Glossary of terms related to hypertension / high blood pressure.

Arterial Hypertension – also just called “hypertension”, refers to a condition where blood pressure is elevated above normal. Normal is usually quoted as below 120/80.

White coat syndrome – a condition where an individual has elevated blood pressure at the doctors office, yet has much reduced / normal blood pressure at home.

Hypertensive emergency – a severe hypertension that impairs proper functioning of the body’s organs. Requires medical treatment to aggressively lower blood pressure.

Exercise hypertension – is a rise in blood pressure in response to exercise. This does not affect everybody, and in healthy individuals, we would expect to see a small drop in blood pressure during exercise due to improved blood flow.

Malignant hypertension – chronic high blood pressure (> 240/120) resulting in organ damage, especially the eyes, kidneys, brain and lungs. Malignant hypertension is accompanied by swelling of the optic disk.

Pulmonary hypertension – is an increase in blood pressure in the pulmonary artery (carrying blood from the heart to the lungs) or vessels in the lungs. The right side of the heart is put under pressure, and one of the common symptoms is shortness of breath and chest pains during exercise.

Renovascular hypertension – also called “renal hypertension” refers to the kidneys. This is caused by a narrowing of the renal arteries (carrying blood to the kidneys), reducing blood flow to the kidneys, which respond by sending out signals to the body to raise blood pressure. Renal hypertension is a secondary form of hypertension (which just means that we know why it happens).

Systolic pressure – the peak pressure in your circulatory system when the heart contracts. When the heart beats, blood is forced out into the aorta, increasing the pressure.

Diastolic pressure – The lowest pressure in your circulatory system, which occurs during the resting stage of the cardiac cycle (heart is resting between beats).

High blood pressure is a problem for many people, but can be especially dangerous when a woman is pregnant, and can lead to life-threatening problems. High blood pressure affects all organs in the body, but when you are pregnant, you have an extra organ – the placenta, which connects you to your baby, so fetal problems can arise.

What is pre-eclampsia?

Pre-eclampsia is also called Toxemia and is a complex disorder.

Preeclampsia definition (source: Medical Terms and Definitions Website): A condition characterized by a sharp rise in blood pressure during the third trimester of pregnancy. High blood pressure may be accompanied by edema (swelling), and kidney problems, as evidenced by protein in the urine. Although preeclampsia is relatively common, occurring in about 5 percent of all pregnancies and more frequently in first pregnancies, it can be a sign of serious problems. In some cases, untreated preeclampsia can progress to eclampsia, a life-threatening situation for both mother and baby.

Who is at most risk?

• First pregnancy
• Women who suffered from high blood pressure before they got pregnant.
• Overweight women.
• Women under 20 or over 40.
• Those who have suffered pre-eclampsia in a previous pregnancy, or if your mother or sister suffered pre-eclampsia.
• Women with medical history of diabetes, kidney disease, rheumatoid arthritis or lupus.
• Multiple pregnancy

From week 20 onwards in your pregnancy, a rise in blood pressure can indicate pre-eclampsia, and you should contact your doctor immediately. The doctor will take your blood pressure and likely do tests including urine analysis to look for protein.

What are the risks?

Preeclampsia can cause low birth weight and other problems for your baby because it can stop the baby getting enough air or food through the placenta. Preeclampsia causes your blood vessels to constrict (getting smaller), which reduces the flow to the placenta and other organs of your body.

Preeclampsia can develop into eclampsia – which can be very serious. It is characterised by convulsions, and can lead to disability or death.

In a few cases, preeclampsia will develop into something called HELLP syndrome (Hemolysis, Elevated Liver enzymes, and Low Platelets). Women who develop HELLP syndrome usually have to deliver early to prevent serious complications.

What are the signs/symptoms of preeclampsia?

Symptoms include:

• Swelling in hands, feet and ankles.
• Puffiness around the eyes.
• Vision problems (light sensitive, blurred etc).
• Nausea and vomiting
• Tender upper abdomen, or pain.
• Weight gain

Some symptoms appear very much like normal pregnancy complaints, so do get checked up if in doubt.

The pressure of your blood depends on a number of factors including:

• the force created by your heart pumping blood into your arteries
• the volume of your blood
• the resistance your blood encounters as it moves through your blood vessels.

You body needs to make sure that there is sufficient pressure to push the blood into all of the capillaries around your body. Capillaries are the smallest blood vessels in your body, and ensure that all cells in your body receive nutrients they require to live.

Maintaining normal blood pressure is delicately balanced. Too high, and your heart and blood vessels are put under strain. Too low and the low blood pressure means some cells may not get the nutrients they require.

High blood pressure is often called the “Silent Killer” since there are often no symptoms. For this reason, it is important you get your blood pressure checked regularly.

Blood pressure readings can be taken by your doctor using a sphygmomanometer and stethoscope, or at home using a blood pressure monitor (the easiest ones to use are digital monitors). The home monitors generally come in two forms. One places a cuff around your wrist, while the other places a cuff around your upper arm (level with your heart). I personally have tried both types and found the most accurate one to be the upper arm cuff.

The blood pressure “numbers”

The blood pressure reading is two numbers. These are the two pressures of your blood at varying stages of your heart beat cycle:

The larger number is the systolic pressure, the lower number is the diastolic pressure.

Systolic pressure is the blood pressure being pumped into the aorta when the heart beats.

Diastolic pressure is the blood pressure in the arteries when the heart relaxes between beats.

Blood pressure does vary with age, sex and health, but in general, a healthy blood pressure is 120/80, or 120 over 80.

This means that systolic blood pressure is 120 mmHg, and the diastolic blood pressure is 80 mmHg.

Your blood pressure can actually tell a doctor a lot about the health of your heart and blood vessels. High blood pressure means that your heart is having to work harder to push your blood to all the cells in your body.

This can happen if e.g. you have narrowing of the arteries, since this narrowing increases the resistance of your blood vessels, and requires more pressure to get the blood through.

High blood pressure is also called hypertension, and can have serious consequences if not treated. e.g. high blood pressure can weaken the artery walls, and lead to rupture. If this happens in the brain, it can lead to a stroke.

There are a wide range of medicines and medications available to treat high blood pressure, and some alternative therapies such as acupuncture may also help, but you can also take immediate steps by looking at your diet and increasing your daily exercise (walking is a great exercise).

We explore some of the dietary considerations on this site, but please do consult a doctor before changing your diet or undertaking an exercise program.