Hypertension is an increase in blood pressure above the normal range. Symptoms of hypertension in the early stages of the disease are unnoticeable or not very characteristic, but nevertheless you should know them. What are the causes and risk factors of high blood pressure? How to recognize its symptoms? What is the treatment of high blood pressure?

Hypertensionis an increase in blood pressure above the normal range.Hypertensioncan be diagnosed if the mean blood pressure values ​​(calculated from at least two measurements made during at least two different visits to the doctor) are equal to or greater than 140 mmHg for systolic blood pressure and / or 90 mm Hg for diastolic pressure. This ideal blood pressure is 120/80 mm Hg.

Hypertension isa disease of civilizationand remains the most important risk factor for premature death worldwide.

Blood pressure is related to mortality and cardiovascular disease incidence:

  • heart attack
  • stroke
  • heart failure
  • peripheral arterial disease
  • kidney failure

Data from the last 20 years show an increase in the prevalence of hypertension in Poland. According to the NATPOL 2011 study, the prevalence of arterial hypertension among people aged 18-79 has increased over 10 years from 30 to 32%, i.e. to about 9 million people.1

Standards of pressure and classification of hypertension

  • blood pressure

Systolic blood pressure (mm Hg)Diastolic blood pressure (mm Hg)
Optimal<120<80
Correct120-12980-84
High correct130-139

85-89

  • hypertension

Systolic blood pressure (mm Hg)Diastolic blood pressure (mm Hg)
Stage 1 (mild)140-15990-99
Grade 2 (moderate)160-179100-109
Grade 3 (severe)≥180≥110
Isolated shrink≥140<90

Hypertension symptoms

Regardless of the cause, however,hypertensionusually gives no symptoms for many years. Sometimes there are symptoms that may also appear in other diseases, which is why they are called non-specific for arterial hypertension.

However, it can be assumed that the more such symptoms you observe in yourself, the greater the probability that you suffer from hypertension.

Hypertension symptoms:

  • pressure in the head - occurs occasionally and usually has the nature of a dull headache
  • dizziness
  • fatigue
  • nose bleed
  • sleep disturbance
  • nervousness
  • heart ailments - with high blood pressure you can feel a distinct pounding of the heart, a feeling of pressure or tightness around it
  • shortness of breath

It is therefore worth checking if the pressure is normal, because when the symptoms start to overlap, it may be too late to compensate for the losses that the body has suffered because of this.

Causes of high blood pressure

U about 95 percent patients with hypertension are diagnosed with its primary form -primary arterial hypertension . This means that the cause of hypertension cannot be unequivocally established or eliminated.

In the rest of patients with arterial hypertension, its cause can be determined - it is a disease whose symptom may be high blood pressure. In this case, the diagnosis issecondary arterial hypertension .2

Common causes of secondary hypertensionRare causes of secondary hypertension
  • obstructive sleep apnea
  • diseases of the kidney parenchyma, kidney transplant
  • narrowing of the renal artery / arteries
  • primary hyperaldosteronism (Conn's disease)
  • pregnancy
  • drugs and chemicals (non-steroidal anti-inflammatory drugs, cyclosporine, oral contraceptives, glucocorticoids)
  • hyperthyroidism
  • anemia
  • aortic regurgitation
  • arteriovenous fistulas
  • tumors that secrete renin
  • defects of mineralocorticoid metabolism
  • congenital adrenal hyperplasia
  • Cushing's syndrome
  • pheochromocytoma
  • tumor originating from extra-adrenal phaeochromocytes (paragangliomas)
  • hyperparathyroidism
  • acromegaly
  • aortic stenosis
  • porphyria
  • vegetative neuropathy
  • increased intracranial pressure
  • lead poisoning
  • tetraplegia
  • Guillain-Barré syndrome
  • surgical procedures

In addition to primary and secondary hypertension, there are alsoresistant arterial hypertension , which is defined as blood pressure remaining above the target value despite the simultaneous use of 3 antihypertensive drugs from different groups (preferably, that one of them was a diuretic) in optimal doses.

There is also amalignant arterial hypertension.Its characteristic feature is that it quickly leads to failure of many organs (including the heart and brain), which is a life-threatening condition .

There is also" white coat hypertension "(white coat syndrome) is diagnosed at elevated blood pressure values ​​in a medical facility, during when measurements carried out outside of it remain within the limits established as correct.

It is believed that the anxiety reaction, which is the result of the presence of medical personnel during blood pressure testing, plays an important role in the development of this phenomenon.

According to an expertBarbara Grzechocińska, MD, PhD, obstetrician gynecologist, assistant professor at the 1st Department and Clinic of Obstetrics and Gynecology of the Medical University of Warsaw

Hypertension in pregnancy

I suffer from primary arterial hypertension. I am now in 24 weeks pregnant. I am currently taking medication, so my blood pressure is normal. However, I am afraid of childbirth because stress and high physical exertion cause my blood pressure to rise significantly. Is natural childbirth or a cesarean better for me?

Dr. Barbara Grzechocińska, MD, PhD, gynecologist - obstetrician, endocrinologist : well-balanced arterial hypertension is not an indication for caesarean section, but it is an indication for labor anesthesia. Each operation (including cesarean section) poses a greater risk of serious complications than vaginal delivery.

However, the indication for a cesarean section is very high blood pressure that cannot be treated. There are several serious complications of high blood pressure in pregnancy. They most often occur in women who do not have follow-up tests and are not treated. Therefore, it is impossible to recognize the risk of complications early or prevent them.

Therefore, I would advise you to follow the recommendations of the attending physician, pay attention to all disturbing symptoms and inform your doctor about them, and you will certainly take early measures to prevent the occurrence ofcomplications.

Diagnosis of hypertension

The basis for the diagnosis of arterial hypertension is a correctly performed indirect in-office blood pressure measurement.

As mentioned, hypertension can be diagnosed if the mean blood pressure values ​​(calculated from at least two measurements taken during at least two different visits to the doctor) are equal to or greater than 140 mmHg for systolic blood pressure and / or 90 mm Hg for diastolic pressure.

Check:Normal blood pressure. How to correctly measure the pressure at home?

Each patient at the time of diagnosis of hypertension should undergo a complete clinical examination including a thorough history, physical examination, and indicated laboratory tests and other diagnostic tests.1

Hypertensive patients are looked after by - cardiologist, hypertensiologist or GP. Treatment of arterial hypertension is life-long.

Each patient should undergo a complete physical examination, paying particular attention to detecting pathologies indicative of secondary hypertension and the presence of organ complications.

Record the patient's weight, height, and calculate the body mass index (waist circumference should be measured).

Hypertension research

The following additional tests should be distinguished:

  • basic (necessary to be performed in every patient with arterial hypertension)
    • blood count
    • fasting glucose
    • sodium concentration
    • potassium concentration
    • total cholesterol, HDL and LDL fractions, and triglycerides
    • creatinine concentration and estimate of the amount of glomerular filtration
    • uric acid concentration
    • urinalysis and albuminuria assessment
    • electrocardiogram
  • extended (performed in patients in whom elements of the history, physical examination or additional basic tests indicate the need to extend the diagnosis. Extended tests include, among others
    • echocardiographic examination of the heart
    • ultrasound of the carotid arteries
    • Ultrasound of the renal arteries
    • albuminuria grade
  • specialized - they are designed to detect certain organ complications (e.g. magnetic resonance imaging in people suspected of hypertensive encephalopathy), they are usually necessary to identify or rule out secondary forms of hypertension

Treatment of hypertension

In many patients, a change in lifestyle alone - without taking any medications - is enough to achievesatisfactory blood pressure values.

Everyone, except patients with severe arterial hypertension (systolic blood pressure ≥ 180 mm Hg; diastolic blood pressure ≥ 110 mm Hg), who should be started on medication immediately should be treated with non-pharmacological treatment for several months.

The concept of non-pharmacological treatment of hypertension includes:3

  • fight obesity and overweight
  • a proper s alt-reduced diet (limiting s alt intake to 4.35-6 g / day causes an average decrease in blood pressure by 2-8 mmHg)
  • physical activity (regular physical activity reduces blood pressure by 4-9 mm Hg)
  • to quit smoking
  • reducing alcohol consumption
  • fight stress

When, despite introducing appropriate lifestyle changes, you cannot achieve the planned reduction in blood pressure, it turns out to be necessary to take pills. Doctors classify antihypertensive drugs into several types, depending on how or where they work in the human body.3

Drugs for hypertension:

  • diuretics (another name is diuretics)
  • beta blockers
  • angiotensin converting enzyme inhibitors (IKA for short)
  • calcium channel blockers (otherwise: calcium antagonists)
  • alpha blockers
  • Direct vasodilators, so-called vasodilators
  • drugs that act on the central nervous system

Drugs of each of the above types reduce blood pressure to a similar extent, but the decision which to use is always made by the doctor.

According to an expertKrystyna Knypl, MD, PhD, internist

Is it possible to stop taking high blood pressure medication?

I have been taking pills for hypertension for a year, which I probably had from nervousness. Now I am at ease because the reason for my nerves is gone. I have a blood pressure monitor, I do it in the morning and for a couple of weeks my blood pressure has been at 120/80. I am 48 years old. Please write, do I have to continue taking medications for hypertension, since I no longer have it? Is elevated heart rate a symptom of some disease?

Dr. Krystyna Knypl, internist, hypertensiologist is answering:

The presented data only shows that you are properly treated, since your blood pressure is 120/80 - but not that your hypertension has resolved. Permanent relief of hypertension can occur only in very rare cases - for example, when it is caused by a narrowing of the renal artery and the narrowing is removed by surgery. Over 95-97 percent humans have essential hypertension that does not go awaydurable.

It is known that in the case of essential hypertension, after discontinuation of drugs, the disease always relapses - about a year after discontinuation of drugs, most people usually have to go back to taking pills. Since you are 48 years old, it should be taken into account that changes in the hormonal profile are slowly starting, which will favor an increase in blood pressure. If there is an increase in heart rate, this means that the circulatory system is not stable.

So when you try to stop taking your pills, you may get complications. Only in situations where the pressure is below 110/70 can you skip the nearest dose of the drug once and then measure the pressure before taking the next dose. If the blood pressure is higher than 120/80 - it means that you need to take the next dose of the drug. If in doubt about the need for continued treatment, always consult your doctor.

Hypertension diet

In the case of problems with hypertension, remove from the menu everything that contributes to the increase in pressure, and introduce products that lower it.

To reduce blood pressure by dieting, reduce the amount of consumed so far to half:

  • white bread
  • white flour pasta
  • white rice
  • fine grain groats
  • egg yolks

You should also completely abandon:

  • sweets
  • whole milk and full fat milk products
  • fatty meats and cold cuts
  • smoked fish
  • canned food
  • of concentrates
  • powdered soups
  • ready-made sauces
  • yellow cheese
  • chips
  • s alty sticks
  • peanuts
  • fast food

Their place should be taken by products that lower blood pressure, especially vegetables and fruits.

Fruits and vegetables that lower blood pressure include:

  • cranberry
  • aronia
  • lemons
  • rowan
  • beetroot
  • tomatoes
  • pepper
  • radish
  • onion
  • garlic
  • parsley
  • lettuce
  • broccoli
  • cauliflower
  • spinach
  • Chinese cabbage
  • green peas
  • root and celery
  • sea buckthorn

These products increase blood pressure:

See the gallery of 11 photos

Hypertension - how to prevent it?

The development of arterial hypertension can be prevented primarily by influencing the environmental conditions.

The most effective method of avoiding or delaying the development of arterial hypertension (primary prevention) is lifestyle modification, especially obesity prevention, as well as an appropriate diet and increased physical activity.

  • Home remedies for hypertension. How to lower blood pressure without medication?
  • Blood pressure: 12 important questions
Worth knowing

Hypertension - effects

If the blood pressure in the body remains even at a slightly elevated level for many years, the blood vessels are irreversibly damaged. This also applies to the vessels that feed many vital organs, such as the eyes, kidneys and brain.

This is why we often learn about hypertension by accident - sometimes from an ophthalmologist, neurologist, or when there are problems with the kidneys or potency.

The worst case scenario is when the first signal is a heart attack or stroke. In patients with hypertension, myocardial infarction occurs 3-5 times more often, and cerebral hemorrhage 4 times more often than in he althy people.

Therefore, even when we are fine, it is worth taking your blood pressure at least once a year to make sure that the circulatory system is working flawlessly.

Category:

Cardiology