 Hi, this is Pankaj. Since we are living in an era of highly stressful life and competitive world, so we have to understand how to keep the healthier heart and internal organs. So before going for the introduction of the hypertension, we should know the definition of the hypertension. So hypertension basically we call as a high blood pressure. So there's a difference between the high blood pressure and normal blood pressure. So high blood pressure basically the stiffness and high tension pressure in the arteries which carries the blood from the heart to the different part of the body. And then we have two numbers about the normal blood pressure. That is upper top number, this is systolic blood pressure which equals to the pressure in the arteries when the heart contracts. And then diastolic and bottom number is basically when it equals to the pressure in the arteries when heart relaxes. So when you are supposed to consider whether you have a hypertension or not or maybe the high blood pressure. So when you are going to check the blood pressure routinely after the age of 18 to 45 years, usually we use to get previously blood pressure after the age of 45 years. Since I told this era of highly stressful lifestyle and competitive world, so we have to keep an eye over the blood pressure after the age of 18 years only. So a lot of patients comes with a high blood pressure at the age of 20, 25, 30, 35 and without any risk factors. So we have a different kind of multifactorial mechanism of developing the hypertension. So we have two categories of the hypertension, one is primary hypertension and another one is secondary hypertension. Primary hypertension basically without any obvious reason. So the person may have a genetic predisposition in terms of the parents, one parent or both the parents might have a history of hypertension. So the risk becomes double compared to the general population. So what are the causes of hypertension? So basically development of hypertension on the basis of the multifactorial means several factors involved in the development of hypertension. First and foremost thing is the lifestyle. That is high intake of the salt or high sensitivity to the salt intake, especially elderly people in obesity who are not doing the exercise. And second is the genetic predisposition. That means one or both the parents has a hypertension so they have a risk almost double than general population. And third is a peculiar kind of condition in which you have a stiffness and thickness of the arteries which lead to the increased resistance in the smaller arterioles of the peripheral arteries in the body. So which increases the peripheral resistance and develop the hypertension. How to diagnose the hypertension? So practically I would say like if you want to officially diagnose the hypertension you have to check the blood pressure at the different settings and different timings and different days. So you can monitor the blood pressure probably twice in a week at least 4 to 6 weeks. If blood pressure is more than 130 by 80 mmHg we can consider it is a high blood pressure. But we have to keep an eye it is not necessary to rush to the specialist or doctor but we have to monitor the blood pressure. So there is two different categories of the blood pressure. One is called home blood pressure and another one is a hospital check blood pressure. That is called white coat blood pressure or office blood pressure. So it is a difference between the house blood pressure and blood pressure in the hospital. Definitely person goes to the hospital there is a different blood pressure readings compared to the home blood pressure. So what are the complications can happen with high blood pressure? So blood pressure itself can lead to the multiple complications in the form the stroke heart attacks heart failure kidney problems and different retinal damages in the eyes. So before going for the treatment part we should know the pathophageology of the hypertension how this develops in person. So in the form the primary hypertension a lot of chemicals release because of stress in the body which increases the peripheral artery resistance. And then secondly hypertension in the form of secondary disease like kidney problem or there is a stenosis or blockage in the renal arteries and hypertrophic cardiomyopathy also. Different kind of endocrine tumor diabetes and probably because of the brain stroke also you may develop the secondary neurogenic hypertension. So how to control the blood pressure? So before controlling the blood pressure we should have a preventive measures that is more important. So always in medical science like prevention is the best medication in terms of any diseases. So you have to check the blood pressure with a doctor in the hospital blood pressure and home blood pressure and compare the readings. So if there is an increase in blood pressure more than 130 by 80 there is an instant lead you have to seek the help of the physician or cardiologist. But if blood pressure is more than 160 by 100 you have to see an emergency doctor physician or cardiologist. So what are the preventive measures we can do in terms of the control of blood pressure? First and foremost thing is the lifestyle modification in the form the dietary control which is very important. And second is the physical activity and exercise. So we have a different kind of diet. So first and foremost thing is you have to cut down the salt. Usually recommended salt is 5 to 6 grams per day. But if somebody has a hypertension you have to decrease the intake of the salt probably less than 4 grams per day. And we have a dash diet to control the hypertension. So dash diet is basically a dietary approach to stop the hypertension which includes the increase in intake of the whole grain, decrease salt intake, decrease fat intake and lean meats intake. And definitely controlling the fat, salt at the same time you have to do the physical exercise in the form of anything physical activity is much better than nothing. So you have to do basically cardiac exercise in terms of at least 35 to 40 minutes walk, jogging and cycling depending on your tolerance. Every day at least 5 days in a week which reduces the weight and controlling the insulin resistance and diabetes and hypertension also. And in terms of secondary or alternative measures in terms of controlling the hypertension or prevention hypertension you have to do yoga, exercise or different kind of modalities which increases the intake of potassium. So potassium rich diet basically consists of a lot of fruits but unless somebody has a kidney problem. And if these modalities are not going to control the blood pressure at least we have to consider the physician, cardiologist or nephrologist depending on the requirement of the medical condition. So in those conditions we can consider the medication or medical therapy, pharmacotherapy because different categories of people require the different molecule. So like person has got the anxiety, stress, palpitation and then different multiple comorbid condition. So we decide the molecule on the basis of the requirement of the clinical profile of the patients. And ultimately hypertension is not only the public hazard at the same time it burden on the economy of the family also. So which increase the risk of the heart attack, brain stroke and kidney problem and increase the burden on the medical therapy also. So what are symptoms person can have and when you are going to reach to the doctor. So person may not have any symptoms with hypertension. So like that's what we call the hypertension is a silent killer. Patient may have symptoms like dizziness, giddiness, headache, blurring of vision, palpitation in terms of increasing heartbeat during sleeping time or maybe some kind of disorientation or difficulty in walking, weakness, lack of concentration. So I would like to conclude that. So hypertension prevention is the best medication in terms of control of hypertension which reduces the risk of the major health problem. Thank you.