Anh Tuan had a family history of hypertension, placing him at risk for cardiovascular disease. He was diagnosed with hypertension at 25 but, experiencing no symptoms, he stopped medication and follow-up care. For the past month, he experienced shortness of breath with exertion, a heavy feeling in the back of his head, and blood pressure readings of 200-220/110 mmHg. He sought examination at Tam Anh General Hospital, Ho Chi Minh City.

Dr. Pham Phong Luan, a cardiology specialist at the Heart Center, reported that Anh Tuan's hypertension had led to multi-organ damage. This included heart failure with an ejection fraction (EF) of only 37% (normal is above 50%), chronic kidney disease stage 3b, and grade 3 retinal damage. "Prolonged and uncontrolled high blood pressure silently damaged the patient's heart, kidneys, and eyes," Dr. Luan stated. Anh Tuan's daily smoking, regular alcohol consumption, sedentary lifestyle, and work stress further elevated his cardiovascular risk, contributing to the severe progression of his hypertension.

Dr. Luan checks the patient's health before discharge. Photo: Tam Anh General Hospital

Dr. Huynh Thanh Kieu, Head of Cardiology 1 at the Heart Center, Tam Anh General Hospital, Ho Chi Minh City, who also treated Anh Tuan, explained that hypertension is a common yet silently progressing disease. Many individuals remain unaware of their condition due to a lack of early symptoms. Young people, such as Anh Tuan, often discontinue medication or skip follow-up appointments, believing their health is stable.

Uncontrolled hypertension often leads to heart failure. Elevated blood pressure forces the heart to work harder, eventually causing the heart muscle to thicken, stiffen, and weaken. Hypertension also contributes to kidney failure, peripheral artery disease, aortic aneurysm, aortic dissection, and retinal damage.

Elevated blood pressure puts immense strain on the small blood vessels within the kidneys, causing them to thicken and narrow. This reduces blood flow to the kidneys, impairing their ability to filter blood. Consequently, the kidneys work harder to regulate the body's water and salt balance, leading to rapid weakening over time. Hypertension can also obstruct blood vessels in the eyes, causing retinal damage and optic disc edema, which affects a patient's vision.

Dr. Kieu prescribed Anh Tuan antihypertensive, diuretic, and heart failure medications. After 5 days, his blood pressure stabilized, and his shortness of breath resolved, leading to his discharge. The doctor strongly advised him to continue treatment, highlighting the risks of requiring regular dialysis, worsening heart failure, blindness from retinal damage, stroke, or myocardial infarction if he did not.

Hypertension developing before age 40 is classified as hypertension in young individuals. Common causes include a sedentary lifestyle, being overweight or obese, smoking, alcohol abuse, sleep apnea, renal artery stenosis, glomerulonephritis, adrenal tumors, hyperthyroidism, and Cushing's syndrome. Some cases have no specific identifiable cause. The American Heart Association (AHA) recommends that all adults aged 20 and older undergo annual blood pressure checks.

To prevent hypertension complications, patients must take medication regularly and monitor their blood pressure during treatment, aiming for readings typically at or below 130/80 mmHg. Adopting a healthy lifestyle is crucial, including regular exercise, avoiding smoking, limiting alcohol, managing weight, maintaining a balanced diet, and reducing stress. These measures collectively help prevent the progression and complications of hypertension.

Thu Ha

*Patient's name has been changed