Heart Disease

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2.77 Classification of Blood Pressure – Every person should know his/her BP and should understand what numbers mean. The classification of BP, based on the law of averages, for persons over 18 years of age is as follows: –

		Systolic Pressure Range	Diastolic Pressure Range
Low Blood Pressure		80-90	60-80
Normal Blood Pressure		90-120	Below 80
Pre-Hypertension (Grey Area)		120-140	80-90
Stage-I Hypertension		140-160	90-100
Stage-II Hypertension		160-180	100-110
Stage-III Hypertension		180 or higher	110 or higher

2.78 Symptoms of High Blood Pressure – The vast majority of people with mild or moderate hypertension may not produce any symptoms and as such may not often be diagnosed for many years by which time the person has subtle evidence of damage to heart, brain or kidneys. The early symptoms may appear in the form of pain towards the back of the head and neck on waking in the morning, which soon disappears. Some of the other usual symptoms (not in any order) are: (i) aches and pains in the arms, shoulder region, legs and back; (ii) frequent urination; (iii) excessive perspiration; (iv) palpitation and irregular heart beat; (v) heaviness in the head and eyes; (vi) headaches; (vii) muscle cramps; (viii) general weakness; (ix) restlessness and nervous tension; (x) irritability; (xi) blurred vision; (xii) nausea; and (xiii) insomnia/wakefulness and sleep apnea.

2.79 Late symptoms of more serious nature could be: (i) hypertensive heart disease with enlarged heart; (ii) possible left ventricular failure; (iii) myocardial infraction; (iv) possible senility; cerebral haemorrhage and paralysis. Some more life-threatening symptoms like dizziness, nose bleeding and blood in the urine or pain in the chest typically don’t occur till BP has reached a more advanced stage of hypertension and these symptoms need immediate medical attention.

2.80 Complications of Hypertension for Heart Disease – The blood supply to the heart is brought to it by the coronary arteries. If the BP is higher than normal over many years, as in untreated hypertension, the lining of the arteries can become roughened and thickened and this eventually causes them to narrow and become less flexible or elastic. This is called arteriosclerosis. In this case of narrowed arteries, sufficient blood does not get to the heart muscle efficiently. So when the heart needs to work a little harder; e.g. when you are walking up a hill, the heart muscle cannot get the blood supply and oxygen that it needs. This causes pain in the chest known as angina or myocardial ischaemia. The increased workload due to narrowed and hardened arteries makes it harder and harder for the heart to pump blood efficiently to the rest of the body. This eventually damages the heart and impairs its performance. Fluid collects in the lungs, causing shortness of breath. This is called heart failure or congestive cardiac failure. If the coronary artery narrows due to high BP and then a blood clot forms in the artery, the part of the heart muscle that relies on that coronary artery dies. This is known as heart attack or coronary thrombosis or myocardial infraction. Experts believe that thin people who are hypertensive have worse coronary heart disease and more complications associated with peripheral vascular disease because their artery walls are thinner and more prone to damage.