Everything you need to know about hypertension (high blood pressure)

Quick Overview

Symptoms: Headaches (especially in the morning), nosebleeds, dizziness, easy fatigue, flushed face, shortness of breath, sleep disorders, tinnitus, etc.; possibly symptoms of secondary diseases such as chest tightness, water retention in the tissue (edema) or visual disturbances

Causes and risk factors: Unhealthy lifestyle (e.g. smoking, high-calorie diet, lack of exercise), stress, age, family predisposition, menopause and pregnancy, other diseases (e.g. metabolic disorders such as diabetes, organ damage such as kidney diseases, cardiovascular diseases ), medicines

Examinations and diagnosis: Physical examinations and blood pressure measurements (usually long-term blood pressure over 24 hours), blood and urine tests, kidney ultrasound, echocardiography

Treatment: lifestyle change (a lot of exercise and sport, losing weight, healthy nutrition, stopping smoking, etc.), possibly antihypertensive medication; Treatment of the underlying disease in secondary hypertension

Course of the disease and prognosis: Course and prognosis are usually very good with consistent therapy; without therapy, complications such as more severe courses of infection, cardiovascular diseases, kidney weakness and kidney failure or damage to the retina in the eye are possible; spontaneous severe high blood pressure as a hypertensive crisis (= emergency)

Prevention: Healthy lifestyle and diet, sufficient exercise, avoiding or minimising stress, relaxation exercises, reducing or stopping smoking

What is high blood pressure? When is blood pressure too high?

In the case of high blood pressure (hypertension), the blood pressure values ​​are permanently too high. Strictly speaking, high blood pressure is not a disease, but rather a risk factor for other, often chronic diseases.

The blood pressure values ​​result from the fact that with every heartbeat the heart pumps blood into the blood vessels, whereby the blood exerts pressure on the vessel wall from the inside. Depending on the action of the heart, doctors differentiate between two blood pressure values ​​- a high and a low one:

Systolic blood pressure (upper value): It occurs during the phase in which the heart contracts (systole). It pumps the blood from the left ventricle into the main artery (aorta) and thus into the systemic circulation; the resulting pressure wave propagates into the arteries and can also be measured in more distant parts of the body (such as arms and legs).

Diastolic blood pressure (lower value): During diastole, the heart muscle expands to allow the ventricles to refill with blood. There is still pressure in the vessels, but it is lower than the systolic blood pressure.

Every person’s blood pressure is subject to certain fluctuations. For example, excitement and physical exertion cause blood pressure to rise, while it is significantly lower when resting or sleeping. These blood pressure fluctuations are normal and serve to adapt the body to the respective situation. In healthy people, the blood pressure values ​​always settle back into the normal range. Treatment is often only necessary if the blood pressure is permanently too high.

Blood Pressure Readings

The unit of measurement for blood pressure is mmHg (millimetres of mercury). For example, a reading of 126/79 mmHg (read: 126 over 79) means that the systolic blood pressure is 126 and the diastolic is 79 mmHg. Doctors describe values ​​of less than 120 mmHg systolic and less than 80 mmHg diastolic as optimal blood pressure. In addition, the following reference ranges apply to blood pressure:

Degree Classification	Systolic	Diastolic
Normal	120-129mmHg	80-84mmHg
high normal	130-139mmHg	85-89mmHg
Hypertension grade 1 (mild high blood pressure)	140-159mmHg	90-99mmHg
Hypertension grade 2 (moderate high blood pressure)	160-179mmHg	100-109mmHg
Grade 3 hypertension (severe high blood pressure)	≥ 180mmHg	≥ 110mmHg
Isolated systolic hypertension	≥ 140mmHg	< 90mmHg

Causes

The cause of hypertension is often not known. In many cases, it is the result of an underlying condition.

High blood pressure that is not due to another condition or disease is known as primary or essential hypertension. If an underlying condition is a cause of increased blood pressure, doctors call this secondary hypertension.

Primary hypertension can result from multiple factors, including:

• having obesity
• insulin resistance
• high salt intake
• excessive alcohol intake
• having a sedentary lifestyle
• smoking

Secondary hypertension has specific causes and is a complication of another health problem. Chronic kidney disease (CKD) is a common cause of high blood pressure, as the kidneys no longer filter out fluid. This excess fluid leads to hypertension. Hypertension can also cause CKD.

Other conditions that can lead to hypertension include:

• diabetes, due to kidney problems and nerve damage
• pheochromocytoma, a rare cancer of an adrenal gland
• Cushing’s syndrome
• congenital adrenal hyperplasia, a disorder of the cortisol-secreting adrenal glands
• hyperthyroidism, or an overactive thyroid gland
• hyperparathyroidism, which affects calcium and phosphorous levels
• pregnancy
• sleep apnea
• obesity

Risk factors

A number of factors increase the risk of hypertension.

Age: Hypertension is more common in people who are more than 65 years of age. Blood pressure can increase steadily with age as the arteries stiffen and narrow due to plaque buildup.

Ethnicity: Some ethnic groups are more prone to hypertension than others. African Americans have a higher risk than other ethnic groups, for example.

Weight: Having obesity is a primary risk factor for hypertension.

Alcohol and tobacco use: Regularly consuming large quantities of alcohol or tobacco can increase blood pressure.

Sex: According to a 2018 review, males have a higher risk of developing hypertension than females. However, this is only until after females reach menopause.

Existing health conditions: Cardiovascular disease, diabetes, chronic kidney disease, and high cholesterol levels can lead to hypertension, especially as people age.

Symptoms

A person with hypertension may not notice any symptoms, and so people often call it a “silent killer.” Without detection, hypertension can damage the heart, blood vessels, and other organs, such as the kidneys. It is vital to check blood pressure regularly.

In rare and severe cases, high blood pressure can cause:

• sweating
• anxiety
• sleeping problems
• blushing

However, most people with hypertension will experience no symptoms at all. If high blood pressure becomes a hypertensive crisis, a person may experience headaches and nosebleeds.

Complications

Long-term hypertension can cause complications through atherosclerosis, where plaque develops on the walls of blood vessels, causing them to narrow. This narrowing makes hypertension worse, as the heart must pump harder to circulate the blood. Hypertension-related atherosclerosis can lead to:

• heart failure and heart attacks
• aneurysm, or an atypical bulge in the wall of an artery that can burst
• kidney failure
• stroke
• amputation
• hypertensive retinopathies in the eye, which can lead to blindness

Regular blood pressure monitoring can help people avoid these more severe complications.

Management and Treatment

Lifestyle adjustments are the standard, first-line treatment for hypertension. Some recommendations are as follows:

Regular physical exercise

Current guidelines recommend that all people, including those with hypertension, engage in at least 150 minutes of moderate-intensity, aerobic exercise every week, or 75 minutes per week of high-intensity exercise.

Alongside 150 minutes of exercise, most adults will benefit from engaging in strength training at least twice per week.

People should exercise at least 5 days every week. Examples of suitable activities are:

• walking
• jogging
• cycling
• swimming

Stress Reduction

Avoiding or learning to manage stress can help a person control blood pressure. A few relaxation techniques that can help relieve stress are:

• meditation
• warm baths
• yoga
• going on long walks

People should avoid consuming alcohol and recreational drugs to cope with stress, as these can contribute to elevated blood pressure and the complications of hypertension.

Smoking can also increase blood pressure. Avoiding or quitting smoking reduces the risk of hypertension, serious heart conditions, and other health issues.

Medication

People can use specific medications to treat hypertension. Doctors will often recommend a low dose at first. Antihypertensive medications will usually only have minor side effects.

Eventually, people with hypertension may need to combine two or more drugs to manage their blood pressure. Medications for hypertension include:

• diuretics, including thiazides, chlorthalidone, and indapamide
• beta-blockers and alpha-blockers
• calcium-channel blockers
• central agonists
• peripheral adrenergic inhibitor
• vasodilators
• angiotensin-converting enzyme (ACE) inhibitors
• angiotensin receptor blockers

The choice of medication depends on the individual and any underlying medical conditions they may experience.

Anyone taking antihypertensive medications should carefully read the labels of any over-the-counter (OTC) drugs they may also take, such as decongestants. These OTC drugs may interact with the medications they are taking to lower their blood pressure.

Diet

People can prevent high blood pressure by following a heart-healthy diet.

Reducing Salt Intake

High sodium consumption contributes to high blood pressure. The main source of sodium in the diet is salt.

The American Heart Association recommends that people without hypertension consume less than 2,300 milligrams (mg)Trusted Source of sodium per day. This roughly equates to one teaspoon. People with hypertension should consume less than 1,500 mg of sodium per day to manage their condition.

Lowering salt intake can benefit people with and without hypertension.

Moderating alcohol consumption

Moderate to excessive alcohol consumption can increase blood pressure.

The American Heart Association recommends a maximum of two alcoholic drinks per day for men, and one for women.

The following would count as one drink:

• a 12-ounce (oz) bottle of beer
• 4 oz of wine
• 5 oz of 80-proof spirits
• 1 oz of 100-proof spirits

A healthcare professional can help people reduce consumption if they find it difficult to moderate their alcohol intake.

Eating more fruits and vegetables and less fat

People who have high blood pressure or people at high risk for developing high blood pressure should reduce their intake of saturated fats in favour of unsaturated forms.

Experts recommend that those with high blood pressure prioritise more heart-healthy foods, such as:

• whole grain, high fibre foods
• a variety of fruits and vegetables
• pulses, such as chickpeas, beans, and lentils
• nuts
• fish rich in omega-3 twice per week
• non-tropical vegetable oils, such as olive oil
• skinless poultry and fish
• low fat dairy products

If a person has high blood pressure or wished to maintain moderate blood pressure, it is important to avoid trans fats, hydrogenated vegetable oils, animal fats, and processed fast foods when creating a diet plan.

However, omega-3 fatty acids, such as those in oily fish and olive oil, have protective effects on the heart. However, these are still fats. While they are typically healthful, people with a risk of hypertension should still include them in their total fat intake.

Managing Body Weight

Excess body weight can contribute to hypertension. A fall in blood pressure usually follows weight loss, as the heart does not have to work so hard to pump blood around the body. A balanced diet with a calorie intake that matches the individual’s size, sex, and activity level will help.

Signs

A sphygmomanometer, or blood pressure monitor, can help people keep track of their blood pressure. A doctor’s visit is not always necessary for blood pressure monitoring.

Having high blood pressure for a short time can be a normal response to many situations. Acute stress and intense exercise, for example, can briefly elevate blood pressure in an otherwise healthy person. For this reason, a diagnosis of hypertension requires several readings that show sustained high blood pressure over time.

The International Society of Hypertension defines hypertension as blood pressure that is consistently higher than 140 over 90 millimetres of mercury (mm Hg). The systolic reading of 130 mm Hg refers to the pressure as the heart pumps blood around the body. The diastolic reading of 80 mm Hg refers to the pressure as the heart relaxes and refills with blood.

If the reading indicates a hypertensive crisis, wait 2 or 3 minutes and then repeat the test. If the reading is the same or higher, this indicates a medical emergency. The person should seek immediate assistance at the nearest hospital.

Hypertension is on the Rise

One in eight deaths worldwide is thought to be the result of high blood pressure, or hypertension. Left untreated, the condition raises the risk of heart attacks, strokes and other severe health problems, and it condition plagues, on average, a quarter of men and a fifth of women. In certain places, the figures are far higher – in Central and Eastern Europe, it is as many as 40 per cent of men, and in the Sahel, more than a third of women. In the Middle East, hypertension levels are also high, ranging from 20 per cent in Iran, 29 per cent in United Arab Emirates and 30 per cent in Oman. Across the GCC, more than a third of adults have hypertension or diabetes, or both, and the average patient with heart disease is almost a decade younger than in the West.

The condition is so prevalent that there is hardly a medical practice in the world where doctors do not start an exam by taking a patient’s blood pressure. Where the condition is chronic, they commonly prescribe daily tablets. The global market for antihypertensive drugs is worth more than $20 billion, and is expected to reach $30 billion by the end of the decade.

Doctors in the UK announced trials for a new course of treatment that, if successful, could revolutionise the industry, and transform the lives of people who suffer from chronic hypertension. The answer, doctors from Queen Mary University London and the UK National Health Service believe, could be a twice-yearly injection.

Why buying a Health Insurance Plan for a Hypertension Patient is Important?

The inflation in medical costs is making it really hard for an average-salaried person to take care of medical expenses like doctors’ fees, expensive medicines, hospitalisation charges, diagnostic tests, etc. By investing in a health insurance plan, you will not only be reimbursed for the hospitalization charges, but it will also safeguard you against out-patient or day-care costs.

People are increasingly switching to private hospitals for getting quality medical treatment. A well-researched and bought health plan will help you focus more on getting the best medical care rather than worrying about expenses.

You need to relax as worrying about medical costs can deteriorate your health further. After all, you can’t afford more tension when you are already a patient of hypertension!