High blood pressure - Arterial hypertension

Our arteries and veins supply the entire body with oxygen and nutrients through the blood. They also carry away toxic waste products. Arterial hypertension (high blood pressure) is promoted by many factors and can significantly weaken the cardiovascular system and the organs. Because it often causes no symptoms for a long time, arterial hypertension is sneaky. High blood pressure can also develop as a side effect of other illnesses, but it can just as well appear without any identifiable cause. In many cases arterial hypertension is the result of an unhealthy lifestyle. That also means it can often be brought under control by changing your habits.

Because it often goes unnoticed for a long time, high blood pressure is commonly called "the silent killer." But too-high blood pressure can lead to serious complications for example cardiovascular diseases such as heart attack, stroke, or kidney failure. The insidious thing is that the disease remains symptom-free for so long. In fact, research by the Robert Koch Institute found that about every second adult between 18 and 79 is affected. Arterial hypertension is therefore usually discovered incidentally during other routine checks. Optimal values are between 105119 mmHg systolic and 6579 mmHg diastolic. Values between 120129 mmHg systolic and 8084 mmHg diastolic are considered normal. When blood pressure is in these ranges, all organs get enough oxygen. To allow the blood to flow evenly, our blood vessels are built to withstand elastic pressure. With high blood pressure they become stiff and thicken. A person with chronically high blood pressure has a life expectancy about 15 years shorter. If the top blood pressure value (systolic) is persistently above 140 mmHg and the bottom value (diastolic) is above 90 mmHg, this is called arterial hypertension. Please also note that according to the Hypertension League's guidelines, a home blood pressure measurement of >=135 and/or >=85 mmHg is considered high blood pressure. Persistently high blood pressure in the arteries damages the vessels and the heart. The vessel walls become stiffer, harden and narrow. There is a greater tendency toward atherosclerosis because fats and calcium build up at critical spots. In the long term, the fine blood vessels in the brain are also affected and the risk of stroke increases. The eyes can be damaged as well.

Essential, also called primary, hypertension occurs in the vast majority of hypertension cases. It is a diagnosis of exclusion, which means no direct cause can be found.
Secondary hypertension is caused by another underlying disease, such as metabolic disorders or impaired kidney function. Vascular diseases can also lead to arterial hypertension, for example vascular inflammation and pathological changes in the coronary arteries. Atherosclerosis is a particularly strong risk factor for arterial high blood pressure. High blood pressure in pregnancy is also classified as secondary hypertension. High blood pressure caused by certain medications is likewise called secondary hypertension. When high blood pressure is diagnosed in connection with another disease, treating the underlying condition must take priority alongside medication for the blood pressure.

To get meaningful readings, blood pressure must be measured several times a day at regular intervals for at least three consecutive days. This can help rule out so-called "white coat hypertension" also called isolated office hypertension. In that case, the patient only shows elevated readings at the doctor's office. At home, the blood pressure is normal. There is also isolated ambulatory hypertension. This so-called masked hypertension shows normal readings in the doctor's office. It often occurs in younger men who drink alcohol, smoke and are prone to stress.

Risk factors for developing arterial hypertension

High blood pressure can be genetic. However, there are a number of risk factors that make developing hypertension more likely.
Excess weight in particular is increasingly recognized as important in the development of high blood pressure, because blood volume, stroke volume and cardiac output are directly related to body mass. With long-term overweight, arterial resistance in the vessels increases.
In addition to smoking, alcohol consumption and lack of physical activity, stress and a high intake of table salt are further risk factors for developing hypertension.
In cases of increased stress, it is particularly the hormone adrenaline that can raise blood pressure. This is a natural and useful process: adrenaline causes the small blood vessels to constrict so that more blood is available to the large muscle groups the body needs for flight or fight. However, if a person is under chronic stress, the stress hormones can cause a chronic narrowing of the vessels, which can lead to persistently high blood pressure (hypertension). Causes of chronic stress are varied for example severe psychological stress, excessive workload, or bullying.

As already described, symptoms often do not appear for a long time. Symptoms usually show up late. During physical exertion, blood pressure can rise excessively. The higher the blood pressure, the more pronounced symptoms like morning nausea and dizziness become. There can also be circulatory problems in the extremities, which show up as tingling and numbness.

Typical symptoms of high blood pressure include

• Dizziness
• Headache in the early morning
• Nosebleeds
• Ringing in the ears
• Palpitations
• unspecified heart-related complaints

Lifestyle changes are very important and highly promising for arterial hypertension. Except for people with organic underlying diseases, blood pressure can often be lowered relatively quickly this way. Even people with the less common secondary hypertension benefit from lower cholesterol levels through healthy foods and more physical activity. Endurance sports help lower blood pressure long-term. If you exercise at least 30 minutes three times a week swimming, cycling, Nordic walking, jogging or similar you can immediately counteract arterial hypertension. Strength training can also help, but blood pressure spikes should be avoided; isometric exercises can also be useful. Smokers should quit smoking is a major risk factor for stroke and heart attack. People who are overweight should reduce their weight. If you drink alcohol, you should significantly cut back. A healthy diet includes plenty of fruit, fresh vegetables and low-fat foods. People at risk should also reduce the amount of animal protein, as it can negatively affect blood pressure and raise cholesterol levels. Ideally, those affected should also regularly check their blood pressure at home.

In many cases, medication is still necessary. The dose and type of drugs depend on the severity of the arterial hypertension. The aim is to normalize levels below 140/90 mmHg, and for patients with kidney disease to below 125/75 mmHg. Common blood-pressure-lowering medications are ACE inhibitors and AT1 receptor antagonists. On one hand they widen the blood vessels and on the other they inhibit production of a hormone that raises blood pressure. Patients with kidney dysfunction are given diuretics. These also achieve good long-term results.

Related articles:

• White coat hypertension
• Pregnancy hypertension
• Pulmonary Hypertension
• Low Blood Pressure Symptoms
• Morning high blood pressure