Hypertension

Hypertension Treatment

Hypertension or high blood pressure puts extra strain on heart and blood vessels and over time this extra strain increases the risk of heart attack or stroke.

	Systolic (mmHg)	Diastolic (mmHg)
Normal blood pressure	Less than 120	Less than 80
Elevated	Between 120 and 129	Less than 80
Stage 1 hypertension	Between 130 and 139	Between 80 and 89
Stage 2 hypertension	At least 140	At least 90
Hypertensive crisis	Over 180	Over 120

Risks of high blood pressure

Risks of high blood pressure
Heart disease
Heart attacks
Strokes
Heart failure
Peripheral arterial disease
Aortic aneurysms
Kidney disease
Vascular dementia

Causes of Hypertension

Primary Hypertension: This type of high blood pressure has no established cause.

Genes: Some people are genetically predisposed to hypertension. This may be from gene mutations or genetic abnormalities inherited from your parents.
Physical changes: If something in your body changes, you may begin experiencing issues throughout your body. High blood pressure may be one of those issues.
Environment: Over time, unhealthy lifestyle choices like lack of physical activity and poor diet can take their toll on your body. Lifestyle choices can lead to weight problems. Being overweight or obese can increase your risk of hypertension.’

Secondary Hypertension: Secondary hypertension often occurs quickly and can become more severe than primary hypertension

Kidney disease
Obstructive sleep apnea
Congenital heart defects
Problems with your thyroid
Side effects of medications
Use of illegal drugs
Alcohol abuse or chronic use
Adrenal gland problems
Certain endocrine tumours

Symptoms of Hypertension

High blood pressure usually has no signs or symptoms, so the only way to know if you have high blood pressure is to have yours measured.

Headaches
Shortness of breath
Nosebleeds
Flushing
Dizziness
Chest pain
Visual changes
Blood in the urine

Complications

If control measures are not taken, excessive pressure on the artery walls can leads to damage the blood vessels and can lead to cardiovascular diseases. The severity depends on the hypertension level and how long it continues without treatment.

Complications of high blood pressure include:
Stroke
Heart attack and heart failure
Blood clots
Aneurysm
Kidney disease
Thickened, narrow, or torn blood vessels in the eyes
Metabolic syndrome
Brain function and memory problems

Hypertension Treatment

Lifestyle adjustments are the standard, first-line treatment of high blood pressure. Lifestyle modification can significantly reduce the risk of hypertension and lowers the blood pressure, without medication.

Regular physical exercise: Engage in aerobic exercise at least 150 minutes of moderate-intensity or 75 minutes of high intensity.
Stress reduction: Smoking, consuming alcohol and junk food can contribute to elevated blood pressure and the complications of hypertension. Meditation, yoga, and activities which makes you happy can make you relax and can help relieve stress.

Medication for Hypertension Treatment

Diuretics, including thiazides, chlorthalidone, and indapamide
Beta-blockers and alpha-blockers
Calcium-channel blockers
Central agonists
Peripheral adrenergic inhibitor
Diuretics
ACE inhibitors
Vasodilators
Angiotensin-converting enzyme (ACE) inhibitors
Angiotensin receptor blockers

Diet for Hypertension Treatment

Reducing salt intake
Moderating alcohol consumption
Eating more fruit and vegetables and less fat
Managing body weight

Cardiac Surgeries

Congenital & Treatment
Non Surgical Heart
Open Heart Surgeries

Congenital and Paediatric Heart Defects Treatment

Heart Hole Surgery
Tetralogy of Fallot Surgery
Patent Ductus Arteriosus Surgery

Non Surgical Heart Treatments

Percutaneous Transluminal Coronary Angioplasty (PTCA) treatment

Causes of Coronary Artery Disease

There are many risk factors related to coronary heart disease. Some of these risk factors can be controlled through lifestyle changes and/or medications, while others cannot. Controllable factors include:

High blood cholesterol
Smoking
High blood pressure
Type 2 diabetes
Physical inactivity
Obesity
Poor diet
Stress / anxiety

Symptoms of Coronary Artery Disease

Coronary artery disease (CAD) is a narrowing of the blood vessels that supply blood and oxygen to the heart. The most common symptom of coronary artery disease is angina or chest pain. Angina can be described as a discomfort, heaviness, pressure, aching, burning, fullness, squeezing, or painful feeling in your chest. It can be mistaken for indigestion or heartburn. Angina may also be felt in the shoulders, arms, neck, throat, jaw, or back. Some other symptoms of coronary artery disease include:

Shortness of breath
Palpitations (Irregular Heartbeats)
A faster heartbeat
Weakness or dizziness
Nausea
Sweating

Diagnosis & Tests:

Investigations like EEG, Chest X-Ray, Stress test, Tilt Table test, Echocardiogram, Electrophysiology, Angiography, CT Heart Scan, Myocardial Biopsy, Heart MRI may be suggested by the doctor.

What is Angiography?

An angiography helps diagnose conditions that affect blood vessels and the flow of blood through them. The image on an angiogram is used to plan surgeries involving the blood vessels, such as Coronary Artery Bypass Grafting (CABG) or Open Heart Surgery & coronary angioplasty (PTCA), which are performed to treat coronary heart disease.

Treatment of Coronary Heart Disease

PTCA is a treatment of coronary artery disease. In angioplasty, a balloon-tipped catheter is inserted through the skin into a blood vessel and to the clogged portion of the artery. There it is threaded into the blockage and inflated, compressing the plaque (build-up of fat and cholesterol) against the arterial walls. Frequent postoperative reclogging (narrowing of a blood vessel) of the treated area has led to the use of stent (sometimes coated with a drug that inhibits narrowing of a blood vessel) designed to hold the plaque back.

Radio Frequency Ablation (RFA) Procedure

(RFA) is a medical procedure where part of the electrical conduction system of the heart, tumor or other dysfunctional tissue is ablated using the heat generated from the high-frequency alternating current to treat a medical disorder. Radio frequency ablation is a minimally invasive procedure used in the treatment of varicose veins and certain types of Artery Blockages. It is an alternative to the traditional stripping operation. If radio frequency ablation is recommended, a doctor will explain the procedure in detail, including possible complications and side effects. An intravenous (IV) line may be placed in a vein in your arm before the procedure and a local anaesthetic and mild sedative may be used to reduce any discomfort during RFA. You may be awake during the process to aid in properly assessing the procedure.

Electro Physiology Study (EPS)

Electrophysiology Study (EP test or EP study) is a minimally invasive procedure which tests the electrical conduction system of the heart to assess the electrical activity and conduction pathways of the heart. The study is indicated to investigate the cause, location of origin, and best treatment for various abnormal heart rhythms. This type of study is performed by an electrophysiologist and using single or multiple catheters situated within the heart through a vein or artery. The study involves placing wire electrodes in the heart. These electrodes measure electrical activity in the heart and its muscle cells. The procedure is done in a hospital laboratory by trained staff that includes a cardiologist, technicians, and nurses. The electrodes detect the heart electrical activity and are used to check the heart’s electrical system.

Electrical signals may be used to make the heart skip beats or produce an abnormal heart rhythm. This can help the doctor understand more about what is causing the abnormal heart rhythm or where in the heart it is starting.

An EPS may be done to:

Test the function of your heart electrical system
Pinpoint a known abnormal heart rhythm (arrhythmia) that is starting in the heart, and help decide the best therapy for it
Determine whether you are at risk for future heart events, especially sudden cardiac death
See if the medicine is controlling an abnormal heart rhythm
See whether you need a pacemaker or implantable cardioverter-defibrillator (ICD)

Open Heart Surgeries

Coronary Artery Bypass Grafting (CABG) / Heart By Pass Surgery / Open Heart Surgery
Coronary Artery Bypass Grafting (CABG) surgery is a procedure used to treat coronary artery disease in certain circumstances. Coronary artery disease (CAD) is the narrowing of the coronary arteries (the blood vessels that supply oxygen and nutrients to the heart muscle), caused by a buildup of fatty material within the walls of the arteries. This buildup causes the inside of the arteries to become narrowed, limiting the supply of oxygen-rich blood to the heart muscle.

There are 2 types of Heart by Pass Surgery

On Pump Procedure
Off Pump Procedure

Valve Replacement Treatment in India / Valve Replacement Surgery

Heart Valve Replacement (VR) surgery be done when valves are damaged or diseased and do not work the way they should. Conditions that may cause heart valve dysfunction are valve stenosis (stiffness) and valve regurgitation (leaky valve).

Valve Replacement Treatment in India / Valve Replacement Surgery

When one (or more) valve(s) becomes stenotic (stiff), the heart must work harder to pump the blood through the valve. Some reasons why heart valves become narrow and stiff include infection (such as rheumatic fever or staphylococcus infections) and aging. If one or more valves become leaky, blood leaks backwards, which means less blood is pumped in the right direction. Based on your symptoms and the overall condition of your heart, your health care provider may decide that the diseased valve(s) needs to be surgically repaired or replaced.

What are the Causes of Valve Replacement (VR)?
Valve Stenosis: valve does not open fully, it will obstruct the flow of blood Valve Incompetence: valve does not close properly, it will allow blood to leak backwards.

Treatment for Valve Replacement (VR) Surgery
Aortic Valve Replacement Surgery / Mitral Valve Replacement Surgery / Tricuspid Valve Replacement Surgery / Pulmonary Valve Replacement Surgery

Traditional Heart Valve Surgery
During traditional heart Valve Replacement (VR) surgery, a surgeon will make an incision down the center of your sternum (breastbone) to get direct access to your heart. The surgeon then repairs or replaces your abnormal heart valve or valves. While this approach remains in use, today most patients with isolated valve disease can be treated with minimally invasive techniques.

Minimally invasive heart valve surgery (The modern procedure)
Minimally invasive surgery is a type of surgery performed through smaller incisions. This type of surgery reduces blood loss, trauma, and length of hospital stay. Heart Valve Replacement (VR) surgery is the most common minimally invasive procedure. Your surgeon will review your diagnostic tests prior to your surgery to see if your are a candidate for minimally invasive Valve Replacement (VR) surgery.

The Ross Procedure for Valve Replacement
This specialized aortic Valve Replacement (VR) surgery is used most often with children and adults under age 35. The procedure involves replacing the patients diseased aortic valve with the patients own pulmonary valve, called an autograft. Then the surgeon replaces the pulmonary valve with a homograft pulmonary valve. That is, a pulmonary valve from a human donor. Compared to traditional valve replacement using manufactured prosthetic valves, the Ross Procedure is most beneficial for young people and active older patients: The pulmonary valve lasts longer than prosthetic valves, which tend to fail after a few years in younger patients.

Coronary Angiography (without contrast)	USD 500
Coronary Angiography(including one medical stent)	USD 4500
CABG	USD 5000
AVR/MVR	USD 5000
Pacemaker	USD 4000

Cardiac Treatment