Title: Hypertension (high blood pressure)
Course: Non-Communicable Diseases, Emergency Care and Mental Health Part 1 - Ethiopia (Full)

Hypertension (high blood pressure)

High blood pressure is medically known as hypertension. There are many causes of hypertension, including kidney diseases, narrowing of the aorta (the biggest artery leaving the heart), diabetes, the excessive use of alcohol and some medical drugs. However, in most cases of hypertension the cause remains unknown and this is called essential hypertension.

Can you name any other causes of hypertension from a previous Module?

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Pre-eclampsia and eclampsia were described in the Antenatal Care Module.

Risk factors for hypertension

Having a high level of fat (cholesterol) in the blood, old age, poor nutrition, being overweight or obese, excessive alcohol intake, diabetes, taking oral contraceptive pills for many years, being physically inactive and, most importantly, being a cigarette smoker – are all risk factors for hypertension. Most of these factors are preventable by teaching the community to change their behaviour to healthier ways.

What could a person stop doing in order to reduce their risk of developing hypertension?

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He or she could stop smoking cigarettes, stop over-eating and drinking excessive amounts of alcohol, and (for women) stop taking oral contraceptive pills and change to another method of birth control after a few years.

What could a person start doing in order to reduce the risk?

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He or she could start eating a healthier diet, start losing weight if already obese, and start taking more exercise.

Signs and symptoms of hypertension

A person with hypertension might come to you with complaints of headaches, blurring of vision, chest pain, nose bleeds and restlessness. You should measure their blood pressure to see if it is high. Refer to Table 1.2 to see the normal and abnormal blood pressure values.

In your Health Post you are supposed routinely to check the blood pressure of your clients, using the blood pressure apparatus supplied to you. Whenever the systolic pressure is greater than 140 mmHg and the diastolic pressure is greater than 90 mmHg, it is advisable to refer the person to the nearest health centre for further evaluation. See Table 1.2 to determine the category of hypertension.

Table 1.2 Blood pressure levels for adults

Category | Systolic (mmHg) | Diastolic (mmHg) | Advice
Normal | Less than 120 | Less than 80 | None
Pre-hypertension (before hypertension starts) | 120-139 | 80-89 | You should advise people with hypertension to make changes in what they eat and drink, to be physically active, and lose extra weight. If your client also has diabetes, refer him or her.
Hypertension | 140 or higher | 90 or higher | This person has high blood pressure. Refer him or her to a higher health facility.