Hypertension, also known as high blood pressure, is a chronic condition where the force of blood against the artery walls is consistently too high. Blood pressure readings consist of two numbers: systolic (pressure when the heart beats) over diastolic (pressure when the heart rests). Normal readings are around 120/80 mmHg.

The causes are categorised into:

1. Primary (Essential) Hypertension: Develops over time without a specific cause. Factors include:

• Genetics
• Unhealthy diet (high in salt, fat, and cholesterol)
• Physical inactivity
• Obesity
• Excessive alcohol use
• Stress
• Aging

2. Secondary Hypertension: Caused by underlying conditions and may appear suddenly. Causes include:

• Kidney disease
• Adrenal gland tumours
• Thyroid issues
• Sleep apnea
• Certain medications
• Illegal drugs

Hypertension, or high blood pressure, exerts excessive force on the walls of the arteries, which can lead to various forms of heart disease and damage. Here are the key ways hypertension affects the heart:

1. Increased Workload on the Heart

• Thickening of the Heart Muscle: The heart has to pump harder to circulate blood against the higher pressure in the arteries. This can cause the left ventricle, the heart's main pumping chamber, to thicken (left ventricular hypertrophy). While initially, this may help the heart pump more effectively, it can lead to increased stiffness and reduced pumping efficiency over time.
• Heart Failure: Over time, the increased workload can cause the heart muscle to weaken and function less efficiently. This can lead to heart failure, where the heart is unable to pump enough blood to meet the body's needs.

2. Damage to the Arteries

• Atherosclerosis: High blood pressure can damage the inner lining of the arteries, making them more susceptible to the buildup of fatty deposits (plaque). This condition, known as atherosclerosis, can narrow and harden the arteries, reducing blood flow to the heart and other organs.
• Coronary Artery Disease: Narrowed or blocked coronary arteries can reduce the supply of oxygen-rich blood to the heart muscle, leading to chest pain (angina), heart attacks, and other complications.

3. Aneurysms

• Hypertension can cause the walls of the arteries to weaken and bulge, forming an aneurysm. If an aneurysm ruptures, it can cause life-threatening internal bleeding.

4. Increased Risk of Blood Clots

• Damaged arteries can lead to the formation of blood clots. If a clot blocks blood flow to the heart, it can cause a heart attack. If it travels to other parts of the body, it can cause strokes or other severe conditions.

5. Arrhythmias

• Hypertension can contribute to arrhythmias or irregular heartbeats. Left ventricular hypertrophy and other changes in the heart muscle can disrupt the heart's normal electrical pathways, leading to conditions such as atrial fibrillation.

6. Heart Enlargement

• Chronic high blood pressure can cause the heart chambers to enlarge and stretch. This condition, known as cardiomegaly, can further impair the heart’s ability to pump blood effectively.

Managing hypertension, or high blood pressure, is essential for preventing serious health issues such as heart disease, stroke, and kidney failure.

1. Adopt a Healthy Diet:
A diet rich in fruits, vegetables, whole grains, and low-fat dairy products can help lower blood pressure.

2. Maintain a Healthy Weight:
Maintaining a healthy weight can reduce the strain on the heart and lower blood pressure.

3. Limit Alcohol Consumption:
Drinking alcohol in moderation can help control blood pressure.

4. Avoid Smoking:
Smoking damages blood vessels and raises the risk of hypertension.

5. Manage Stress:
Chronic stress can contribute to high blood pressure. Managing stress through relaxation techniques is essential.

6. Exercise Regularly:
Engaging in regular physical activity, such as walking, jogging, or cycling, helps maintain a healthy blood pressure.

7. Medications:

• Angiotensin-converting enzyme (ACE) Inhibitors:
  • These medications help the body produce less angiotensin, a chemical that causes blood vessels to narrow. By reducing angiotensin levels, ACE inhibitors help blood vessels relax and open up, lowering blood pressure.

• Angiotensin II Receptor Blockers (ARBs):
  • These medications block the receptors for angiotensin, preventing it from constricting blood vessels. As a result, blood vessels remain open, which reduces blood pressure.

• Calcium Channel Blockers:
  • These medications relax and widen blood vessels by blocking calcium from entering the cells of the heart and blood vessel walls. This helps lower blood pressure.

• Diuretics:
  • Also known as "water pills," diuretics help the body eliminate excess sodium (salt) and water through urine. This process reduces the volume of blood, which helps lower blood pressure. Diuretics are often used in combination with other blood pressure medications.

• Beta Blockers:
  • These medications reduce the heart rate and the heart’s workload, decreasing the amount of blood the heart pumps out. This helps to lower blood pressure.

8. Renal Denervation:
This is a procedure to help reduce hypertension by using radiofrequency ablation to disrupt the nerves that signal the kidneys to regulate blood pressure.

Seeing a cardiologist for hypertension is essential when your blood pressure is difficult to control, you experience severe symptoms, or you have additional risk factors or complications.

1. Uncontrolled Hypertension

• Persistent High Blood Pressure: If your blood pressure remains high despite lifestyle changes and medication prescribed by your primary care doctor, it’s time to see a cardiologist. Uncontrolled hypertension can lead to serious complications, including heart disease and stroke.

2. Hypertensive Crisis

• Severe High Blood Pressure: If your blood pressure is extremely high (systolic blood pressure over 180 mmHg or diastolic blood pressure over 120 mmHg), and you experience symptoms such as severe headache, shortness of breath, nosebleeds, or chest pain, seek immediate medical attention. This situation warrants an evaluation by a cardiologist.

3. Secondary Hypertension

• Underlying Conditions: If your hypertension is suspected to be caused by an underlying condition such as kidney disease, endocrine disorders, or sleep apnea, a cardiologist can help diagnose and treat the root cause effectively.

4. Complications from Hypertension

• Heart Disease Symptoms: If you develop symptoms that could indicate heart complications from hypertension, such as chest pain, shortness of breath, palpitations, or swollen ankles, consult a cardiologist. These symptoms may indicate heart failure, coronary artery disease, or other heart conditions.

5. Family History of Heart Disease

• Genetic Risk: If you have a family history of heart disease, you may be at higher risk for complications from hypertension. A cardiologist can provide a comprehensive evaluation and preventive care plan.

6. Severe or Unusual Symptoms

• Alarming Symptoms: If you experience severe headaches, vision changes, or neurological symptoms (such as weakness or numbness), which could be associated with hypertensive complications, seeing a cardiologist is crucial.

7. Pre-Existing Heart Conditions

• Existing Heart Disease: If you already have heart disease or have had a heart attack, managing your hypertension is critical to preventing further complications. A cardiologist can tailor your treatment to protect your heart health.

8. Planning for Pregnancy

• Hypertension in Pregnancy: If you have hypertension and are planning to become pregnant, or are currently pregnant, it’s important to see a cardiologist to manage your blood pressure and reduce risks for you and your baby.