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Hypertension (high blood pressure)

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

If the pressure rises frequently or for a long time, and during the examination it is not possible to identify the reasons for this, a diagnosis of hypertension is made. If a person has any disease that has caused an increase in pressure (for example, a head injury in the past, kidney disease, etc. ), then it is called secondary arterial hypertension. 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 have obvious symptoms, especially in the early stages. It has been established that 20-30% of the adult population has high blood pressure, although many do not know about their disease for a long time. If hypertension is not treated, it increases the risk of heart attack or stroke. The only way to find out if there is a problem isBlood pressure measurement with an electronic tonometermeasure blood pressure regularly.

Blood pressure is the force with which the blood presses against the walls of the blood vessels and the heart. With hypertension, the 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 recorded in two dimensions:

  • systolic pressure: blood pressure when the heart contracts and pushes blood into the arteries;
  • Diastolic pressure is the blood pressure when the heart muscle relaxes between two contractions.

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

Optimal blood pressure in an adult is considered to be less than 120/80 mm Hg. Art. However, numbers up to and including 139/89 are within the normal range. If, based on the results of various measurements, your pressure exceeds 140/90 inclusive, you have arterial hypertension, an additional examination and, possibly, treatment is required.

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're pregnant, it's important to check your blood pressure regularly, even if it's not high. Controlling blood pressure during pregnancy reduces the risk of complications. High blood pressure in a pregnant woman can lead to pre-eclampsia. This is a dangerous condition in which there is a problem with the placenta (the organ that provides blood circulation to the fetus).

Sometimes the symptoms of high blood pressure are:

  • headache;
  • dimming or double vision;
  • nosebleeds;
  • dyspnoea

Such signs appear in people with very high pressure. If you experience any of these symptoms, see your doctor. If left untreated, high blood pressure can lead to serious illnesses, such as strokes and heart attacks. Make an appointment with your doctor right away if you experience any of these symptoms or 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. So hypertension is called essential or primary. Factors that can increase your risk of developing primary hypertension include:

  • age: the risk of developing hypertension increases with age;
  • in his family there were cases of hypertension (the disease can be hereditary);
  • excess salt in your diet;
  • lack of exercise;
  • I complete it;
  • of 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 known as secondary hypertension. Typical reasons for increased pressure in this case are:

  • nephropathy;
  • 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 that affect the connective tissues of the body, such as systemic lupus erythematosus;
  • birth control pills (oral contraceptives);
  • pain relievers known as nonsteroidal anti-inflammatory drugs (NSAIDs);
  • club drugs such as cocaine, amphetamines, and crystal methamphetamine;
  • some herbal remedies, herbal supplements.

Diagnosis of hypertension

To diagnose high blood pressure and identify its possible causes, systematic blood pressure measurement is first used. This can be done by a healthcare professional or by yourself using a home blood 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 of hypertension, you should have your blood pressure checked more often, ideally once a year.

Blood pressure checks are usually easy to do at most clinics and hospitals. Blood pressure is usually measured with a sphygmomanometer (manometer), a device that consists of a stethoscope, a cuff, a measuring device, an air blower, and a valve.

The cuff is wrapped around the upper arm and inflated to restrict blood flow in the artery. The cuff is then slowly deflated while the pulse is listened to with a stethoscope. Listening to your pulse under the deflated cuff provides a reliable reading of your blood pressure. In addition, automatic (digital) blood pressure monitors, which measure pressure and pulse using electrical sensors, are now common.

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 down 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 fluctuate. Pressure can build 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 removing the "fear of the white coat", you can get 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 recorded in two ranges:

  • systolic pressure: blood pressure when the heart contracts and pushes blood into 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 over 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 less than 130/80 mmHg. Art.

If your pressure readings are above 140/90 for several days, you have high blood pressure and further examination is required.

Treatment of hypertension

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

If your blood pressure is slightly above 130/80 mm Hg. Art. , and at the same time your risk of developing cardiovascular diseases is low, then you should be able to lower your blood pressure only by making certain changes in your lifestyle.

If your blood pressure is moderately high (140/90 mmHg or higher) and you are at 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 higher), you will need treatment soon, possibly with additional tests, depending on your health.

lifestyle in hypertension

Below are some of the lifestyle changes you could make to lower your blood pressure. Some of them will lead to rapid improvement in 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 meals that include plenty of fresh fruits and vegetables.
  • Stay active: Staying physically active is one of the key things you need to do to prevent or control high blood pressure.
  • Reduce your alcohol consumption.
  • Give up smoking. Smoking greatly increases your chances of developing lung and heart disease.
  • Lose weight.
  • Drink less coffee, tea, or other caffeinated beverages like colas. Drinking more than four cups of coffee a day can increase blood pressure.
  • Try relaxation techniques like yoga, meditation, and stress management (autogenic training).

The more healthy habits you adopt, the greater the positive effect it will have. In practice, some people find that by maintaining a healthy lifestyle, they do not need to take any medication.

Pharmacological treatment of hypertension

There is a wide variety of blood pressure medications available. 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 medicine for the rest of your life. However, if your blood pressure remains under control for several years, you may be able to stop drug treatment. Most high blood pressure medications can cause side effects, but this problem can be resolved by changing the medications you take.

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

  • I feel sleepy;
  • pain in the kidney area (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 the 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 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 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 lowers your blood pressure.

    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 with your doctor.

  3. diuretics(diuretics) work by removing excess fluid and salt from the body through urine.

  4. Beta blockers (beta blockers)They work by reducing the rate and strength of the heart's contractions, which lowers blood pressure. Beta blockers used to be a popular drug for high blood pressure, but today they're only used when other drugs don't work. This is because beta-blockers are considered less effective than other types of high blood pressure medication.

    Also, beta blockers can interfere with other medications and cause side effects. Check with your doctor before taking other medicines in combination with beta-blockers.

    Do not stop taking beta-blockers suddenly without talking to your doctor. This can cause serious side effects, such as high blood pressure or angina.

  5. Alpha Blockers (Alpha Blockers)They're not usually recommended as the first choice for high blood pressure unless other medications don't work. Alpha blockers work by relaxing blood vessels, making it much easier for blood to flow through them.

    Common side effects of alpha blockers include:

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

Complications of hypertension

High blood pressure puts extra pressure on the heart and blood vessels. If left untreated, high blood pressure increases the 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:

  • race;
  • myocardial infarction;
  • embolism: occurs when a blood clot or air bubble blocks the flow of blood in a vessel;
  • aneurysm: develops when the wall of a blood vessel is stretched 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 affect their function. This complication can cause symptoms such as:

  • fatigue;
  • swelling of the ankles, feet or hands (due to water retention in the body);
  • dyspnoea;
  • the presence of blood in the urine;
  • frequent urination, especially at night;
  • skin itch

Kidney disease is treated with medications and nutritional supplements. More severe cases require dialysis (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 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 significantly.

High pressure power supply

Reduce the amount of salt in your diet, eat plenty of fruits and vegetables. Salt raises blood pressure. The more salt you eat, the higher your blood pressure will be. Try to eat less than 6 grams of salt per day, which is about the same as a teaspoon.

Eating low-fat, high-fiber foods (such as brown rice, bread, and pasta) and plenty of fruits and vegetables have been shown to help lower blood pressure. Fruits and vegetables are rich in vitamins, minerals, and fibers that keep your body healthy. Try to eat five 80g servings of fruits and vegetables each day.

Drinking more than the legal limit on a regular basis will cause your blood pressure to rise over time. It is not recommended that men consume more than 2 to 4 servings of alcohol per day on a regular basis, and women more than 2 to 3. Regular use means every day or most days of the week. 1 serving of alcohol corresponds approximately 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, consequently, an increase in blood pressure.

Drinking more than four cups of coffee a day can cause high blood pressure. If you're a big fan of coffee, tea, or other caffeinated beverages (such as Coca-Cola and some energy drinks), consider cutting back. It's great 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 fluid.

Weight and exercise for hypertension.

Being overweight forces the heart to work harder to pump blood throughout the body, which often leads to increased blood pressure. If you really need to lose weight, it's important to remember that losing even two or three kilograms of weight will significantly change your blood pressure readings and improve your overall health.

An active lifestyle and regular exercise lead to 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 bicycling 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 uphill. Physical activity can include a wide variety of exercises, from sports to walking to 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. 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 your heart rate or blood pressure in real time. Your doctor may make a referral for biofeedback.

Which doctor should I contact 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 diseases, choose a cardiologist.