when any three of these risk factors are present:
- High blood glucose (sugar)
- Low levels of HDL (good) cholesterol in the blood
- High levels of triglycerides in the blood
- Large waist circumference or “apple-shaped” body
- High blood pressure
Clinician’s Verdict
As per my opinion—- high blood pressure should not be taken lightly. It silently and slowly affects every organ of the body. I would recommend that every person—whether having HBP or not–should be vigilant about the complications of high blood pressure and should get it checked. Remember, our best protection is knowledge, management and prevention. One should take all possible steps to reduce the risks and manage the blood pressure—Make heart-healthy lifestyle changes, take any medication as prescribed and work in partnership with your doctor—-to enjoy a healthy and stress-free life.