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Hypertension (high blood pressure)

An increase in pressure above the age norm is correctly called arterial hypertension.

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

Hypertension is known as the "silent killer" because it does not always have obvious symptoms, especially in the initial stages. It has been established that 20-30% of the adult population have high blood pressure, although many do not know about their disease 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 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 your 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 optimal blood pressure in an adult is considered to be less than 120/80 mm Hg. Art. However, figures up to 139/89 inclusive lie within the normal range. If, according to the results of several measurements, your pressure exceeds 140/90 inclusive, you have arterial hypertension, additional examination and, possibly, treatment is required.

Symptoms of arterial hypertension (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 take your blood pressure. Adults should have their blood pressure checked at least once every five years.

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

Sometimes symptoms of high blood pressure are:

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

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

Causes of hypertension (arterial hypertension)

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

  • age: the risk of developing hypertension increases with age;
  • have had a history of hypertension in your family (the disease may be hereditary);
  • excess salt in your diet;
  • lack of exercise;
  • completeness;
  • smoking;
  • 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 referred to as secondary hypertension. Typical reasons for the increase in pressure in this case are:

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

Diagnosis of hypertension

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

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

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

The cuff is wrapped around the upper arm and inflated to restrict blood flow to 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 common, which measure pressure and pulse using electrical sensors.

Before you start measuring 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 you have high blood pressure during one of the measurements, this does not necessarily mean that you have hypertension. During the day, blood pressure levels can fluctuate. The pressure can rise during a doctor's appointment due to anxiety and stress. In these cases, it is recommended to measure the pressure during the day on your own, using a home tonometer. By eliminating the "white coat fear", you can get more objective indicators.

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

Deciphering the readings of the tonometer

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

  • systolic pressure - blood pressure when your 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 they say that 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 the pressure readings are above 140/90 for several days, you have arterial hypertension and further examination is required.

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 your 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 diseases is low, then you should be able to lower the pressure only by making certain changes in your lifestyle.

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 testing, depending on your health condition.

Lifestyle in hypertension

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

  • Reduce your salt intake to less than 6 grams per day.
  • Eat healthy, low-fat, balanced foods, including plenty of fresh fruits and vegetables.
  • Stay active: Staying physically active is one of the key things you should do to prevent or control hypertension.
  • Cut down on 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 drinks like cola. Drinking more than four cups of coffee a day can increase 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 it will have. In practice, some people find that by maintaining a healthy lifestyle, they do not need to take medication at all.

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 hypertension.

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 be able to stop the drug treatment. Most high blood pressure medications can cause side effects, but this problem can be solved by changing the medications you take.

Tell your doctor if you experience any of the following common drug side effects:

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

Below are the most commonly used drugs 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 the side effects start to bother you, you may be advised to take drugs such as angiotensin-2 receptor antagonists, which work in a similar way to ACE inhibitors.

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

  2. Calcium channel blockers(calcium antagonists) prevent the entry of calcium into the cells of the muscle tissue 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 may increase the 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)act 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 used only when other drugs do not work. This is because beta-blockers are considered less effective than other types of high blood pressure medications.

    Also, beta-blockers can interfere with other drugs, causing side effects. Check with 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 the first choice for high blood pressure, unless other drugs are not working. Alpha blockers work by relaxing your blood vessels, greatly facilitating blood flow within them.

    Common side effects of alpha blockers include:

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

Complications of hypertension

High blood pressure puts extra stress on your heart and blood vessels. 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 blood vessels and vessels of the heart (cardiovascular disease), including:

  • stroke;
  • 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;
  • skin itching.

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

Prevention of high blood pressure

Hypertension can be prevented by eating a healthy diet, maintaining a healthy weight, getting regular exercise, limiting alcohol intake, and not smoking.

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

Power supply at high pressure

Reduce the amount of salt in your diet, eat plenty of fruits and vegetables. Salt raises blood pressure. The more salt you consume, the higher your blood pressure. Aim to eat less than 6 grams of salt per day, which is about the same as one teaspoon.

Eating low-fat, high-fiber foods (such as whole grain rice, bread, and pasta) and plenty of fruits and vegetables have been shown to help lower blood pressure. Fruits and vegetables are rich in vitamins, minerals and fibers that keep your body healthy. Aim to eat five 80g servings of fruits and vegetables each 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 per day regularly, and women - more than 2-3. By regular use is meant every day or most of the days of the week. 1 serving of alcohol roughly corresponds to a glass of vodka, half a glass of wine or half a beer.

Also, since alcohol is high in calories, regular consumption of alcohol leads to weight gain, and, accordingly, to an increase in your 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 (such as Coca-Cola and some energy drinks), consider cutting back. It is very good when you drink tea and coffee as part of a balanced diet, but it is important that such drinks are not your only source of fluid.

Weight and exercise for hypertension

Being overweight forces the heart to work harder to pump blood throughout the body, which usually results in an increase in your blood pressure. If you really need to lose weight, it is important to remember that losing even two to three kilograms 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 by keeping the heart and blood vessels in good condition. Regular exercise also helps you lose weight, which also helps you lower your blood pressure.

An adult should spend at least 150 minutes (2 hours and 30 minutes) each week doing moderate-intensity outdoor exercise, such as cycling or brisk walking. When doing exercises, you should be guided by the fact that you should feel warm and slightly out of breath. For a full person, to reach this state, it may be enough to walk a little up the hill. Physical activity can include a wide variety of exercises, 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 cope with problems. You can discuss with your doctor the possibility of you undergoing such psychotherapy.
  • Biofeedback (a self-regulating method used to help you consciously control your blood pressure): A small monitor shows you your heart rate or blood pressure in real time. A referral for biofeedback can be made by your doctor.

Which doctor should I contact for hypertension?

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