Understanding hypertension

Understanding hypertension

Blood pressure is the force of blood pushing against the walls of your arteries as the heart pumps. It is written as two numbers: the higher (systolic) number is the pressure while the heart contracts, and the lower (diastolic) number is the pressure while the heart relaxes between beats. Hypertension means this pressure is repeatedly higher than it should be, forcing the heart to work harder and gradually straining artery walls, even when you feel entirely well.

Blood pressure naturally varies through the day — with activity, stress, sleep and even the time of the reading — so a single high number in clinic does not confirm hypertension. Diagnosis is usually based on repeated readings over time, sometimes supported by home or 24-hour monitoring, to see the true underlying pattern rather than one moment.

What you may notice

Hypertension is often called a "silent" condition for good reason:

• ●Usually no symptoms at all, even at levels that are damaging over time
• ●Sometimes discovered incidentally, during a check-up for something unrelated
• ●Occasional headache, though this is an unreliable sign and often has other causes
• ●Family history, diabetes or kidney disease may raise the likelihood
• ●Complications, when they occur, can affect the heart, brain, kidneys and eyes

Because it so rarely causes symptoms, hypertension is usually found through routine measurement rather than because someone feels unwell — which is exactly why regular checks matter even when you feel fine.

What causes hypertension

In most people, no single cause is found — this is called primary (essential) hypertension, and it develops from a combination of genetic and lifestyle factors over time. In a smaller number of people, hypertension results from an identifiable underlying cause, called secondary hypertension.

Primary hypertension

The most common form, thought to result from a combination of family history, ageing arteries, salt intake, weight and activity levels acting together, without one single trigger.

Secondary hypertension

A smaller number of cases are caused by an identifiable condition, such as kidney disease, some hormone-producing gland problems, or certain medicines — worth considering particularly when blood pressure is very high, appears suddenly, or is difficult to control.

Who is more likely to develop hypertension

• ●Family history of high blood pressure
• ●Increasing age
• ●High salt intake — a significant factor in typical Nigerian diets, often from seasoning cubes and preserved foods rather than table salt
• ●Excess weight, particularly around the waist
• ●Diabetes
• ●Kidney disease
• ●Low physical activity levels
• ●Heavy alcohol use
• ●Chronic stress and poor sleep

What happens if this goes untreated

Because hypertension rarely causes symptoms, its complications are often the first sign that it was present — which is why treatment matters even without symptoms.

Heart disease. The heart has to pump against constantly higher pressure, which over time can enlarge and weaken the heart muscle and contribute to heart failure; it also accelerates artery narrowing that can cause heart attacks.

Stroke. High blood pressure is one of the strongest risk factors for both major types of stroke — from a blocked artery or from bleeding in the brain.

Kidney disease. Sustained high pressure damages the small blood vessels within the kidneys, gradually reducing their ability to filter blood.

Eye damage. Blood vessels at the back of the eye can be damaged by long-standing high pressure, potentially affecting vision.

Hypertensive emergency. Very high pressure, particularly with chest pain, breathlessness, vision change or weakness, can cause sudden, serious organ damage and needs immediate emergency care.

How Cardiocare finds the cause

Confirming hypertension and assessing its impact typically involves:

• 01
  Accurate repeated readings. Blood pressure measured correctly on more than one occasion, since a single reading is not enough to diagnose hypertension.
• 02
  Home or ambulatory monitoring. Readings taken at home, or a portable cuff worn for 24 hours, to see the true pattern outside the clinic.
• 03
  Blood and urine tests. Checking kidney function, diabetes and cholesterol, all closely linked to blood pressure and its risks.
• 04
  12-lead ECG. A painless recording of the heart's electrical activity, taking minutes.
• 05
  Echocardiogram. Where indicated, a painless ultrasound scan checking whether the heart muscle has thickened or weakened.
• 06
  Eye examination. Where indicated, checking the blood vessels at the back of the eye for early changes.
• 07
  Investigation for secondary causes. Considered when blood pressure is very high, appears suddenly, or is difficult to control with usual treatment.

How hypertension is treated

Treatment combines lifestyle measures with medicine, personalised to your readings and overall risk.

Lifestyle measures

Reducing salt intake, maintaining a healthy weight, regular activity, limiting alcohol and managing stress all lower blood pressure meaningfully, and support medicine where it is needed.

Medicines, by class

Several classes of blood pressure medicine exist, often used in combination; your clinician will discuss what suits you:

• ●ACE inhibitors and ARBs — relax blood vessels and protect the kidneys, particularly helpful in diabetes
• ●Calcium channel blockers — relax and widen blood vessels
• ●Diuretics ("water tablets") — help the body eliminate excess salt and fluid
• ●Beta blockers — slow and steady the heart, used in selected situations

Lifelong treatment

For most people, hypertension treatment is lifelong. Feeling well is a sign the treatment is working, not a reason to stop — stopping tablets once blood pressure feels controlled is the most common cause of it rising again.

Living well with hypertension: everyday self-care

• ✓Take medicines at the same time every day, including on days you feel completely well
• ✓Taste food before adding salt, and use fewer seasoning cubes and less preserved fish where possible
• ✓Stay active in ways that are safe for you, as advised by your clinician
• ✓Limit alcohol intake
• ✓Keep a reliable record of home readings, taken at the same times of day
• ✓Manage stress in ways that genuinely work for you — exercise, prayer, family support or counselling

Preparing for your appointment

What to bring

• ✓Your home blood pressure reading record, if you monitor at home
• ✓A list of all medicines you take, including herbal and over-the-counter products
• ✓Previous blood test results or hospital letters
• ✓Your HMO card or payment details
• ✓A valid means of identification

What we will ask

How long you have had high readings, home reading patterns if you monitor, family history, other conditions such as diabetes or kidney disease, and all medicines you currently take.

Questions worth asking us

• ●What is my blood pressure target?
• ●Do I need any tests for an underlying cause?
• ●Are there signs my heart, kidneys or eyes have already been affected?
• ●What should I do if my home readings are high before my next visit?