High blood pressure - what is it and how do we treat it?

What is hypertension?

Hypertension also means high blood pressure - when the pressure in the blood vessels is too high (140/90 mmHg or more). Blood pressure is written as two numbers. The first number is the systolic pressure or the pressure in the blood vessels when the heart contracts or beats. The second number is the diastolic pressure or the pressure in the vessels when the heart rests between beats. Hypertension is diagnosed if, when blood pressure is measured on two different days, the systolic blood pressure values on both days are ≥140 mmHg and/or the diastolic blood pressure values on both days are ≥90 mmHg.

Hypertension classification

Blood pressure values may indicate:

• normal blood pressure - less than 120/80 mm Hg;
• pre-hypertension - systolic pressure between 120 and 129 mm Hg, diastolic pressure greater than 80 mm Hg;
• grade 1 hypertension - systolic between 130 and 139 mm Hg, diastolic between 80 and 89 mm Hg;
• grade 2 hypertension - systolic value 140 mm Hg or higher, diastolic value 90 mm Hg or higher;
• grade 3 hypertension (also called hypertensive crisis) - systolic over 180 mm Hg or diastolic over 120 mm Hg.

Hypertension symptoms

Hypertension is generally a silent or silent condition. Many people will not experience any symptoms. It can sometimes take years for the condition to reach levels severe enough for symptoms to become obvious. When they do appear, some symptoms may include:

• redness;
• blood spots in the eye (subconjunctival bleeding);

The best way to know if you have high blood pressure is to monitor your blood pressure regularly using a blood pressure monitor.

High blood pressure causes

There are two types of high blood pressure. Each type has a different cause.

Primary hypertension

This type of hypertension develops over time. Causes include:

• genetic predisposition;
• old age - over 65 especially;
• obesity;
• high alcohol consumption;
• sedentary lifestyle;
• diabetes mellitus or metabolic syndrome;
• high sodium intake.

Secondary hypertension

Secondary hypertension often occurs suddenly and can become more severe than primary hypertension. Causes of secondary hypertension may also include:

• kidney disease;
• obstructive sleep apnea;
• congenital heart defects;
• thyroid problems;
• side effects of medications;
• drug use;
• increased alcohol consumption etc.

What can be the complications of high blood pressure?

Long-term high blood pressure can cause some complications through atherosclerosis, where plaques develop on the walls of blood vessels, causing them to narrow. This narrowing worsens hypertension because the heart has to work harder for blood to circulate. Thus, high blood pressure is a major risk factor for the development of cardiovascular diseases, such as:

• coronary heart disease - where the main arteries supplying the heart (coronary arteries) become clogged with fatty deposits;
• stroke - a serious condition where the blood supply to the brain is interrupted;
• heart attack - a serious condition in which the blood supply to part of the heart is blocked.

Diabetes and kidney disease are also linked to complications of high blood pressure. Hypertension can also lead to retinopathy in the eye.

Hypertension treatment

Treatments for hypertension include lifestyle changes and medication. It is important to go to your doctor for diagnosis and hypertension treatment regimen. If your high blood pressure is caused by another condition or a medication, treating that condition or stopping the medication may lower your blood pressure.

Mild high blood pressure can usually be treated by lifestyle changes including:

• Regular physical activity - walking, running, cycling, swimming etc - exercise can help lower blood pressure naturally and support the cardiovascular system;
• quit smoking - the chemicals in cigarette smoke can damage the body's tissues and harden blood vessel walls;
• change your diet - reduce salt and fat intake;
• reducing excess body weight;
• limiting alcohol consumption;
• effective stress management - including relaxation techniques.

High blood pressure medication

However, lifestyle changes may not be enough every time. Some people also need high blood pressure pills to help lower blood pressure to normal limits. Doctors will often recommend a low dose at first. People with high blood pressure may need a combination of high blood pressure pills.

Medications for high blood pressure include:

• diuretics, including thiazides, chlorthalidone and indapamide - remove extra water from the body, lowering blood pressure;
• beta-blockers and alpha-blockers - these make the heart beat slower and with less force, which reduces the amount of blood pumped through the arteries with each beat, lowering blood pressure;
• calcium channel blockers - including amlodipine and felodipine, which relax blood vessels;
• angiotensin-converting enzyme inhibitors such as enalapril, lisinopril, captopril - these relax blood vessels and prevent kidney damage;
• angiotensin receptor blockers - including losartan and telmisartan, which relax blood vessels and prevent kidney damage.

Remember that sometimes it is necessary to change your treatment plan over time. It is therefore essential to have regular check-ups to assess the effectiveness of your treatment.

Supplements for hypertension

Your doctor may also sometimes recommend a number of supplements, such as:

• Calcium supplements - calcium deficiency has been associated with high blood pressure;
• Coenzyme Q10 (CoQ10) - a coenzyme Q10-based supplement, such as Cardio Q10, may play a role in producing an energy source called adenosine triphosphate (ATP) which helps maintain a regular heartbeat;
• fish oil - contains Omega-3 fatty acids, beneficial for heart health - for example Omega-3 Cardio from Doppelherz;
• magnesium - magnesium deficiency is linked to high blood pressure, and magnesium supplements, such as MagneVie Cardio, may help lower blood pressure;
• Potassium - like magnesium, potassium may also help lower blood pressure, such as a supplement like Cardiovita Naturalis.

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There are also some supplements that can increase blood pressure, such as arnica, caffeine-based supplements, licorice root, sunflowers, etc. Keep in mind that supplements of any kind should only be taken as directed by your doctor. Many supplements can interact with regular medicines, including blood pressure medicines.

Diet for high blood pressure

A heart-healthy diet is very important to help reduce high blood pressure. It is also important for managing high blood pressure that is kept under control and reducing the risk of complications. These complications include heart disease, stroke and heart attack.

A heart-healthy diet should contain a balanced intake of:

• fruits and vegetables;
• whole grains;
• lean proteins such as fish.

Try to limit foods high in sugar. Also reduce sodium intake. The best way to reduce sodium is to cook fresh foods more often and limit the amount of ultra-processed, fast food or pre-packaged foods.

Monitor blood pressure

Another way to prevent complications and avoid problems is to recognize high blood pressure early. Keep a blood pressure diary and present it to your doctor at your check-ups. Measure your blood pressure regularly.

References:

• https://medlineplus.gov/highbloodpressure.html
• https://www.healthline.com/health/high-blood-pressure-hypertension
• https://www.healthline.com/health/high-blood-pressure-home-remedies
• https://www.cdc.gov/bloodpressure/about.htm
• https://www.who.int/news-room/fact-sheets/detail/hypertension
• https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/what-is-high-blood-pressure