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Hypertension: Hypertensive Heart Disease

Hypertensive heart disease is the No. 1 cause of death associated with hypertension and is actually a group of disorders that include heart failure, ischemic heart disease, and left ventricular hypertrophy (excessive thickening of the heart muscle).


What Is Heart Failure?
Heart failure does not mean the heart has stopped working. Rather, it means that the heart's pumping power is weaker than normal or the heart has become less elastic. With heart failure, blood moves through the heart and body less effectively and pressure in the heart increases. As a result, the heart cannot pump enough oxygen and nutrients to meet the body's needs. The chambers of the heart respond by stretching to hold more blood to pump through the body. This helps to keep the blood moving, but in time, the heart muscle walls weaken and are unable to pump as strongly. As a result, the kidneys often respond by causing the body to retain fluid (water) and sodium. If fluid builds up in the arms, legs, ankles, feet, lungs, or other organs, the body becomes congested, and congestive heart failure is the term used to describe the condition.
Hypertension brings on heart failure by causing coronary artery disease and left ventricular hypertophy. Symptoms of heart failure include:



**Shortness of breath
**Swelling in the feet, ankles, or abdomen
**Difficulty sleeping flat in bed
**Bloating
**Irregular pulse
**Nausea
**Fatigue
**Greater need to urinate at night



What Is Ischemic Heart Disease?
Hypertension can also cause ischemic heart disease. This means that the heart muscle isn't getting enough blood. Ischemic heart disease is usually the result of atherosclerosis or hardening of the arteries (coronary artery disease), which impedes the blood flow. This can progress to a heart attack. Symptoms of ischemic heart disease may include:



**Chest pain which may radiate (travel) to the arms, back, neck, or jaw
**Chest pain with nausea, sweating, shortness of breath, and dizziness; these associated **symptoms may also occur without chest pain
**Irregular pulse
**Fatigue and weakness



Any of these symptoms warrant immediate medical evaluation



What Is Hypertrophic Cardiomyopathy?
Hypertrophic cardiomyopathy is a condition in which the muscular walls of the heart are thickened. This can prevent the heart valves from functioning normally or may keep blood from flowing out of the heart. It usually occurs independently of high blood pressure.



Symptoms of hypertrophic cardiomyopathy may include:
>Chest pain
>Irregular pulse
>Rapid heartbeat
>Shortness of breath
>Fatigue, weakness
>Fainting



How Is Hypertensive Heart Disease Diagnosed?


Your doctor will look for certain signs, including:
High blood pressure
Enlarged heart and irregular heartbeat
Fluid in the lungs or lower extremities
Unusual heart sounds



Your doctor may perform tests to determine if you have hypertensive heart disease, including a electrocardiogram, echocardiogram, cardiac stress test, chest X-ray, and coronary angiogram



In addition, your doctor may advise you to make changes to your lifestyle, including



Diet: If heart failure is present, lowering the total amount of sodium to 2,000 mg or 2 g or less per day; eating foods high in fiber and potassium; limiting total daily calories to lose weight if necessary; and limiting foods that contain refined sugar, saturated fats, and cholesterol



Monitoring your weight: This involves daily recording of weight; increasing your activity level (as recommended by your doctor); resting between activities more often; planning your activities



Avoiding tobacco products and alcohol


Regular medical checkups: During follow-up visits, your doctor will make sure you are staying healthy and that your heart disease is not getting worse.


In some cases, you may need surgery to correct the heart disease. Surgeries include coronary bypass grafting (to bypass clogged heart arteries), mitral valve repair (to repair a leaky valve caused by cardiomyopathy or ischemia), vascular surgeries (to repair defects of the blood vessels), and implantation of a left ventricular assist device (to improve pumping if you have heart failure as a bridge to heart transplantation).

Hypertension: High Blood Pressure and Stroke

A stroke, sometimes called a "brain attack," occurs when blood flow to an area in the brain is cut off. As a result, the brain cells, deprived of the oxygen and glucose needed to survive, die. If not caught early, permanent brain damage can result.
People who have hypertension are 4 to 6 times more likely to have a stroke. Over time, hypertension leads to atherosclerosis and hardening of the large arteries. This, in turn, leads to blockage and weakening of the walls of small blood vessels in the brain, causing them to balloon and burst. The risk of stroke is directly related to how high the blood pressure is.



How Does a Stroke Occur?


There are two types of stroke.
Ischemic stroke is similar to a heart attack, except it occurs in the blood vessels of the brain. Clots can form either in the brain's blood vessels, in blood vessels leading to the brain or even blood vessels elsewhere in the body which then travel to the brain. These clots block blood flow to the brain's cells. Ischemic stroke can also occur when too much plaque (fatty deposits and

cholesterol) clogs the brain's blood vessels. About 80% of all strokes are of this nature.


Hemorrhagic (heh-more-raj-ik) strokes occur when a blood vessel in the brain breaks or ruptures. The result is blood seeping into the brain tissue, causing damage to brain cells. The most common causes of hemorrhagic stroke are high blood pressure and brain aneurysms. An aneurysm is a weakness or thinness in the blood vessel wall that causes it to balloon outward.



Warning Signs of Stroke


If you experience any of the following symptoms, call 911 immediately.

>>Sudden numbness or weakness in the face, arm, or leg (especially on one side of the body)
>>Sudden blurred vision or decreased vision in one or both eyes
>>Sudden inability to move part of the body (paralysis)
>>Sudden dizziness or headache with nausea and vomiting
>>Difficulty speaking or understanding words or simple sentences
>>Difficulty swallowing
>>Dizziness, loss of balance, or poor coordination
>>Brief loss of consciousness
>>Sudden confusion



A transient ischemic attack (TIA), often called a “mini-stroke,” is a warning of an impending stroke. It typically consists of the same signs and symptoms of stroke, but the symptoms are temporary. It occurs when blood flow to a certain part of the brain is cut off for a short period of time, usually 15 minutes or less. A TIA can occur anywhere from a few minutes to several months before a stroke. A TIA is a painless episode, but it is a warning that something is wrong. It should be treated as seriously as a stroke.


What Should I Do If I Experience Stroke Symptoms?
Immediately call 911. Stroke is a medical emergency. Immediate treatment can save your life or increase your chances of a full recovery

Hypertension: Blood Pressure Basics

What is hypertension? What causes hypertension and what are the symptoms?

Blood pressure is the force of blood pushing against blood vessel walls. The heart pumps blood into the arteries (blood vessels), which carry the blood throughout the body. High blood pressure, also called hypertension, is dangerous because it makes the heart work harder to pump blood to the body and it contributes to hardening of the arteries or atherosclerosis and the development of heart failure.

What Is "Normal" Blood Pressure?

There are several categories of blood pressure, including:
** Normal: Less than 120/80
** Prehypertension: 120-139/80-89
** Stage 1 hypertension: 140-159/90-99
** Stage 2 hypertension: 160 and above/100 and above

People whose blood pressure is above the normal range should consult their doctor about methods for lowering it.

What Causes Hypertension?
The exact causes of hypertension are not known. Several factors and conditions may play a role in its development, including:
** Smoking
** Being overweight
** Lack of physical activity
** Too much salt in the diet
** Too much alcohol consumption (no more than 1 to 2 drinks per day)
** Stress
** Older age
** Genetics
** Family history of high blood pressure
** Chronic kidney disease

** Adrenal and thyroid disorders

What Are the Symptoms of Hypertension?
There are usually no symptoms or signs of hypertension. In fact, nearly one-third of those who have it don't know it. The only way to know if you have hypertension definitely is to have your blood pressure checked.

If your blood pressure is extremely high, there may be certain symptoms to look out for, including:

** Severe headache
** Fatigue or confusion
** Vision problems
** Chest pain
** Difficulty breathing
** Irregular heartbeat
** Blood in the urine

Who Is More Likely to Develop Hypertension?

** People with family members who have high blood pressure.
** People who smoke.
** African-Americans.
** Women who are pregnant.
** Women who take birth control pills.
** People over the age of 35.
** People who are overweight or obese.
** People who are not active.
** People who drink alcohol excessively.
** People who eat too many fatty foods or foods with too much salt

How Is Hypertension Diagnosed?
Your health care provider can tell if you have hypertension by checking your blood pressure with a special meter called a sphygmomanometer, which consists of a stethoscope, arm cuff, dial, pump, and valve. You can also measure your own blood pressure at home. You should have your blood pressure checked at least once a year to make sure you don't have hypertension.

What Health Problems Are Associated With Hypertension?

Hypertension is a serious condition that can damage the heart and blood vessels, and can eventually lead to several other conditions, including:

** Stroke
** Heart Failure
** Heart Attack

** Kidney Failure

** Vision Problems

Accept the things you can’t change

Some sources of stress are unavoidable. You can’t prevent or change stressors such as the death of a loved one, a serious illness, or a national recession. In such cases, the best way to cope with stress is to accept things as they are. Acceptance may be difficult, but in the long run, it’s easier than railing against a situation you can’t change.

Don’t try to control the uncontrollable. Many things in life are beyond our control— particularly the behavior of other people. Rather than stressing out over them, focus on the things you can control such as the way you choose to react to problems.

Look for the upside. As the saying goes, “What doesn’t kill us makes us stronger.” When facing major challenges, try to look at them as opportunities for personal growth. If your own poor choices contributed to a stressful situation, reflect on them and learn from your mistakes.

Share your feelings. Talk to a trusted friend or make an appointment with a therapist. Expressing what you’re going through can be very cathartic, even if there’s nothing you can do to alter the stressful situation.

Learn to forgive. Accept the fact that we live in an imperfect world and that people make mistakes. Let go of anger and resentments. Free yourself from negative energy by forgiving and moving on.

Adapt to the stressor

If you can’t change the stressor, change yourself. You can adapt to stressful situations and regain your sense of control by changing your expectations and attitude

Reframe problems. Try to view stressful situations from a more positive perspective. Rather than fuming about a traffic jam, look at it as an opportunity to pause and regroup, listen to your favorite radio station, or enjoy some alone time.

Look at the big picture. Take perspective of the stressful situation. Ask yourself how important it will be in the long run. Will it matter in a month? A year? Is it really worth getting upset over? If the answer is no, focus your time and energy elsewhere.

Adjust your standards. Perfectionism is a major source of avoidable stress. Stop setting yourself up for failure by demanding perfection. Set reasonable standards for yourself and others, and learn to be okay with “good enough.”

Focus on the positive. When stress is getting you down, take a moment to reflect on all the things you appreciate in your life, including your own positive qualities and gifts. This simple strategy can help you keep things in perspective.

Alter the situation

If you can’t avoid a stressful situation, try to alter it. Figure out what you can do to change things so the problem is avoided in the future. Often, this involves changing the way you communicate and operate in your daily life.

Express your feelings instead of bottling them up. If something or someone is bothering you, communicate your concerns in an open and respectful way. If you don’t voice your feelings, resentment will build and the situation will likely remain the same.

Be willing to compromise. When you ask someone to change their behavior, be willing to do the same. If you both are willing to bend at least a little, you’ll have a good chance of finding a happy middle ground.

Be more assertive. Don’t take a backseat in your own life. Deal with problems head on, doing your best to anticipate and prevent them. If you’ve got an exam to study for and your chatty roommate just got home, say up front that you only have five minutes to talk.

Manage your time better. Poor time management can cause a lot of stress. When you’re stretched too thin and running behind, it’s hard to stay calm and focused. But if you plan ahead, you can avoid these stress-inducing pitfalls.

Time management tips to reduce stress

Create a balanced schedule
All work and no play is a recipe for burnout. Try to find a balance between work and family life, social activities and solitary pursuits, daily responsibilities and downtime.

Don’t over-commit yourself
Avoid scheduling things back-to-back or trying to fit too much into one day. All too often, we underestimate how long things will take.

Prioritize tasks
Make a list of tasks you have to do, and tackle them in order of importance. Do the high-priority items first. If you have something particularly unpleasant to do, get it over with early. The rest of your day will be more pleasant as a result.

Break projects into small steps
If a large project seems overwhelming, make a step-by-step plan. Focus on one manageable step at a time, rather than taking on everything at once.

Delegate responsibility
You don’t have to do it all yourself, whether at home, school, or on the job. If other people can take care of the task, why not let them? Let go of the desire to control or oversee every little step. You’ll be letting go of unnecessary stress in the process

Avoid unnecessary stress

How Resilient Are You?


Your ability to handle and bounce back from stress depends on many factors, including a:
*Sense of control
*Optimistic attitude
*Strong support system
*Healthy body
*Ability to adapt to change
*Ability to handle unpleasant emotions
*Belief in a higher power or purpose
*Confidence in yourself
*Sense of humor



Stress management strategy #1: Avoid unnecessary stress


Not all stress can be avoided, and it’s not healthy to avoid a situation that needs to be addressed. You may be surprised, however, by the number of stressors in your life that you can eliminate



Learn how to say “no” – Know your limits and stick to them. Whether in your personal or professional life, refuse to accept added responsibilities when you’re close to reaching them. Taking on more than you can handle is a surefire recipe for stress



Avoid people who stress you out – If someone consistently causes stress in your life and you can’t turn the relationship around, limit the amount of time you spend with that person or end the relationship entirely.



Take control of your environment – If the evening news makes you anxious, turn the TV off. If traffic’s got you tense, take a longer but less-traveled route. If going to the market is an unpleasant chore, do your grocery shopping online.



Avoid hot-button topics – If you get upset over religion or politics, cross them off your conversation list. If you repeatedly argue about the same subject with the same people, stop bringing it up or excuse yourself when it’s the topic of discussion.



Pare down your to-do list – Analyze your schedule, responsibilities, and daily tasks. If you’ve got too much on your plate, distinguish between the “shoulds” and the “musts.” Drop tasks that aren’t truly necessary to the bottom of the list or eliminate them entirely