Hypertension

Hypertension is generally defined as a systolic blood pressure greater than 140 mmHg and a diastolic pressure greater than 90 mmHg. Human blood pressure naturally fluctuates throughout the day. High blood pressure is a problem only when the blood pressure is persistent. Blood pressure makes the circulatory system and organs that receive blood supply (including the heart and brain) becomes strained (Palmer, 2005).

According to the WHO limit of normal blood pressure is 120-140 mmHg systolic and 80-90 mmHg diastolic pressure. A person suffering from hypertension when blood pressure > 140/90 mmHg. Meanwhile, according to JNC VII 2003 blood pressure in adults aged over 18 years are classified stage I hypertension when sistoliknya pressure 140-159 mmHg and diastolic pressure of 90-99 mm Hg were classified with hypertension stage II when the pressure over 160 mmHg sistoliknya and diastolic over 100 mmHg, whereas hypertension stage III when the pressure over 180 mmHg sistoliknya 21 and diastolic pressure over 116 mmHg. Hypertension in the elderly is defined as a systolic pressure of 160 mmHg and a diastolic pressure of 90 mmHg (Smeltzer, 2001).

A. Clinical Manifestations

The clinical manifestations of hypertension is generally divided into (Rokhaeni, 2001)

1. No symptoms

There are no specific symptoms that can be associated with increased blood pressure, in addition to the determination of arterial pressure checked by a doctor. This means that arterial hypertension will never diagnosed when arterial pressure was not measured.

2. Symptoms commonly

It is often said that the common symptoms that accompany hypertension include headache and fatigue. In fact this is a common phenomenon that the majority of patients who seek medical help.

The clinical manifestations of hypertension in the elderly in general are: Headache, nose bleeding, Vertigo, Nausea vomiting, vision changes, Tingling in the feet and hands, shortness of breath, seizures or coma, chest pain (Smeltzer, 2001).

High blood pressure is a disorder "long life" but sufferers can live a normal life like everyone healthy as long as it is able to control their blood pressure well. On the other hand, people who are young and healthy should always monitor his blood pressure, at least once a year.

Especially for those who have hypertension trigger factors such as being overweight, diabetic, have heart disease, there is a family history of high blood pressure, pregnant women taking the contraceptive pill, smokers and people who never revealed his blood pressure was a little high. If hypertension is known earlier, the control can be done immediately.

B. Hypertension Risk Factors

The age factor is very influential on hypertension. As age increases, the higher the risk of hypertension. The incidence of hypertension increased with increasing age. This is often caused by natural changes in the body that affect the heart, blood vessels and hormones. Hypertension in aged less than 35 years will increase the incidence of coronary artery disease and premature death (Julianti, 2005).

Family history is also a problem that triggers the problem of hypertension. Hypertension tends to be a hereditary disease. If one of the parents had a history of hypertension throughout life then we have a 25% chance of hypertension (Astawan, 2002). Salt is a factor in the pathogenesis of hypertension.

Hypertension is almost never found in ethnic groups with a minimum of salt intake. Salt intake of less than 3 grams per day led to lower hypertension. If salt intake is between 5-15 grams per day, the prevalence of hypertension increased to 15-20%. The effect of salt intake on the incidence of hypertension terjadai through increased plasma volume, cardiac output and blood pressure (Basha, 2004).

Salt contains 40% sodium and 60% chloride. People who are sensitive sodium increase sodium more easily, leading to fluid retention and increased blood pressure (Sheps, 2000). Salt is closely linked to high blood pressure. Vascular disorders is hardly found in tribal low salt intake. If salt intake is less than 3 grams a day presentation hypertension prevalence is low, but if the salt intake of 5-15 grams per day, will increase the prevalence of 15-20% (Wiryowidagdo, 2004). 

The salt has a water holding properties. Consuming more salt or eating food marinated in itself will raise blood pressure. Avoid excessive use of salt or salty foods. This does not mean stopping the use of salt in the diet altogether. Instead the amount of salt consumed is limited (Wijayakusuma, 2000).

Smoking is one of the factors that can be changed, while the relationship of smoking with hypertension is nicotine. Nicotine will cause an increase in blood pressure because the nicotine is absorbed in the small blood vessels of the lungs and circulated by the blood vessels to the brain, the brain reacts to nicotine by way signals the adrenal glands to release epinephrine (adrenaline). This powerful hormone that constricts blood vessels and forces the heart to work harder because the pressure is higher. In addition, the carbon monoxide in cigarette smoke replaces oxygen in the blood. This would lead to blood pressures as the heart is forced to pump enough oxygen to enter into the organs and tissues (Astawan, 2002).

Activities greatly affects the occurrence of hypertension, in which the person will tend to have high activity heart rate is higher. So that the heart muscle has to work harder at each contraction. The more violent and frequent pumping of the heart muscle, the greater the pressure imposed on the arterial (Amir, 2002).

Stress is an issue that is closely trigger hypertension. The relationship between stress and hypertension presumably through an increase in sympathetic nerve activity can raise blood pressure intermittently (erratic). Chronic stress can lead to high blood pressure settled. Although this has not been proven but the incidence is higher in urban than in rural areas. This can be attributed to the influence of stress experienced by the people living in the city (Dunitz, 2001).

C. How The Management of Hypertension

To cope with hypertension can be done by:

1) Reduce the consumption of salt and saturated fat,

2) Exercise regularly and dynamic (which is not too much exertion) such as swimming, jogging, brisk walking and cycling,

3) Stopping smoking,

4) Maintain the stability of weight, avoiding overweight and obesity.

5) Keep and avoid stress with religious and spiritual approach as one of its efforts.

D. Complications of Hypertension

Stroke can result from high pressure bleeding in the brain, or due to an embolus that apart from non brain vessels exposed high pressure. Stroke can occur in chronic hypertension when the arteries that supply blood to the brain undergoes hypertrophy and thicken, so that blood flow is reduced. Arteries of the brain that had weakened so that atherosclerosis may increase the likelihood of aneurysm formation (Corwin, 2000).

Symptoms of stroke include headache suddenly, like, people are confused, bewildered or behave like a drunk, one part of the body feels weak or difficult to be moved (eg, face, mouth, or a stiff arm, can not speak clearly) and sudden unconsciousness (Santoso, 2006).

Complications of hypertension can also lead to kidney failure and heart failure.

I hope this information is useful and makes us more aware of hypertension.