High blood pressure, or hypertension, is the most common primary diagnosis in the US. In the following article, we’ll review the basics of it.
Globally, this disease affects around 26% of the world’s population, and the cases are expected to increase in the following 5 years. The high prevalence of high blood pressure represents a huge economic burden due to the many complications it causes. Moreover, this condition is the top risk factor for the first and third cause of death globally: cardiovascular disease and stroke.
In this reading, you’ll find questions to the most frequently asked questions about hypertension—everything you need to know, from causes, symptoms, diagnosis, and treatment. The best part is that these questions are answered by a doctor but in simple words. So, I invite you to keep reading and find out everything about this silent but dangerous disease.
What is high blood pressure or hypertension?
First, we need to talk about what blood pressure (BP) is and its normal levels to talk about high blood pressure. Basically, blood pressure is the amount of force your heart has to put into pumping blood to your whole body.
In every heartbeat, your heart will pump blood to the main artery, the aorta. This blood contains oxygen to supply every tissue of your organism. The aorta will then divide into other smaller arteries, and these arteries will divide as well. This way, every tissue and organ in your body gets the blood and oxygen they need to function properly.
The blood pressure is expressed in mm Hg (mercury millimeters). For adults, the healthy blood pressure is around 120/80mm Hg. So you can see we have two numbers. The first (and higher) number is the systolic blood pressure, and the second (or lower) number corresponds to diastolic blood pressure. Systolic pressure is basically the pressure your heart puts to push blood. On the other side, diastolic pressure is the pressure your heart has while it rests in between beats.
Normally, your body will keep balanced blood pressure. However, there are moments in which blood pressure will change. This can be since tissues need a larger amount of blood, for example, during exercise. These changes are normal, and your body will quickly return your blood pressure to its normal levels. On the other side, certain conditions may result in an increase (or decrease) of blood pressure.
Hypertension, or high blood pressure, is a chronic condition in which the levels of BP are above 140/90mm Hg. It requires treatment since it can be a risk factor for many diseases like kidney disease and cardiovascular disease.
What causes it?
Doctors agree that in almost 95% of the cases, there is not a single identifiable cause. In fact, they describe it as a complex and multifactorial disease, meaning that many factors can be involved. This occurs because the control of blood pressure in the body depends on many factors too.
Characteristics like the amount of blood circulating, the diameter and elasticity of the blood vessels, and blood viscosity modulate BP. Some investigations also say that the cause of hypertension can be immunological, but this is not clear yet.
Other factors like salt intake, family history of hypertension, obesity, smoking, and age can contribute to developing the disease. However, the combination of all these factors is considered the main cause of why people develop hypertension.
On the other side, some specific conditions can cause the disease. The most common diseases that can cause hypertension includes:
- Kidney diseases: Normally, the kidneys are organs in charge of regulating your blood pressure. When kidney damage appears, the disease can develop. These conditions include polycystic kidney disease, glomerular disease, and diabetic nephropathy.
- Hormonal diseases: Hormones also are essential allies that regulate blood pressure. The most common hormonal diseases that can cause this disease include thyroid problems, aldosteronism (a problem of adrenal glands), and pheochromocytoma (a tumor of adrenal glands).
- Vascular diseases: When blood vessel walls are affected, this can result in increased blood pressure.
- Obesity: A larger body weight results in a more significant amount of blood circulating in your body. A larger amount of blood puts more pressure on the blood vessels, causing the disease.
- Medications: Many medications like birth control pills, antidepressants, and pain relievers can increase blood pressure.
What are the different types of high blood pressure or hypertension?
There are two ways in which this disease can be classified: depending on the cause and depending on the blood pressure numbers.
When you classify blood pressure by what causes it, we have two divisions:
- Essential hypertension: Also called primary hypertension. This type corresponds to more than 95% of all hypertension cases. This is the case when there is no identifiable cause for it. In this case, the cause for high blood pressure is a combination of many factors.
- Secondary hypertension: It is high blood pressure that’s caused by another medical condition. Like we mentioned before, kidney, hormonal and vascular diseases can cause it. Other factors like obesity, medications, and pregnancy can result in higher blood pressure too.
Taking into account blood pressure numbers, the division goes as follows:
- Elevated blood pressure: Systolic blood pressure (SBP) between 120 and 129 mmHg, and diastolic blood pressure (DBP) less than 80 mmHg.
- Stage 1 hypertension: SBP between 130 and 139 mmHg and DBP between 80 and 89 mmHg.
- Stage 2 hypertension: SBP of 140 mmHg or higher and DBP of 90 mmHg or higher.
What problems does this disease cause?
High blood pressure can cause damage to your health in many ways. The most affected organs are the heart, brain, kidney, and eyes.
- Heart attack or heart disease: This disease can cause damage to your arteries. It makes them less elastic, narrower and decreases the blood flow to your heart. This can cause heart disease and heart attacks. After a long time, it can also cause heart failure.
- Stroke and brain damage: The disease can also result in a stroke. This happens either because of the bursting of blood vessels or the blockage of a blood vessel. In both cases, a low oxygen supply will cause the death of brain cells, which is not reversible.
- Chronic kidney disease: Damage of blood vessels that nurture the kidney will result in kidney damage and potential kidney disease.
- Eyes: The retina (the back of your eye) is what makes you able to see. For the retina to function, it needs a large amount of oxygen that comes from tiny arteries. In this disease, these tiny arteries are easily damaged. This can result in impaired vision and visual symptoms.
What are the signs and symptoms of high blood pressure?
Most of the time, it will not cause any symptoms at all. Yes, this means that you can have the disease and don’t know it. Normally, when patients start experiencing symptoms, it’s a sign that there is something already wrong. Among the most common symptoms of hypertension, we find:
- Vision problems
- Chest pain
- A pounding sensation in your ears, neck, or chest.
- Fatigue, confusion, or dizziness
- Bloody urines
The appearance of symptoms can be a sign that there is damage to certain organs. The most affected organs in this condition are the heart, kidneys, and brain.
Since this disease remains asymptomatic most of the time (without symptoms), it is imperative to have constant checkups. The only way to know you have hypertension is to have your blood pressure measured.
Who is more likely to develop the disease?
As we mentioned before, many risk factors can contribute to developing high blood pressure. We’ll just briefly mention the most common ones:
- Family history of high blood pressure: Any person who has a family history of hypertension is more likely to develop this condition.
- Obesity or being overweight: A higher body weight requires a higher blood flow and oxygen to supply your tissues.
- Sex: Men are more likely to develop it than women.
- Race: It is more common among people with African heritage.
- Salt intake: A higher salt (or sodium) intake is a significant risk factor for it. This because sodium makes you retain water, increasing your blood pressure.
- Smoking: Can increase blood pressure because of the substances that cigarettes contain.
- Low physical activity: Also related to a higher chance of obesity and a higher chance of hypertension.
- Chronic conditions: As we mentioned before, diabetes, kidney, and vascular disease may result in this disease.
What are pregnancy complications caused by high blood pressure?
High blood pressure is a very common cause of complications during pregnancy. For this reason, every pregnant woman should have a rigorous medical checkup during the pregnancy. The many complications resulting from this disease during pregnancy include:
- Injury to the mother’s organs: It can damage your brain, kidneys, and heart, putting the mother’s life at risk.
- Lower blood flow to the placenta: The placenta is an organ that develops only during pregnancy. Its main function is to supply the baby with oxygen and nutrients. The placenta needs a huge amount of blood flow to function normally. When the mother has hypertension, the blood flow of the placenta can decrease. This results in lower oxygen and blood flow to the fetus.
- Growth restriction: When the fetus gets less oxygen and nutrients, it can’t grow the same way it used to. Therefore, hypertension can be a cause of intrauterine growth restriction.
- Placental abruption: In this condition, the placenta separates from the inner walls of the uterus. This is a result of poor oxygen supply to the placenta. When this happens, there can be heavy bleeding, threatening the life of the mother and the baby.
What is the link between high blood pressure and stroke?
Uncontrolled high blood pressure and stroke are actually very closely related. In fact, hypertension is one of the main risk factors and causes of stroke. There are two main mechanisms in which this disease causes strokes:
- Hemorrhagic stroke: There is bleeding around the brain. High blood pressure can cause this by putting too much pressure on the blood vessels. This can affect weakened blood vessels, causing them to burst inside the brain.
- Ischemic stroke: In this type of stroke, the blood flow to the brain is decreased. Hypertension can cause this by damaging the blood vessels of your body. When the blood pressure increases, it puts higher pressure on vessels. As a result, these vessels become narrower and harder. This increases the chance of blockage in the blood vessels of the brain.
How do you know if you have high blood pressure?
Like we mentioned before, this disease will not cause any symptoms in most cases. Therefore, the only way to know your blood pressure levels is by a blood pressure reading.
Measuring blood pressure is a simple and painless procedure, and any health professional can do it. First, they start by putting you in a comfortable sitting position, with both feet on the ground. Then, they will put an inflatable blood pressure cuff around your arm. Finally, they will inflate it, and the cuff will gently tighten in your arm. This cuff has a valve that measures your blood pressure.
You can even do this at home, with a little training from a health professional. This way, it’s easier to keep track of your blood pressure levels.
What should I do if I have high blood pressure?
If you have this disease or a higher than normal blood pressure reading, you should go to the doctor. In a doctor’s appointment, your doctor will ask about your medical history, as well as your family history.
He or she will also perform a physical examination, including a blood pressure measurement. Since hypertension doesn’t cause any symptoms, doctors will probably not find anything relevant in the physical examination.
If you happen to have high blood pressure at the moment of the appointment, don’t panic. The nerves of going to the doctor can increase your blood pressure for a moment. However, if you do get high BP levels, your doctor will tell you they’ll need to measure it again.
To make this diagnosis, you need to get a high BP in two measurements at two separate times. Doctors don’t need any other laboratory tests or imaging studies to diagnose the disease. However, they may ask for them if they suspect further organ damage as a result of it.
How often should your blood pressure be checked?
This depends on each individual patient and each individual case. You should ask your doctor how often do they think you need to check your BP. Sometimes, you may even have a blood pressure machine to check your BP every once in a while.
Why do you need to worry about high blood pressure?
You should worry about this disease because of all the complications it may carry. As you can tell from this reading, even if it is asymptomatic, it can cause serious damage.
This condition is a major risk factor for stroke, heart attack, vascular disease, and chronic kidney disease. All of these conditions can be life-threatening if not taken seriously. Also, the higher your blood pressure is, the more likely you are to develop these complications. In an uncontrolled context, these conditions can end in heart failure and kidney failure.
What is the treatment of high blood pressure?
There are two main approaches doctors use to treat it. The first one includes, of course, blood pressure medications. In this approach, doctors use many different medications that can even be combined to get the desired effect. The type of blood pressure medicine depends on the type of patient. For example, African Americans or elderly patients will probably have a different treatment than younger, white patients. This is since high blood pressure can be a little harder to manage in some groups than in others. The most common high blood pressure medication includes:
- ACE inhibitors: Also known as angiotensin/converting enzyme inhibitors, like enalapril.
- Calcium channel blockers: Mostly used in hard to control hypertension, like nifedipine.
- Beta-blockers: Like propranolol and bisoprolol.
The previous drugs will usually be combined with a common type of diuretics: thiazides diuretics. The other approach in the management of high blood pressure is through healthy lifestyle changes. Changes like increasing physical activity, ceasing smoking, and a healthy diet is great ways to manage blood pressure.
How can you reduce your risk of high blood pressure?
You can reduce your risk of having high blood pressure by adopting some healthy lifestyle habits. For example, maintaining a healthy weight, a low sodium diet, stop smoking, and exercising are healthy habits that will reduce your hypertension risk. Also, if you are already diagnosed with hypertension, you should still put into practice these habits. This way, you will prevent having further complications from this condition.
Do you have risk factors or symptoms for this disease?
This tool is a Hypertension Symptoms Checker. It gathers the most important signs, symptoms, and risk factors for this disease. Therefore, the tool will tell anybody who uses it the likelihood of having it. Using the tool is free and would only take a few minutes.