Hypertension is an asymptomatic disease that damages your organs before any symptoms appear. In other words, you may find out you have hypertension when it is too late to do something about it, in a stage of complications that may lead to death. Thus, it’s known as “The silent killer.”
If you -as a hypertension patient- were not diagnosed early and your case was not managed the correct way, your blood pressure would reach high levels (140/90) that may cause life-threatening or disabling complications. For example, hypertension can affect the following organs:
- The blood vessels, causing narrowing or occlusion
- The heart, causing heart failure
- Your brain, decreasing the blood flow and causing stroke
- The kidneys, causing renal failure
- The eye, causing blindness.
Doctors consider these complications as emergency conditions that need urgent intervention and hospitalization. Thus, we will discuss the complications of hypertension in a simple, understandable way.
The blood vessels, causing narrowing or occlusion
Hypertension is the increase in the pressure of the blood that runs in the blood vessels. Evidently, before affecting any organ, it will affect your blood vessels in the first place. When the blood pressure increases, it causes injury to the inner layer of your blood vessels (endothelial layer) as well as the middle layer of muscles. These changes will affect the nature of the blood vessel lining, such as the elastic nature that allows blood vessels to adapt to blood pressure changes and maintain blood flow to the organs. Also, this injury leads to the formation of thrombi -due to activation of the coagulation system- that occlude the blood vessels or narrow them down. These effects result in a condition called: “atherosclerosis”.
This progressive damage of your blood vessels will affect the rest of your organs and cause several complications associated with hypertension. For example, it can affect your heart through the coronary arteries, your kidney through the renal arteries, your brain through the cerebral arteries, and the retina in your eye through retinal arteries.
The heart, causing heart failure
In your heart, when hypertension damages the coronary arteries -blood vessels that supply your heart muscles with blood and oxygen-, this will reduce the blood supply to the heart muscles and causes heart infarction (damage or death of the heart muscle). This effect will lead to coronary heart disease (CHD), also known as coronary artery disease (CAD). In these cases, you may experience symptoms such as chest pain that radiates to your left arm, back, or neck which may be accompanied by nausea, sweating, and dizziness.
Also, the increase in your blood pressure will increase the load on your heart, forcing your heart to work harder with more pumping power than the average to overcome the increased pressure inside the blood vessels and maintain adequate blood flow to your body tissues. In this condition, your heart begins several adapting changes to make up for these increased needs. This pressure change prolonged in time leads to hypertrophy (thickening and stiffness) of the heart wall -especially the wall of the left ventricle. But instead of a good thing, hypertrophy of heart muscle results in a less efficient heart that’s unable to meet your body needs from oxygen and other nutrients, i.e. “heart failure.” You may experience a “heart failure” in the form of several symptoms such as shortened and difficult breath, recurrent heart attacks, fatigue, and edema (swelling in the lower limb and abdomen).
We have discussed how hypertension affects your cardiovascular system (the heart and blood vessels). This effect won’t stop at the cardiovascular system because this system pumps and carries the blood to all organs in your body, including vital organs such as the brain, kidney, eye…etc. These organs will suffer from a decrease in the oxygen levels and nutrient supply, and this will affect their performance and their vital function.
Your brain, decreasing the blood flow and causing stroke
Now, let’s discuss the neurological complications of hypertension. Hypertension may damage the blood vessels that carry blood to your brain (cerebral arteries), leading to their narrowing or even occlusion by thrombus (cerebral atherosclerosis), which reduce the blood flow to your brain. This effect results in the death of the brain areas supplied by these affected vessels, which is clinically known as stroke (embolic stroke). There are areas of the brain to control your thinking, reasoning, memory, speaking, vision, and all your motor and sensory functions. Thus, stroke is a primary cause of disability and death with a higher risk in hypertensive patients.
Also, hypertension may rupture the small blood vessels in the brain, which causes another type of stroke called “hemorrhagic stroke” that is usually less common but more dangerous than the embolic stroke. So, hypertension may affect your brain in a dangerous way that may lead to death.
The kidneys, causing renal failure
Now, let’s discuss the renal complication of hypertension. Your kidneys have a critical function. They filtrate your blood, eliminating the waste products into the urine while reabsorbing the essential elements that you need back to your blood. Your kidneys perform this function through a small structural and functional unit called nephron. The role of the kidneys depends on the integrity of the blood vessels that carry blood to be filtered through the nephrons and supply these functional units with oxygen and nutrients.
Hypertension may damage the blood vessels that supply your kidneys (renal arteries), which means your kidneys won’t receive enough amount of blood to filtrate, and the nephrons won’t function properly due to the reduced oxygen and nutrient supply. This means that your kidneys will fail to perform their function, and the waste products will accumulate in your body in a condition called “Renal failure”.
Also, your kidneys play an essential role in regulating your blood pressure by their ability to secrete the aldosterone hormone under normal conditions. Kidneys with renal failure -due to hypertension- can’t secrete aldosterone, and this leads to further increase in blood pressure readings and further damage. This means that hypertension and renal failure lead to one another, resulting in a closed circle of harmful events.
The eye, causing blindness
The complications of hypertension may also extend to your eyes in the case of long-term hypertension, and this may lead to severe harmful effects, including loss of vision. Your eyes have small blood vessels that supply vital structures such as the retina and the optic nerve. Hypertension damages the blood vessels in the retina and reduces the blood supply. This condition will disrupt the function of the eye and may even cause a complete loss of vision in a condition called “Hypertensive Retinopathy”.
Additionally, hypertension damages the blood vessels that supply the optic nerve, causing optic nerve death in a condition called“optic neuropathy”. The optic nerve is one of the essential elements for vision, and without it you will lose your ability to see. This is how hypertension may cause temporary or even permanent vision loss.
Hypertension can also affect your eyes by another mechanism through its effect on the brain. Hypertension causes stroke (damage of the brain areas) which may involve the areas of the brain where our visual field travels or is registered via the optic nerve. If the stroke affected these areas, it would impair your vision and lead to blindness.
Hypertension could also affect your sexual life regardless of your gender.
In males, a penile erection occurs by pumping large amounts of blood into the empty spaces in the penile tissue. Then, the penis swells and hardens, and the erection occurs. This mechanism depends on the dilation of the blood vessels supplying the penis to pump the blood required to the erection, and this doesn’t happen in the case of hypertension because the damaged blood vessels can’t dilate and the patient won’t achieve an erection of the same quality. This condition is known as “erectile dysfunction”.
In females, hypertension can affect their libido (sexual desire) because it reduces the blood flow to the vagina, affecting vaginal lubrication and the enjoyment of the sexual act.
Hypertension in pregnant females (called gestational hypertension) has dangerous complications such as eclampsia (toxemia of pregnancy), and it may also continue after pregnancy causing chronic hypertension. Also, it might affect the baby if the blood vessels that supply the placenta are damaged -by hypertension- because that would lead to a lack of oxygen and nutrient supply to the baby.
In the end, you need to know that you could avoid these complications if you are diagnosed with hypertension and start an early treatment. And you could discover this condition earlier still if you understood more about its causes and risk factors. Information is fundamental to good health, which is why I recommend you to keep on reading and researching about hypertension to detect this condition early and start doing something about it.