What are the important risk factors for heart disease?
In general, when we talk about risk factors for heart disease, we tend to think about the most common variety of heart disease in adults – coronary artery disease. Risk factors for heart disease can be divided into modifiable and non modifiable ones. The non modifiable ones are age, gender, ethnicity and family history. The risk of coronary artery disease increases as age advances. So also, the risk is more in males compared to pre-menopausal females. A strong family history of premature heart disease is an important risk factor. Some races are more prone to coronary artery disease than others. Obviously, all these risk factors cannot be modified.
We are more concerned about the modifiable risk factors because that is where the individual and the community can act to reduce the risk. Important modifiable risk factors are smoking, high blood pressure (hypertension), high blood sugar (diabetes mellitus), high body weight (obesity), high levels of lipids in the blood (dyslipidemia) and chronic kidney disease. There are other risk factors as well, though not always checked for – increased levels of homocysteine, fibrinogen, C-reactive protein (CRP) and lipoprotein (a) [Lp(a)] in the blood. Though Lp (a) levels carry significant risk, there are no well established ways of reducing the risk due to it.
What is high blood pressure?
Normal pressure in the main blood vessels arising from the heart is below 120/80 mm Hg. The higher value occurs when the heart contracts and pumps blood and is known as systolic blood pressure. The lower value occurs when the heart relaxes. When the blood pressure is above 140/90 mm Hg, it is usually called high blood pressure (hypertension). Blood pressure varies with age – it is low in a new born baby and rises as the age increases. The values mentioned above are for adults above the age of 18 years. In younger individuals, we have to check with normal blood pressure chart for each age as it is difficult to memorize the values for each age.
What are the symptoms of high blood pressure?
Very often there are no symptoms for high blood pressure and a good number of individuals who have high blood pressure do not know it. High blood pressure is detected during evaluation for other illnesses. Headache, though an important symptom of high blood pressure, is most often due to other causes. Dizziness is another symptom which could occur with high blood pressure. Sometimes an individual comes with symptoms due to complications of high blood pressure rather than due high blood pressure itself.
What are the important complications of high blood pressure?
When the blood pressure goes up very high at a very fast rate, it cause rupture of a blood vessel. This typically occurs in the brain causing bleeding into the brain (cerebral hemorrhage). If a large portion of the brain is damaged due to rapid bleeding, it can lead to sudden death. Otherwise the person gets a bleeding stroke (hemorrhagic stroke), which often manifests with weakness of one side of the body with our without loss of consciousness or difficulty in speaking. High blood pressure can damage the heart, kidneys and the eyes. In the heart it can lead to heart attack and heart failure. Kidneys may fail due to high blood pressure (renal failure). Bleeding into the layers of the eye can occur due to high blood pressure. For that matter, high blood pressure can damage the blood vessels in any part of the body.
What causes high blood pressure?
The most common cause of high blood pressure in adults is unknown and it is called essential hypertension. Other causes of high blood pressure are known as secondary hypertension. Kidney disease, certain hormone disorders, obstruction to blood vessels, diseases of blood vessels and even undue anxiety and stress can cause high blood pressure. Secondary causes are more likely in younger individuals.