Hypertension

For most people, the cause of their high pressure is not known. However, when they have a family history of high blood pressure, they are considered to have essential hypertension (it is also known as primary hypertension).

• Smoking
  
• Excessive Alcohol consumption
  
• Sedentary lifestyle
  
• Overweight
  
• Diet with high salt intake
  
• High blood cholesterol
  

• Diabetes
  
• Chronic Kidney Disease
  
• Renal artery disease
  
• Coarctation of aorta
  
• Obstructive sleep apnoea
  
• ​Thyroid disorders such as Thyrotoxicosis
  
• ​Adrenal gland tumour such as Pheochromocytoma, Hyperaldosteronism, Cushing Syndrome
  
• ​Pregnancy induced such as Gestational hypertension and Preeclampsia
  
• Certain medications such as Birth control pills, oral steroid (Prednisolone), Cyclosporin; Erythropoietin 
• Use of illicit drugs such as cocaine and amphetamines
  
• Acute stress such as peri-operation, alcohol withdrawal, white-coat hypertension
  

Most people with high blood pressure usually have no signs or symptoms even when the reading is very high; unless the very high blood pressure develops acutely or has caused organ damage resulting in stroke, confusion, heart attack or heart failure for example.

​Our blood pressure varies throughout the day, and from moment to moment. It may increase when you are seeing a doctor (white-coat hypertension). Therefore, your doctor will likely take a few readings of your blood pressure on separate appointments before diagnosing you having high blood pressure. Generally, you are considered to have high blood pressure if your reading is greater than 140/90 mmHg on 3 separate settings.

Nonpharmacological treatment
Lifestyle changes targeted at the risk factors associated with high blood pressure can reduce blood pressure. Weight reduction, exercise and a low salt healthy diet can help to reduce blood pressure. However, sometimes lifestyle changes alone are not enough, and medication is needed to lower your blood pressure to target.

Pharmacological treatment
There are many different classes (types) of medications that are available to treat high blood pressure. Generally, it is the amount of reduction in blood pressure rather than a specific type of blood pressure lowering medication, is the major determinant in reducing your cardiovascular risk. The choice of blood pressure lowering agents depends on the patient pre-existing co-morbidities and lifestyles. Therefore, management of high blood pressure can be complex, and thus it is best to seek your doctor’s guidance on this matter.