Is High Blood Pressure Damaging Your Organs? A Simple Urine Or Blood Test Can Tell
World Hypertension Day: High blood pressure affects 1 in 4 Indian adults but often goes undiagnosed. It's a 'silent killer'. Diagnosis involves regular blood pressure checks & tests for organ damage.
By Dr Renji Jacob
Hypertension, or high blood pressure, is a condition characterised by persistently elevated pressure in the arteries, the blood vessels that carry blood from the heart to the rest of the body. This increased pressure forces the heart to work harder to circulate blood, which over time can lead to serious health complications.
In India, at least one in four adults is affected by hypertension. Alarmingly, approximately 46% of those with the condition are unaware of their diagnosis, underscoring a significant gap in early detection and management. Less than half of adults with hypertension are diagnosed and treated.
Most people with hypertension do not experience any symptoms, which is why it is often referred to as the “silent killer.” In some cases of very high blood pressure, individuals may experience symptoms like headaches, blurred vision, chest pain, and shortness of breath. If left unmanaged, hypertension can lead to severe complications such as stroke, heart attack, heart failure, kidney damage, or vision loss.
How Is Hypertension Diagnosed?
The best way to know if you have high blood pressure is to measure it regularly. Hypertension is diagnosed when, on two different days, the systolic blood pressure (the top number) is ≥140 mmHg and/or the diastolic blood pressure (the bottom number) is ≥90 mmHg. In elderly individuals, target blood pressure levels may be moderated based on existing comorbidities.
In addition to blood pressure measurement, initial evaluation includes basic tests such as:
- Fasting blood glucose
- Complete blood count
- Lipid profile
- Serum creatinine with estimated glomerular filtration rate (eGFR)
- Serum electrolytes (sodium, potassium, calcium)
- Uric acid
- Thyroid-stimulating hormone (TSH)
- Urine analysis
During follow-ups, markers of target organ damage should be assessed to monitor disease progression. To evaluate potential kidney involvement, tests such as urinary protein-to-creatinine ratio (UrP/C), urinary microalbumin (UrMab), serum creatinine, and serum electrolytes should be done.
Concurrent dyslipidemia, marked by high total cholesterol, elevated low-density lipoprotein (LDL), and low high-density lipoprotein (HDL), also increases the risk of cardiovascular disease. Additional cardiac markers like homocysteine, atrial natriuretic peptide (ANP), and brain natriuretic peptide (BNP) can help assess heart health more precisely.
In cases of suspected secondary or drug-resistant hypertension, further testing such as 24-hour urine metanephrines and normetanephrines, 24-hour urine aldosterone, and aldosterone-renin ratio may be necessary.
Hypertension In Pregnancy
Preeclampsia, a form of hypertension that develops during pregnancy, requires special attention. Evaluation of end-organ damage in preeclampsia includes lab markers such as abnormally low platelet count, elevated serum creatinine, and liver transaminases more than twice the upper limit of normal.
Managing Blood Pressure = Managing Your Life
Managing your blood pressure is crucial to maintaining overall health. Effective hypertension control significantly reduces the risk of heart failure and slows the progression of kidney disease associated with high blood pressure.
Treatment includes both lifestyle changes and, when necessary, antihypertensive medications.
Lifestyle modifications involve:
- Adopting a diet rich in fruits, vegetables, and low-fat dairy
- Reducing processed foods and salt intake
- Engaging in regular physical activity
- Moderating alcohol consumption
- Managing stress effectively
Many individuals will also require medications to reach their target blood pressure. The choice of medication, or a combination of drugs, depends on several factors, including age, severity of hypertension, the presence of other cardiovascular risk factors, comorbidities, and practical considerations such as cost, potential side-effects, and dosing frequency.
While hypertension poses a major health challenge, it doesn’t have to define your life. With timely detection, the right treatment, and consistent lifestyle changes, high blood pressure can be effectively controlled, allowing individuals to lead healthier and longer lives.
Dr Renji Jacob is Head of Lab Operations, MD Pathology, at Metropolis Healthcare Limited (Kerala).
[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]
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