Hypertension (HTN): The Silent Killer you Should not Ignore.

Hypertension—commonly known as high blood pressure—is one of the most widespread health conditions affecting millions of people worldwide. What makes it particularly dangerous is that most people don’t even realize they have it until complications arise. Because of its silent nature, HTN is often called the “Silent Killer.”

 In this blog, we will explore what hypertension is, its causes, symptoms, diagnosis, prevention, and treatment so you can protect yourself and your loved ones.

What Is Hypertension?

Hypertension (HTN) is a medical condition where the force of blood against the artery walls stays consistently higher than normal.

Normally, a healthy blood pressure is around 120/80 mmHg.

When the reading remains 140/90 mmHg or higher on multiple checks, it indicates hypertension.

High blood pressure makes your heart work harder, damages blood vessels, and increases the risk of serious health issues.

Causes & Types of Hypertension:

1. Primary (Essential) Hypertension: 85 - 95% (unknown aetiology).

• Develops gradually over years.
• No clear cause.
• Most common type.

2. Secondary Hypertension:10-15%

• Kidney disease.
• Thyroid problems.
• Sleep apnea.
• Hormonal disorders.
• Certain medications.
• Birth control pills.
• Renal artery stenosis.
• Coarctation of aorta.
• Cushing's syndrome.
• Chronic kidney disease (CKD).
• Conn's syndrome (primary hyperaldosteronism)
• Polycystic kidney disease.
•  Pregnancy.
•  Drugs: OCP, corticosteroids, NSAIDs etc.
• Hyperthyroidism.
• Hypothyroidism.

3.Isolated Systolic Hypertension.

4.Borderline Hypertension.

5.Resistant Hypertension.

6.Malignant Hypertension.

7.Bengin Hypertension.

8.White coat Hypertension.

 Risk Factors:

Hypertension can develop due to multiple factors:

A. Non Modifiable Risk Factors 

• Family history of hypertension.
• Age & Gender .
• Race & Ethnicity.
• Postmenopausal women.
• Diabetes Mellitus.
•  Genetics / Hereditary

2. Modifiable Risk Factors

• Obesity
• High salt intake.
• Lack of physical activity.
• Smoking.
• Alcohol consumption.
• Stress.
• Chronic kidney disease.
• Weight reduction.
• Caffeine
• Saturated fat.
• Low socioeconomic status.

Understanding these factors can help reduce your risk.

Clinical Manifestations of Hypertension:

Hypertension often has no symptoms, which is why it is considered a silent disease.

However, in severe or uncontrolled cases, symptoms may include:

• Asymptomatic at first and remain so for many years.
• Headache.
• Dizziness.
• Blurred vision.
• Chest pain.
• Shortness of breath.
• Fatigue.
• Nosebleeds.
• Chest pain.
• Palpitations
• Severe anxiety.
• Angina.
• Weakness
• Increased blood pressure.
  

                         

How Hypertension Is Diagnosed

Assessment of the patient with hypertension must be detailed and thorough. There are also diagnostic tests that can be performed to establish the diagnosis of hypertension.

• Assessment.
• ECG.
• 12 lead ECG.
• Blood tests.
• Echocardiography.
• Urine tests.
• Creatinine clearance.
• Kidney function tests
• Blood urea nitrogen.
• Eye examination.
• Renin level.
• Thyroid Studies.
• Uric acid.
• Urine steroids
• Intravenous pyelogram (IVP).
• Kidney & renography nuclear scan.
• Excretory urography.
• Chest x-ray.
• Computed tomography (CT) scan. 

These help identify any complications or underlying causes.

Management of Hypertension

                             

Hypertension Management Gov. Protocol

Hypertension (HTN) is a major public health concern in Bangladesh. Proper identification, lifestyle modification, and timely treatment are essential to reduce complications such as stroke, heart attack, and kidney damage.

1. Non-Pharmacological Management (Lifestyle Modifications):

• Lifestyle changes are recommended for all patients with elevated blood pressure.
• Salt intake < 5g/day.
• Maintain BMI 18.5–24.9 .
• Regular physical activity 30–45 min/day, 5 days/week.
• Eat fruits, vegetables, and low-fat diet.
• Avoid tobacco and alcohol.
• Stress control and adequate sleep (7–8 hours).
• Reduce oily and high-fat foods.
• Encourage weight reduction in overweight patients.

                            

Dietary Approaches To Stop Hypertension

2. Pharmacological Management:

Medication should be started based on BP level and patient risk factors.

When to Start Medicine:

• BP ≥ 140/90 mmHg (multiple readings).
• BP ≥ 130/80 mmHg with Diabetes, CKD , Heart disease.

First-Line Drugs:

• ACEI/ARB (Enalapril, Losartan).
• CCB (Amlodipine).
• Thiazide diuretics (Hydrochlorothiazide).

Combination Therapy:

• ACEI/ARB + CCB.
• CCB + Diuretic.
• ACEI/ARB + Diuretic.

Second-Line Drugs:

• Beta-blocker (if heart disease).
• Spironolactone (for resistant HTN).

Common Medications that lower blood pressure.

BP Monitoring & Follow-Up:

• Recheck BP after 1 month of starting therapy.
• Adjust medication if BP uncontrolled.
• Stable patients: follow-up every 3 months.

Yearly tests:

1. Renal function.
2. Lipid profile.
3. ECG.
4. Fundoscopy.

 Target Blood Pressure (According to Govt Guidelines):

• General adult: <140/90 mmHg.
• Diabetes/CKD: <130/80 mmHg.
• Elderly: <140/90 mmHg (if tolerated).

Hypertensive Emergency (Immediate Referral):

• Refer urgently if:
• Severe headache.
• Chest pain.
• Neurological deficit.
• Blurred vision.
• Breathlessness.
• BP > 180/120 mmHg.

Key Government Message:

• Lifestyle modification is essential for all patients.
• Drug therapy should follow protocol.
• Regular monitoring prevents complications.
• Early detection saves life.

Government-standard hypertension management focuses on lifestyle change, proper medication selection, and regular follow-up. Effective control significantly reduces the risk of heart disease, stroke, and kidney failure.

Complications of Untreated Hypertension:

If left uncontrolled, HTN can lead to life-threatening problems:

• Heart attack.
• Stroke.
• Heart failure.
• Kidney failure.
• Vision loss.
• Aneurysm.
• Damage to blood vessels.

Early detection and proper management can prevent most of these complications.

Can Hypertension Be Prevented?

Yes—hypertension can often be prevented by following a healthy lifestyle, regular checkups, and early diagnosis. Maintaining a balanced routine can greatly lower your risk.

1. When to See a Doctor.
2. You should consult a doctor if:
3. Your BP is consistently 140/90 mmHg or above.
4. You have diabetes or kidney disease.
5. You experience severe headaches or blurred vision.
6. You are pregnant with high BP.

Hypertension is a silent yet serious condition. But the good news is—it can be managed and prevented. With healthy lifestyle habits, regular blood pressure monitoring, and proper treatment, you can lead a normal, healthy life.

Take control of your health today.

Stay informed, stay healthy.