High Blood Pressure (Hypertension): Symptoms, Causes, and Treatment

What Is High Blood Pressure?

High blood pressure, also called hypertension, occurs when blood pressure stays higher than normal for a long time. A high blood pressure range is anything more than 139/89 mm Hg (millimeters of mercury). It is a prevalent and serious condition that, if ignored, can damage the heart, kidneys, brain, and eyes.

What Is Considered High Blood Pressure?

Blood pressure has two numbers: systolic (top number) and diastolic (bottom number). It is measured in millimetres of mercury or mm Hg.

According to hypertension guidelines, blood pressure is considered:

1. Normal: When the value is less than 120/80 mm Hg.

2. High: When the value is consistently above 130/80 mm Hg.

Depending on how high the blood pressure is, it is grouped in the following stages:

1. Stage 1 Hypertension: When the top number (systolic) is 130-139 mm Hg or the bottom number (diastolic) is 80-89 mm Hg.

2. Stage 2 Hypertension: If the top number is 140 mm Hg or more, and the bottom number is 90 mm Hg or more, it is considered stage 2 hypertension.

What Are the Symptoms of High Blood Pressure?

Most people with high blood pressure don’t notice any signs early on. Some may develop certain warning signals, which are classic symptoms of high blood pressure, like:

• Hypertension headache, especially at the back of the head.

• Restlessness.

• Dry mouth.

• Occasions of dehydration.

• Palpitations.

• Rapid eye movement.

• Nausea.

• Confusion.

What Are the Causes of Hypertension?

The causes of high blood pressure vary. Based on the causes, they are categorized as:

1. Primary Hypertension: In most cases, it develops gradually with age and other risk factors, with no identifiable medical condition involved. It is also called essential hypertension.

2. Secondary Hypertension: This type of high blood pressure is caused by medical conditions such as kidney problems or hormonal issues and sometimes due to medications that a person is taking.

What Are the Risk Factors for High Blood Pressure?

• Age: The risk increases with age, with more women having high blood pressure after 65.

• Family History: A person is more likely to have high blood pressure if their parents or siblings suffer.

• Race: Black people are more commonly affected by high blood pressure than white people.

• Obesity: Excess weight causes stress on the blood vessels and other organs, causing increased blood pressure.

• Too Much Salt: Excess salt causes the body to retain fluid, further increasing blood pressure.

• Tobacco Use or Vaping: It can damage the blood vessel walls and speed up their hardening, increasing blood pressure.

• Low Potassium Levels: Lack of potassium in the diet or certain medical conditions can cause high blood pressure due to a disturbance in the body's salt balance.

• Stress: Increased levels of stress can cause temporary high blood pressure.

• Alcohol: Regular heavy drinking is related to high blood pressure.

What Are the Complications of Hypertension?

With time, the constant high pressure damages blood vessels and weakens the organs they supply.

Below are the major complications.

Artery-Related Damage:

• Arterial Stiffness: High blood pressure damages the inner lining of the arteries, making them lose some of their elasticity with time. Fat deposits can build up in the injured arteries and restrict the blood flow.

• Aneurysm: Continuous pressure may cause part of an artery wall to bulge (aneurysm). It is an emergency if it ruptures, as it can cause internal bleeding.

Heart-Related Complications:

• Heart Artery Disease: Narrowed arteries reduce blood supply to the heart, leading to pain in the chest (angina), abnormal heart rhythms, or a heart attack.

• Heart Failure: Constant strain due to elevated blood pressure can stiffen the heart muscle or weaken and impair its normal function. The overburdened heart gradually begins to fail.

• Left Heart Enlargement: The heart’s main pumping chamber, the left lower one, thickens due to the extra load of higher blood pressure. This increases the risk of heart attack, failure, or sudden cardiac death (sudden stopping of the heart's beating).

• Metabolic Syndrome: Metabolic syndrome includes five health problems, such as high blood pressure, high blood sugar, low HDL (high-density lipoprotein) cholesterol, high triglycerides, and a large waist circumference. They raise the risk of stroke and heart disease.

Brain-Related Complications:

• Transient Ischemic Attack: Often called a ministroke, it is due to an obstruction in blood flow to the brain. These signals indicate a high risk of future major stroke.

• Stroke: Constant high blood pressure can narrow, burst, or leak blood vessels, cutting off oxygen and killing brain cells.

• Dementia: Narrowed or blocked arteries can restrict the brain's blood supply, leading to vascular dementia. Multiple small strokes may also cause memory decline.

• Mild Cognitive Impairment: Difficulties with thinking, memory, or language may appear before dementia develops, more commonly in hypertensive patients.

Kidney Damage:

Damaged kidney arteries reduce the organ’s ability to filter waste, permitting toxins and harmful fluid levels to build up in the body. Over time, hypertension is one of the leading causes of chronic kidney disease and failure, often requiring dialysis and transplant.

Eye Damage:

• Retinopathy: Weak eye vessels can rupture or leak, leading to blurred vision, bleeding, or even vision loss. The risk increases when diabetes and high blood pressure coexist.

• Choroidopathy: Fluid that builds beneath the retina may cause blurred vision or, sometimes, scarring that can impair eyesight.

Emergencies:

When the blood pressure suddenly rises to very high levels, it leads to complications like:

• Stroke or mini stroke.

• Blindness or sudden loss of vision.

• Acute heart failure with fluid buildup in the lungs (pulmonary edema).

• Kidney failure.

• Memory loss, altered personality, difficulty focusing, agitated mood, or progressive unconsciousness.

• Severe injury to the aorta, the body's major artery.

• Pregnancy complications, such as eclampsia or preeclampsia, are conditions associated with high blood pressure.

How to Diagnose Hypertension?

Here’s how it's diagnosed:

1. Conventional Blood Pressure Measurement: Blood pressure is measured using a cuff (sphygmomanometer or digital monitor). Doctors diagnose hypertension after two or more high readings on at least two different occasions while the person is at rest.

2. Ambulatory Blood Pressure Monitoring: Sometimes, the doctors recommend wearing a portable device that records BP over 24 hours. This gives a more accurate picture.

3. Laboratory Tests: For secondary hypertension, blood and urine tests are used to look for causes of kidney diseases, thyroid issues, or hormonal problems. The tests also assess whether high blood pressure has already affected the organs.

What Are the Treatment Options for Hypertension?

The goal of therapy is to bring blood pressure within normal range. A stepwise approach is applied.

The first step is lifestyle modifications, which include:

• Limiting dietary salt intake.

• Aerobic exercise for at least 30 minutes daily, five times a week.

• Stopping smoking and limiting alcohol.

• Maintaining a healthy weight.

• Reducing dietary fat content.

• Increasing fruits and vegetables in the diet.

These measures should be followed in all individuals with hypertension, regardless of whether the decision has been made to implement drug therapy. If lifestyle changes aren’t enough, doctors may prescribe medication for high blood pressure.

Commonly used medications are:

• Angiotensin-converting enzyme inhibitors.

• Angiotensin receptor blockers.

• Beta blockers.

• Calcium channel blockers.

• Diuretics.

• Aldosterone antagonists.

Most of the time, patients may need a combination of hypertension medications for long-term control. When a cause is identified for secondary hypertension, the treatment addresses the cause.

How to Prevent Hypertension?

Following simple daily habits helps lower the risk:

• Keep salt intake in control.

• Sustain a healthy weight.

• Eat fruits and vegetables.

• Engage in regular exercise.

• Refrain from or use alcohol sparingly.

• Sleep well and manage stress.

How to Live With Hypertension?

With the right treatment and healthy habits, hypertensive patients can live long and active lives. Following your doctor’s advice and taking medications on time is necessary. Reducing salt intake and being active also makes a great difference in maintaining hypertension. Regular checkups help track changes in blood pressure and catch any issues early. Most importantly, listen to your body, avoid stress, and care for your health.

Conclusion:

High blood pressure is a cardiovascular condition in which the heart and blood vessels exert more force to function efficiently. This condition must be corrected and reversed, or else it may lead to permanent heart injury. The good news is that high blood pressure can often be managed successfully with early diagnosis, proper treatment, and healthy lifestyle changes.

Key Takeaways From iCliniq:

• Hypertension is a prevalent condition and is dangerous if ignored. Worldwide, around 1.28 billion people have hypertension, which is the leading cause of premature deaths.

• Leading a healthy lifestyle with adequate sleep and managing stress can help in prevention. They are often silent; therefore, regular preventive checkups are necessary.

• If you or a family member has any of the symptoms, consult an iCliniq cardiologist, who can help with diagnosis and management.