An increase in pressure above the age norm is rightly called arterial hypertension.
If the pressure rises often or for a long time, and it is not possible to determine the reasons for that during the examination, a diagnosis of hypertension is made. If a person has any disease that has caused an increase in blood pressure (for example, traumatic brain injury in the past, kidney disease, etc. ), then it is talking about secondary arterial hypertension. However, colloquially, all cases of high blood pressure are often referred to as hypertension.
Hypertension is known as a "silent killer" because it does not always have obvious symptoms, especially in the initial stages. It has been determined that 20-30% of the adult population has high blood pressure, although many have not known about their disease for a long time. If left untreated, hypertension increases the risk of heart attack or stroke. The only way to find out if there is a problem is
measure your blood pressure regularly.
Blood pressure is the force with which blood presses against the walls of blood vessels and the heart. With hypertension, the 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 blood pressure when the heart muscle relaxes between two contractions.
For example, if your doctor says that your blood pressure is "140 to 90", it means that 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 and including 139/89 lie within normal limits. If, according to the results of several measurements, the pressure exceeds 140/90 inclusive, you have arterial hypertension, additional examination and possible 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 measure 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 pregnant women can lead to preeclampsia. This is a dangerous condition in which there is a problem with the placenta (the organ that ensures blood circulation to the unborn child).
Sometimes the symptoms of high blood pressure are:
- headache;
- blackout 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 diseases, including stroke and heart attack. Make an appointment with your doctor immediately 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 the risk of developing primary hypertension include:
- years: the risk of developing hypertension increases with age;
- there have been cases 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 called secondary hypertension. Typical reasons for the increase in pressure in this case are:
- kidney disease;
- diabetes;
- narrowing of the arteries that supply blood to the kidneys;
- hormonal disorders such as Cushing's syndrome (a condition in which the body produces too many steroid hormones);
- diseases affecting the connective tissue 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, amphetamines and crystalline methamphetamine;
- some herbal remedies, herbal supplements.
Diagnosis of hypertension
In order to diagnose arterial hypertension and identify its possible causes, they first 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 of hypertension, you should check your blood pressure more often, ideally once a year.
Blood pressure testing is usually easy to perform in most clinics and hospitals. Blood pressure is usually measured with a sphygmomanometer (manometer), a device consisting of a stethoscope, cuff, measuring device, ventilator and valve.
The cuff is wrapped around the upper arm and inflated to restrict blood flow in the artery. The cuff is then slowly released while listening to the pulse with a stethoscope. Listening to your pulse under a blown 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 must sit and not talk during the procedure.
If one of the measurements showed high blood pressure, it does not necessarily mean that you have hypertension. During the day, blood pressure levels can vary. Pressure may increase during a doctor's examination due to anxiety and stress. In these cases, it is recommended to measure the pressure during the day with a home tonometer. By eliminating the "fear of the white coat" 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 tonometer reading
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 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 your blood pressure is 140 to 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 additional testing is needed.
Treatment of high blood pressure
Effective actions to lower blood pressure include lifestyle changes and taking 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 just above 130/80 mm Hg. Art. , and at the same time the risk of developing cardiovascular disease is low, then you should be able to lower the pressure only by certain changes in your lifestyle.
If your blood pressure is moderately high (140/90 mmHg or more) and there is a risk of developing heart disease in the next 10 years, treatment will include medication and lifestyle changes.
If your blood pressure is very high (180/110 mmHg or more), you will soon need treatment, perhaps with additional tests, depending on your health condition.
Lifestyle in hypertension
Below are some of the changes you can make to your lifestyle to lower your blood pressure. Some of them will lead to a rapid improvement within a few weeks, others will take effect over a longer period of time.
- Reduce salt intake to less than 6 grams per day.
- Eat healthy, low-fat, balanced foods, including lots of fresh fruits and vegetables.
- Staying Active: Physically active is one of the key things you need to do to prevent or control hypertension.
- Reduce alcohol intake.
- Quit smoking. Smoking greatly increases your chances of developing lung and heart disease.
- Lose weight.
- Drink less coffee, tea or other caffeinated beverages such as 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. In practice, some people feel that maintaining a healthy lifestyle does not require them to take medication at all.
Treatment of hypertension with drugs
A wide variety of blood pressure medications are 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 stays under control for several years, you may be able to stop your medication. Most high 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:
- I'm sleepy;
- pain in the kidney area (in the lumbar region);
- dry cough;
- dizziness, exhaustion or lethargy;
- skin rash.
Below are the most commonly used medications for high blood pressure.
Angiotensin converting enzyme (ACE) inhibitors.lower blood pressure by relaxing the walls of blood vessels. The most common side effect is persistent dry cough. If side effects start to bother you, you may be advised to take medicines 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 medications, including over-the-counter medications. Before you start taking any additional medication, check with your doctor to see if the combination will cause adverse side effects.
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 can increase the risk of side effects. You can talk to your doctor for more information on this issue.
Diuretics(diuretics) work by removing excess fluid and salt from the body in the urine.
Beta-blockersthey work by reducing the speed and strength of heart contractions, thereby lowering blood pressure. Beta-blockers were once a popular drug for high blood pressure, but today they are usually used only when other drugs do not work. This is because beta-blockers are considered less effective than other types of drugs for high blood pressure.
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 abruptly stop taking beta-blockers without talking to your doctor. This can lead to serious side effects such as high blood pressure or angina.
Alpha blockers (alpha blockers)they are generally not recommended as a first choice for high blood pressure unless other medications are working. Alpha blockers work by relaxing your blood vessels, greatly facilitating the flow of blood in them.
Common side effects of alpha blockers include:
- fainting on the first dose of the drug ("first dose effect");
- dizziness;
- headache;
- swelling of the ankles;
- fatigue.
Complications of hypertension
High blood pressure puts extra strain on your heart and blood vessels. If left untreated, hypertension increases the risk of heart attack, stroke and kidney disease over time.
Cardiovascular diseases in hypertension
Hypertension can cause many different diseases of the heart and blood vessels and blood vessels of the heart (cardiovascular disease), including:
- stroke;
- myocardial infarction;
- embolism: occurs when a blood clot or air bubble blocks blood flow in a vessel;
- aneurysm: occurs 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;
- itchy skin.
Kidney diseases are treated with drugs and supplements. In more serious cases, dialysis is needed (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, exercising regularly, limiting alcohol intake and not smoking.
Smoking alone does not cause high blood pressure, but it does increase the risk of heart attack and stroke. Smoking, like high blood pressure, causes narrowing of the arteries. If you smoke when you have hypertension, your arteries will narrow much faster and the risk of developing heart and lung disease will increase significantly in the future.
High pressure power supply
Reduce the amount of salt in your diet, eat lots of fruits and vegetables. Salt raises blood pressure. The more salt you eat, the higher your blood pressure. Try to eat less than 6 grams of salt a day, which is about the same as one teaspoon.
Consuming foods low in fat and high in fiber (such as whole grain rice, bread and pasta) and lots of fruits and vegetables have been shown to help lower blood pressure. Fruits and vegetables are rich in vitamins, minerals and fiber that keep your body healthy. Aim to eat five servings of fruits and vegetables of 80 g each day.
If you regularly drink more than the legal limit, your blood pressure will rise over time. It is not recommended for men to regularly consume more than 2-4 servings of alcohol per day, and for women more than 2-3. Regular use means every day or most 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 alcohol consumption leads to weight gain, and thus to an increase in blood pressure.
Drinking more than four cups of coffee a day can lead to high blood pressure. If you are a big fan of coffee, tea or other caffeinated beverages (such as Coca-Cola and some energy drinks), consider a reduction. 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 fluids.
Weight and exercises for hypertension
Being overweight forces the heart to work harder to pump blood throughout the body, which usually results in an increase in blood pressure. If you really need to lose weight, it is important to remember that losing as much as two to three pounds of weight will significantly change your blood pressure and improve your overall health.
An active lifestyle and regular exercise lead to lowering 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 outdoor exercises of moderate intensity, such as cycling or brisk walking. When performing exercises, you should be guided by the fact that you are warm and lightly breathless. For a full man, to get to this state, it may be enough to walk a little uphill. Physical activity can include a wide range of exercises, from sports to walking and gardening.
Relaxation exercises can lower blood pressure. These 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 deal with problems. You can talk to your doctor about the possibility of 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. Your doctor may refer you to biofeedback.
Which doctor should I go to 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 problems or chronic cardiovascular disease, choose a cardiologist.