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Hypertension (high blood pressure)

An increase in pressure above the age norm is correctly called high blood pressure.

If the pressure increases frequently or for a long time, and during the examination it is not possible to identify the reasons for this, the diagnosis of hypertension is made. If a person has an illness that has caused an increase in blood pressure (eg, a past traumatic brain injury, kidney disease, etc. ), then he speaks of secondary high blood pressure. However, colloquially, all cases of high blood pressure are often referred to as hypertension.

Hypertension is known as the "silent killer" because it doesn't always have obvious symptoms, especially in the early stages. It has been established that 20-30% of the adult population has high blood pressure, although many have not known about their condition for a long time. If hypertension is not treated, the risk of heart attack or stroke increases. The only way to find out if there is a problem isMeasuring blood pressure with an electronic tonometermeasure blood pressure regularly.

Blood pressure is the force with which blood presses against the walls of blood vessels and the heart. With hypertension, blood pressure in the arteries and heart becomes excessively high, which leads to premature wear and tear of these organs and increases the risk of other diseases, such as kidney or brain damage.

Blood pressure is measured in millimeters of mercury (mmHg) and is recorded in two dimensions:

  • systolic pressure - blood pressure when the heart contracts and pushes blood into the arteries;
  • diastolic pressure is the blood pressure when the heart muscle relaxes between two contractions.

For example, if your doctor says your blood pressure is "140 over 90", that means your systolic pressure is 140 mmHg. Art. , and diastolic pressure - 90 mm Hg. Art.

The ideal blood pressure in an adult is considered to be less than 120/80 mm Hg. Art. However, values up to and including 139/89 are within the normal range. If, according to the results of several measurements, your blood pressure exceeds 140/90 inclusive, you have high blood pressure, additional tests, and possibly treatment is needed.

Symptoms of high blood pressure (hypertension)

An increase in blood pressure is not always accompanied by a change in well-being. The only way to know for sure if you have hypertension is to measure your blood pressure. Adults should have their blood pressure checked at least once every five years.

If you are pregnant, it is important to regularly check your blood pressure, even if it is not high. Monitoring blood pressure during pregnancy reduces the risk of complications. High blood pressure in a pregnant woman can lead to preeclampsia. This is a dangerous condition where there is a problem with the placenta (the organ that provides blood circulation to the fetus).

Sometimes the symptoms of high blood pressure are:

  • headache;
  • dimming or double vision;
  • nosebleeds;
  • dyspnea.

Such signs appear in people with very high blood pressure. If you experience any of these symptoms, see your doctor. If left untreated, hypertension can lead to serious illnesses, including stroke and heart attack. Make an appointment with your doctor right away if you have any of these symptoms or high blood pressure. If symptoms are severe, call an ambulance.

Causes of hypertension (high blood pressure)

In more than 90% of cases, the cause of hypertension cannot be determined. So hypertension is called essential or primary. Factors that can increase your risk of developing primary hypertension include:

  • age: the risk of developing hypertension increases with age;
  • there have been cases of hypertension in your family (the disease can be hereditary);
  • excess salt in your diet;
  • lack of exercise;
  • completeness;
  • smoke;
  • alcohol abuse;
  • stress.

Known causes of hypertension

About 10% of cases of high blood pressure are the result of a specific disease or specific cause. These cases are called secondary hypertension. Typical reasons for the pressure increase in this case are:

  • kidney disease;
  • diabetes;
  • narrowing of the arteries that supply blood to the kidneys;
  • hormonal disorders such as Cushing's syndrome (a condition in which the body makes too many steroid hormones);
  • diseases that affect the body's connective tissues, such as systemic lupus erythematosus;
  • birth control pills (oral contraceptives);
  • pain relievers known as non-steroidal anti-inflammatory drugs (NSAIDs);
  • club drugs like cocaine, amphetamines and crystal meth;
  • some herbal remedies, herbal supplements.

diagnosis of hypertension

To diagnose high blood pressure and identify its possible causes, they first of all resort to systematic blood pressure measurement. This can be done by a healthcare professional or by yourself using a home blood pressure monitor.

Healthy people over the age of 40 should have their blood pressure measured at least every five years. If you are at higher risk for hypertension, check your blood pressure more often, preferably once a year.

Blood pressure checks are usually easy to perform at most clinics and hospitals. Blood pressure is usually measured with a sphygmomanometer (manometer), a device consisting of a stethoscope, cuff, measuring device, an air blower, and a valve.

The cuff is wrapped around the arm and inflated to restrict blood flow in the artery. The cuff is then slowly deflated while listening to the pulse with a stethoscope. Listening to your pulse below the deflated cuff provides a reliable reading of your blood pressure. In addition, automatic (digital) blood pressure monitors are now commonplace, which measure pressure and pulse using electrical sensors.

Before starting to measure your blood pressure, you should rest for at least five minutes and empty your bladder. To get an accurate blood pressure reading, you need to sit and not talk during the procedure.

If one of the measurements showed high blood pressure, it doesn't necessarily mean you have high blood pressure. During the day, blood pressure levels can fluctuate. Pressure can build up during the doctor's appointment due to anxiety and stress. In such cases, it is recommended to measure the pressure during the day on your own, using a homemade tonometer. By eliminating the "fear of the white coat", you can get more objective indicators.

You may also have blood and urine tests to check for conditions that increase your risk of high blood pressure, such as kidney disease.

Deciphering the tonometer readings

Blood pressure is measured in millimeters of mercury (mmHg) and is recorded in two ranges:

  • systolic pressure - blood pressure when the heart contracts and pushes blood into the arteries;
  • diastolic pressure is the blood pressure when the heart muscle relaxes between two contractions.

For example, if your systolic blood pressure is 140 mm Hg. Art. , and diastolic blood pressure is 90 mm Hg. Art. , then say your pressure is 140 over 90.

Ideally, blood pressure should be less than 120/80. However, readings below 140/90 are generally considered normal. If you have kidney disease, diabetes, or heart or circulatory disease, your target blood pressure should be below 130/80 mmHg. Art.

If your blood pressure readings are above 140/90 for several days, you have high blood pressure and further examination is needed.

high blood pressure treatment

Effective actions to lower blood pressure levels include lifestyle changes and medication. The choice of treatment regimen will depend on your blood pressure levels and risk of developing cardiovascular disease.

If your blood pressure is slightly above 130/80 mm Hg. Art. , and at the same time your risk of developing cardiovascular disease is low, so you should be able to lower the pressure just by making a few lifestyle changes.

If your blood pressure is moderately high (140/90 mmHg or higher) and you are at risk of developing heart disease within the next 10 years, treatment will include medication and lifestyle changes.

If your blood pressure is very high (180/110 mmHg or higher), you will need treatment soon, possibly with additional tests, depending on your health status.

Lifestyle in hypertension

Below are some of the changes you can make to your lifestyle to lower your blood pressure. Some of them will lead to rapid improvement within a few weeks, others will take effect for a longer period of time.

  • Reduce your salt intake to less than 6 grams a day.
  • Eat healthy, low-fat, balanced foods, including lots of fresh fruits and vegetables.
  • Stay active: Staying physically active is one of the main things you should do to prevent or control high blood pressure.
  • Reduce your alcohol intake.
  • Quit smoking. Smoking greatly increases your chances of developing lung and heart disease.
  • Lose weight.
  • Drink less coffee, tea or other caffeinated beverages such as cola. Drinking more than four cups of coffee a day can raise your blood pressure.
  • Try relaxation techniques such as yoga, meditation, and stress management (autogenic training).

The more healthy habits you adopt, the greater the positive effect you will have. In practice, some people find that, maintaining a healthy lifestyle, they do not need to take any medication.

Drug treatment of hypertension

There is a wide variety of blood pressure medications available. You may need to take more than one type of medication because sometimes a combination of medications is needed to treat high blood pressure.

In some cases, you will need to take blood pressure medication for the rest of your life. However, if your blood pressure remains under control for several years, you may want to discontinue drug treatment. Most high blood pressure medications can cause side effects, but this problem can be resolved by changing the medications you take.

Tell your doctor if you have any of the following common medication side effects:

  • feeling sleepy;
  • pain in the kidney area (in the lower back);
  • dry cough;
  • dizziness, exhaustion or lethargy;
  • skin rash.

Below are the most commonly used medications for high blood pressure.

  1. Angiotensin Converting Enzyme (ACE) Inhibitorslower blood pressure by relaxing the walls of blood vessels. The most common side effect is a persistent dry cough. If side effects start to bother you, you may be advised to take medications such as angiotensin-2 receptor antagonists, which work similarly to ACE inhibitors.

    ACE inhibitors can cause unexpected side effects when taken with other medications, including over-the-counter medications. Before starting any additional medication, check with your doctor if the combination will cause any negative side effects.

  2. calcium channel blockers(calcium antagonists) prevent calcium from entering the muscle tissue cells of the heart and blood vessels. This causes your arteries (large blood vessels) to dilate and lower your blood pressure.

    Drinking grapefruit juice while taking certain types of calcium channel blockers can increase your risk of side effects. For more information, you can discuss this issue with your doctor.

  3. diuretics(diuretics) work by removing excess fluid and salt from the body in the urine.

  4. Beta-blockers (beta-blockers)they work by reducing the rate and force of heart contractions, thus lowering blood pressure. Beta-blockers used to be a popular drug for high blood pressure, but nowadays they are usually only used when other medications don't work. This is because beta blockers are considered to be less effective than other types of high blood pressure medication.

    Also, beta blockers can interfere with other medications, causing side effects. Consult your doctor before taking other medicines in combination with beta blockers.

    Do not stop taking beta-blockers suddenly without talking to your doctor. This can lead to serious side effects such as high blood pressure or angina.

  5. Alpha blockers (alpha blockers)are generally not recommended as a first choice for high blood pressure unless other medications are not working. Alpha blockers work by relaxing blood vessels, making it much easier for blood to flow through them.

    Common side effects of alpha blockers include:

    • fainting on the first dose of the drug ("first dose effect");
    • dizziness;
    • headache;
    • ankle swelling;
    • fatigue.

Complications of hypertension

High blood pressure puts extra stress on the heart and blood vessels. If left untreated, hypertension increases your risk of heart attack, stroke, and kidney disease over time.

Cardiovascular disease in hypertension

Hypertension can cause many different diseases of the heart and the blood vessels and vessels of the heart (cardiovascular disease), including:

  • leakage;
  • myocardial infarction;
  • embolism: occurs when a blood clot or air bubble blocks the flow of blood in a vessel;
  • aneurysm: develops when the wall of a blood vessel stretches and can rupture at any time, causing internal bleeding.

Kidney disease and high blood pressure

Hypertension can also damage the small blood vessels in the kidneys and impair their function. This complication can cause symptoms such as:

  • fatigue;
  • swelling of the ankles, feet or hands (due to water retention in the body);
  • dyspnea;
  • the presence of blood in the urine;
  • frequent urination, especially at night;
  • itchy skin.

Kidney disease is treated with medications and nutritional supplements. More severe cases require dialysis (a medical procedure in which the blood is artificially cleansed of toxic metabolic products in the body) or a kidney transplant.

High blood pressure prevention

Hypertension can be prevented by eating a healthy diet, maintaining a healthy weight, exercising regularly, limiting your alcohol intake, and not smoking.

Smoking by itself does not cause high blood pressure, but it does significantly increase the risk of heart attack and stroke. Smoking, like high blood pressure, causes the arteries to narrow. If you smoke when you have high blood pressure, your arteries will narrow much faster and your risk of developing heart and lung disease in the future will increase significantly.

High pressure feeding

Reduce the amount of salt in your diet, eat lots of fruits and vegetables. Salt increases blood pressure. The more salt you consume, the higher your blood pressure will be. Aim to eat less than 6 grams of salt a day, which is roughly the same as a teaspoon.

Eating low-fat, high-fiber foods (such as brown rice, bread, and pasta) and lots of fruits and vegetables help lower blood pressure. Fruits and vegetables are rich in vitamins, minerals and fiber that keep your body healthy. Aim to eat five 80g servings of fruits and vegetables a day.

Drinking more than the legal limit on a regular basis will cause your blood pressure to rise over time. Men are not recommended to consume more than 2-4 servings of alcohol a day regularly, and women - more than 2-3. Regular use means every day or most days of the week. 1 serving of alcohol corresponds approximately to a glass of vodka, half a glass of wine or half a beer.

Also, as alcohol is high in calories, regular consumption of alcohol leads to weight gain and, consequently, to increased blood pressure.

Drinking more than four cups of coffee a day can lead to high blood pressure. If you're a big fan of coffee, tea, or other caffeinated beverages (like Coke and some energy drinks), consider cutting back. It's great to have tea and coffee as part of a balanced diet, but it's important that these drinks aren't your only source of fluids.

Weight and exercise for hypertension

Being overweight forces the heart to work harder to pump blood throughout the body, which often results in an increase in blood pressure. If you really need to lose weight, it's important to remember that losing even two to three pounds of weight will significantly change your blood pressure readings and improve your overall health.

An active lifestyle and regular exercise lead to lower blood pressure, keeping the heart and blood vessels in good condition. Regular exercise also helps you lose weight, which also helps lower your blood pressure.

An adult should spend at least 150 minutes (2 hours and 30 minutes) a week doing moderate-intensity outdoor exercise, such as cycling or brisk walking. When exercising, you should be guided by the fact that you feel warm and slightly breathless. For a full person, to reach this state, it may be enough to go up the hill a little. Physical activity can include a wide variety of exercise, from sports to walking and gardening.

Relaxation exercises can lower blood pressure. They include:

  • Stress management (autogenic training), meditation or yoga.
  • Cognitive Behavioral Therapy, which focuses on how your thoughts and beliefs can affect your well-being and ability to deal with problems. You can discuss with your doctor the possibility of undergoing this psychotherapy.
  • Biofeedback (a self-regulation method used to help you consciously control your blood pressure): A small monitor shows your heart rate or blood pressure in real time. A referral for biofeedback can be made by your doctor.

Which doctor should I see for hypertension?

If you have high blood pressure, look for a good therapist who can understand the causes of the condition and prescribe treatment. If you have heart problems or chronic cardiovascular disease, choose a cardiologist.