This article is compiled by Sanjana Varma, a freelance writer at Proactive For Her.
What is hypertension?
Hypertension/High Blood Pressure is a lifestyle disease that is increasingly becoming more common. If not treated, hypertension can lead to severe organ damage and heart diseases. It is a common trigger for heart attacks. Hypertension usually takes years to cause serious damage, hence, the importance of early treatment.
Stages of hypertension
Under the new 2017 guidelines, all blood pressure measurements over 120/80 mm Hg are considered elevated. Now blood pressure measurements are categorized as follows:
- Normal: systolic less than 120 mm Hg and diastolic less than 80 mm Hg
- Elevated: systolic between 120-129 mm Hg and diastolic less than 80 mm Hg
- Stage 1: systolic between 130-139 mm Hg or diastolic between 80-89 mm Hg
- Stage 2: systolic at least 140 mm Hg or diastolic at least 90 mm Hg
Who should get tested for hypertension?
You'll likely have your blood pressure taken as part of a routine doctor's appointment. Ask your doctor for a blood pressure reading at least every two years starting at age 18. The normal blood pressure for a healthy adult is 120/80 mm Hg. The following people are at a higher risk for developing hypertension:
- If your age is 60 and above. The older you the greater your chance of developing hypertension.
- If you have a family history of hypertension
- If you are obese or overweight
- If you are not physically active
- If you consume too much alcohol or tobacco products
- If you are under a lot of stress in life
- If you take too much salt
- If you have less potassium in your diet
- If you have diabetes, kidney disorder or sleep apnea
Sometimes pregnancy contributes to high blood pressure as well.
Recommended Tests
Blood pressure is traditionally measured using a stethoscope and a blood pressure cuff that reads the pressure in millimetres of mercury (mm Hg). This is still considered the best method but, more commonly, devices that combine a blood pressure cuff with electronic sensors are used to measure blood pressure. Once a diagnosis of hypertension has been made there will be a thorough workup of the patient to rule out the presence of other diseases which may cause hypertension. An evaluation using an array of lab tests will also be done to estimate the extent of damage hypertension has caused.
The following are some of the common tests that your doctor may recommend that you get done.
1. Haemoglobin and hematocrit
What is the test?
Haemoglobin (Hb) is a protein in red blood cells that contains an iron molecule. Haemoglobin carries oxygen from the lungs to the body's tissues and returns carbon dioxide from the tissues back to the lungs. Hematocrit is a measurement of the number of red blood cells as related to total blood cell count. A patient is said to be anaemic if the haemoglobin in their body is low.
What is the relevance?
- A low hematocrit due to anaemia could increase your risk for strokes and heart attacks.
- If a hypertensive patient is found to be anaemic, the underlying cause must be found and addressed, and the anaemia corrected. Anaemia may also be the result of severe kidney damage that is a complication of hypertension.
2. Urinalysis / Urine Examination
What is the test?
When the kidneys filter blood, they separate waste from the blood cells and proteins. The waste is sent to the bladder as urine. By examining what is present in a patient’s urine, the provider can determine how well a patient’s kidneys are functioning.
A urinalysis consists of a chemical, microscopic and visual examination of urine samples. The test may reveal the presence of substances in urine like glucose and protein which are not normally found and this may indicate a defect in the normal functioning of the kidney.
What is the relevance?
- Urinalysis is used to screen for causes of secondary hypertension, and to look for damage to the kidneys as a result of hypertension. Normally, protein is too large a substance to be filtered through our kidneys, so urine usually doesn’t contain any protein.
- Sometimes, however, untreated hypertension can cause damage to the kidneys. When this happens, the filtration system may leak, allowing protein and sometimes blood to enter the fluid that is filtered out to become urine. When blood or protein is found in the urine, it may indicate that damage due to high blood pressure has occurred.
3. Kidney Function Tests
What is the test?
Kidney function tests are done to evaluate how well your kidney is functioning. They are used to help diagnose and manage conditions affecting kidney function. They may be used as part of general health screening or to screen someone who is at risk of developing kidney disease, especially if your family has a history of kidney diseases.
It includes:
- Urine tests to look for any kidney disease
- Blood tests for checking imbalances in kidney function such as blood urea and creatinine levels
What is the relevance?
- Diabetes and hypertension are common causes and main risk factors for kidney disease.
- Some of the parameters estimated in renal function tests like serum creatinine, blood urea nitrogen (BUN) may be elevated and can indicate kidney damage.
- Estimated glomerular filtration rate (eGFR) is another parameter of the renal function test. A reduced value indicates that your kidneys are not functioning as efficiently as they should.
4. Thyroid profile
What is the test?
The thyroid profile evaluates the functioning of the thyroid gland. The thyroid is a butterfly-shaped gland situated in front of your neck. Specifically, it measures the amounts of thyroid hormones and thyroid-stimulating hormones in the body. Three hormones are part of a standard thyroid panel: TSH (thyroid-stimulating hormone), Free T4 (thyroxine) and T3 (triiodothyronine).
What is the relevance?
- The drop or increase in your thyroid hormones affects the blood flow which pushes your kidney to increase the blood pressure.
- Hypothyroidism has been especially linked to hypertension. Hypothyroidism is also linked to raised blood cholesterol which can cause heart diseases.
- Hypertension is a leading cause of heart disease. Hence it is necessary to ensure that thyroid hormones especially in a hypertensive patient are at optimum levels while managing elevated blood pressure.
5.Lipid Profile
What is the test?
The lipid panel measures the amount of specific fat molecules called lipids in the blood. As a panel test, it measures multiple substances, including several types of cholesterol. The lipid panel analyzes your blood to estimate:
- Total cholesterol
- Low-density lipoprotein (LDL) cholesterol /bad cholesterol
- High-density lipoprotein (HDL) cholesterol/good cholesterol
- Triglycerides
What is the relevance?
- Hypertension is associated with an abnormally high level of lipids.
- Hypertension is associated with alterations in lipid metabolism which gives rise to abnormalities in serum lipid and lipoprotein levels.
- The presence of hyperlipidaemia substantially worsens the prognosis in hypertensive patients.
- Lipid levels increase as BP increases.
- High lipid levels increase your risk for heart disease and a heart attack or stroke. It is important in hypertensive patients to keep cholesterol levels in the normal range to prevent cardiovascular complications.
6. Blood Sugar test
What is the test?
A blood test is an accurate way to diagnose blood sugar. Your doctor may recommend a fasting blood sugar test, postprandial test and HbA1C test. Fasted blood sugar is measured after a minimum of 8 hours of fasting. It is usually taken in the morning. The postprandial range is measured two hours after eating food. HbA1C measures the average blood sugar level in your blood. It gives you an idea about your sugar level for three months.
What is the relevance?
- Raised blood sugar can increase your risk for developing high blood pressure and more importantly diabetes.
- Diabetes and high blood pressure together are part of a health condition called metabolic syndrome.
7. Electrolyte Panel
What is the test?
Electrolytes are electrically charged minerals that help control the number of fluids and the balance of acids and bases in your body. They also help control muscle and nerve activity, heart rhythm, and other important functions. An electrolyte panel, also known as a serum electrolyte test, is a blood test that measures levels of the body's main electrolytes: sodium, potassium, chloride and bicarbonate. Abnormal electrolyte levels can also be caused by several different conditions including:
- Dehydration
- Kidney disease
- Heart disease
- Diabetes
- Vomiting
Even medication for hypertension can cause abnormal electrolyte levels.
What is the relevance?
- High blood pressure medication works by affecting the fluid and electrolyte balance in your body.
- Electrolyte testing is recommended to monitor the side effects of blood pressure medication and look for signs of kidney disease.
Non-laboratory tests
Hypertension often causes damage to blood vessels without producing any symptoms initially. Hence, it is important to regularly monitor for any ongoing damage to various organs in the body.
Here are some of the tests besides blood tests that your doctor would recommend to detect signs of any damage due to hypertension:
- Ophthalmoscopic tests to identify signs of hypertensive damage to the eyes.
- X-Ray Imaging to identify any abnormalities in the size of your heart.
- Electrocardiogram (ECG OR EKG) to monitor the electrical activity of the heart. It can help diagnose common hypertension-related cardiac complications like hypertrophy, muscle damage, ischemic disease and more.
- Cardiac Ultrasound or Echocardiogram to capture and transmit images of the beating heart to a video screen. The test can accurately identify hypertension-related damage to the heart in the form of increased muscle thickness, stiffening of the heart muscle and weakness of heart chambers.
- Arterial Stiffness Assessment, a non-invasive test that monitors the condition of the blood vessels. Hypertension leads to stiffening of the blood vessels which ultimately causes all the damage to the organs. Arterial stiffness measurement can diagnose it at an early stage.
Your heart matters.
Hypertension can be fatal if untreated. It is important to listen to your body and go for annual body check-ups to rule out any lifestyle diseases. Hypertension can be managed with medication and a healthy active lifestyle. You can buy a blood pressure monitor at home and check at your convenience. Let’s take matters of the heart more seriously. You are worth it!
Disclaimer - This information is provided for educational purposes and should not be construed as medical advice. Please consult with your healthcare practitioners before undertaking any changes in your diet or adding supplements.
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