Understanding Hypertension and Its Impact on Your Health
The heart is a muscular organ that contracts rhythmically, having the role of pushing blood through a system of "ducts" (blood vessels) to all organs in the body.
What is Blood pressure?
Blood pressure refers to the force exerted by blood on the walls of blood vessels as it circulates through the body. This pressure is influenced by two main factors:
the amount of blood pumped by the heart into the arteries
the resistance offered by the blood vessel walls to the flow of blood.
The heart, a muscular organ, beats regularly to propel blood through a network of tubes (blood vessels) to all parts of the body.
Blood vessels have complex, elastic walls that contain both muscle and elastic fibers, enabling them to alter their diameter as blood is pumped into the arteries by the heart
Increased blood volume or reduced elasticity of the blood vessel walls can result in increased blood pressure and the development of high blood pressure or hypertension.
Blood pressure is represented by two values, namely the systolic blood pressure and the diastolic blood pressure. The first one refers to the maximum pressure exerted by the heart when pumping blood into the arteries, while the last one represents the residual pressure in the arteries when the heart is relaxed and filling with blood.
In order for proper blood circulation to occur, the systolic blood pressure should always be higher than the diastolic blood pressure.
What is arterial hypertension?
As per current medical guidelines, arterial hypertension is diagnosed when the maximum value of blood pressure consistently reaches or exceeds 140 mmHg and/or the minimum value reaches or exceeds 90 mmHg (blood pressure is measured in millimeters of mercury).
The medical literature also refers to "optimal" blood pressure values up to 120/80 mmHg, and "normal" values that fall below the threshold of 130/80 mmHg.
Blood pressure within the range of 130-139/85-89mmHg is classified as normal-high, but without lifestyle modifications, it can increase the risk of developing hypertension in the future.
High blood pressure is rarely found alone, as it is commonly associated with other cardiovascular risk factors such as dyslipidemia (elevated cholesterol and/or triglyceride levels), obesity, and impaired glucose tolerance (increased blood glucose levels). These metabolic factors can greatly amplify the risk of cardiovascular events, including stroke and myocardial infarction, in hypertensive patients.
Hypertension is the primary preventable cause of cardiovascular disease and the leading cause of overall mortality globally and in Europe.
Therefore, it is crucial to focus on early diagnosis, proper treatment, and most importantly, prevention of hypertension.
The prevalence of hypertension is constantly increasing worldwide due to a sedentary lifestyle and increased body weight, and it is estimated that by 2025, 1.5 billion people will be affected by this condition.
Types of Hypertension
Primary hypertension (essential hypertension) has no known cause. It could be several factors: lifestyle, genetics, age etc.
Secondary hypertension has an identifiable and potentially reversible cause (thyroid abnormalities, renal artery stenosys, adrenal gland disease, obstructive sleep apneea etc).
While sleeping, the average value of blood pressure (BP) typically decreases by around 10%, a phenomenon known as the "dipper" profile. Some individuals exhibit a "non-dipper" profile due to various factors including sleep disorders, sleep apnea syndrome, obesity, high salt intake, chronic kidney disease, or advanced age.
White coat hypertension is a temporary condition in which BP is higher than normal when measured by a doctor, but normal outside of a clinical setting.
"Masked hypertension" describes the situation in which BP appears normal when measured at the doctor's office but is actually higher outside of the clinic.
Measurement of blood pressure
Blood pressure values can vary greatly, so a diagnosis should not be made based on a single set of measurements unless the maximum value exceeds 180 mmHg. In other cases, it is recommended to repeat the measurements to confirm persistent high blood pressure values.
There are different instruments available to measure blood pressure, including manual and electronic devices.
It is recommended to measure blood pressure in both arms, to check for consistent differences between them.
If there is a difference of at least 15 mmHg between the arms, it may suggest the presence of atherosclerosis, which is the buildup of cholesterol inside the blood vessels.
Hypertension can accelerate the atherosclerosis process, leading to narrowed arteries and inadequate blood flow to the organs, increasing the risk of cardiovascular disease.
Symptoms of Hypertension
Most often, the first symptoms of hypertension appear only when disease gets complicated, but sometimes people with high blood pressure may present:
nausea and vomiting;
ringing in the ears;
Management of Hypertension
Untreated hypertension can cause damage to specific organs known as target organs, which include the heart, brain, kidney, and eyes.
Uncontrolled hypertension significantly increases the risk of serious conditions such as:
chronic kidney disease.
The uncontrolled hypertensive patient is at increased risk of having myocardial infarction, heart failure, stroke or chronic kidney disease. A correct treatment instituted by the specialist and respected by the patient leads to the normalisation of the measurements or and to the lasting control of the disease hypertensive.
High blood pressure is a chronic disease that can be controlled only by the antihypertensive medication (sometimes therapeutic schemes involving combinations of medications) and through a correct lifestyle.
However, with proper treatment prescribed by a specialist and adherence to the treatment plan, patients can achieve normal blood pressure levels and long-term control of the disease.
Hypertension is a chronic disease that can only be managed with:
antihypertensive medication (sometimes through combination therapy),
healthy lifestyle (this includes a diet low in salt and fat, quitting smoking, maintaining a healthy body weight, and engaging in regular physical exercise.
These factors are essential in preventing the onset of high blood pressure or normalising it for those already diagnosed with hypertension.
1. Williams B et al, European Heart Journal, Volume 39, Issue 33, 01 September 2018, Pages 3021–3104, 2018 ESC/ESH; Guidelines for the management of arterial hypertension: The Task Force for the management of arterial hypertension of the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH)
2. https://www.healthline.com/health/types-and-stages-of-hypertension, accessed at 16.02.2023
Please note that the information provided on this blog is for educational and informational purposes only. It is not intended to be used as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this blog.