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Hypertension (high blood pressure)

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

If the pressure increases frequently or for a long time and the reasons for this cannot be identified during the examination, a diagnosis of hypertension is made. If a person has a disease that caused an increase in pressure (for example, traumatic brain injury in the past, 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 show obvious symptoms, especially in the early stages. It has been established that 20-30% of the adult population suffers from high blood pressure, although many have not known about their disease for a long time. If high blood pressure is left untreated, the risk of heart attack or stroke increases. The only way to know 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, causing premature wear and tear on these organs and increasing 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 through the arteries;
  • diastolic pressure is the blood pressure when the heart muscle relaxes between two contractions.

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

The optimal blood pressure in an adult is considered to be less than 120/80 mm Hg. From Art. However, numbers up to and including 139/89 are within the normal range. If, according to the results of several measurements, your pressure exceeds 140/90 inclusive, you suffer from arterial hypertension, an additional examination and possibly a treatment is essential.

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 high blood pressure 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. 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 in which there is a problem with the placenta (the organ that provides blood circulation to the unborn child).

Sometimes the symptoms of high blood pressure are:

  • headache;
  • darkening 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 strokes and heart attacks. Make an appointment with your doctor right away if you experience any of these symptoms or have 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 high blood pressure cannot be determined. Then, hypertension is said to be essential or primary. Factors that may increase your risk of developing primary hypertension include:

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

Known causes of hypertension

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

  • kidney disease;
  • Diabetes;
  • narrowing of the arteries supplying the kidneys;
  • hormonal disorders such as Cushing's syndrome (a condition in which the body produces too much steroid hormone);
  • diseases that affect the connective tissues of the body, such as systemic lupus erythematosus;
  • birth control pills (oral contraceptives);
  • painkillers known as nonsteroidal anti-inflammatory drugs (NSAIDs);
  • club drugs such as cocaine, speed and crystal meth;
  • certain herbal remedies, herbal supplements.

Diagnosis of hypertension

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

Healthy people over the age of 40 should have their blood pressure checked at least every five years. If you are at increased risk for high blood pressure, 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, ventilator, and valve.

The cuff is wrapped around the upper arm and inflated to restrict blood flow through the artery. The cuff is then slowly deflated while listening to the pulse with a stethoscope. Listening to your pulse under the deflated cuff provides a reliable reading of your blood pressure. Also, 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 should sit down and not talk during the procedure.

If any of the measurements showed high blood pressure, it does not necessarily mean that you have high blood pressure. During the day, blood pressure levels can fluctuate. Pressure can increase 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 "fear of the white coat", you can obtain 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.

Decipher tonometer readings

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 through 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 the diastolic blood pressure is 90 mm Hg. Art. , then they say your pressure is 140 out of 90.

Ideally, blood pressure should be below 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 pressure readings are above 140/90 for several days, you have high blood pressure and further investigation is needed.

Treatment of high blood pressure

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

If your blood pressure is slightly above 130/80 mm Hg. Art. , and while your risk of developing cardiovascular disease is low, you should only be able to reduce the pressure by making certain 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 soon need treatment, possibly with additional tests, depending on your condition.

Lifestyle in hypertension

Here are some of the lifestyle changes you can make to lower your blood pressure. Some of them will bring about 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 main things you should do to prevent or control high blood pressure.
  • Reduce your alcohol consumption.
  • Stop smoking. Smoking greatly increases your chances of developing lung and heart disease.
  • Losing weight.
  • Drink less coffee, tea, or other caffeinated beverages like 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. In practice, some people find that maintaining a healthy lifestyle, they do not need to take medications at all.

Drug treatment of hypertension

There are a wide variety of medications for high blood pressure. You may need to take more than one type of medicine because sometimes a combination of medicines 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 be able to stop the drug treatment. Most blood pressure medications can cause side effects, but this problem can be solved by changing the medications you are taking.

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

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

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 blockers, which work in the same way as 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 to see if the combination will cause any 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 your blood pressure to drop.

    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 through urine.

  4. Beta-blockers (beta-blockers)work by reducing the rate and force of heart contractions, thereby lowering blood pressure. Beta-blockers used to be a popular medication for high blood pressure, but these days they're usually only used when other medications aren't working. This is because beta-blockers are considered less effective than other types of 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 suddenly stop taking beta-blockers 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 do not work. Alpha-blockers work by relaxing your blood vessels, making it much easier for blood to flow through them.

    Common side effects of alpha-blockers include:

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

Complications of hypertension

High blood pressure puts extra stress on your heart and blood vessels. Without treatment, high blood pressure increases your risk of heart attack, stroke, and kidney disease over time.

Cardiovascular disease in hypertension

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

  • caress;
  • myocardial infarction;
  • embolism: occurs when a blood clot or air bubble blocks the flow of blood through 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

High blood pressure 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 fluid 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 serious cases require dialysis (a medical procedure in which the blood is artificially cleaned 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, exercising regularly, limiting alcohol consumption 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 dramatically.

High pressure feed

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

Eating low-fat, high-fiber foods (like whole-grain rice, bread, and pasta) and plenty of fruits and vegetables has been shown to help lower blood pressure. Fruits and vegetables are rich in vitamins, minerals and fiber which keep your body healthy. Aim to eat five 80g servings of fruit and vegetables each day.

If you regularly drink more than the legal limit, your blood pressure will increase over time. Men are not recommended to regularly consume more than 2-4 servings of alcohol per day, and women - more than 2-3. Regular use means every day or most days of the week. 1 serving of alcohol is roughly equivalent 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, therefore, 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 Coca-Cola and some energy drinks), consider cutting back on them. It's fine when you drink tea and coffee as part of a balanced diet, but it's important that these beverages 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 usually causes your blood pressure to rise. If you really need to lose weight, it's important to remember that losing even two to three kilograms of weight will dramatically change your blood pressure readings and improve your overall health.

An active lifestyle and regular physical activity lower blood pressure by 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) 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 on 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 your ability to cope with problems. You can discuss with your doctor the possibility of undergoing such psychotherapy.
  • Biofeedback (a self-regulation 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 condition and prescribe treatment for you. If you have heart problems or chronic cardiovascular disease, choose a cardiologist.