Hypertension: what it is, what its symptoms are, and how it’s treated.

What is hypertension?

Hypertension is defined as a prolonged high blood pressure value, i.e. a repeatedly measured increase in blood pressure above 140/90 mm Hg, detected in at least two out of three measurements. Blood pressure is measured in millimeters of mercury column (mm Hg) and is given in two values. The first, systolic pressure, corresponds to the amount of pressure in the blood vessels during the contraction of the heart and the discharge of blood into the bloodstream. The number after the slash, the diastolic pressure, indicates the amount of pressure during the resting phase of the heart, when the heart is relaxed and the pressure in the blood vessels is at its lowest.

The optimal pressure is defined as 120/80 mm Hg, but the result should always be judged individually. People suffering from diabetes or infants have a lower value, for example, and external and internal environmental stimuli, age, changes during the day depending on the activity, etc. are all factors). If a doctor repeatedly measures a patient with a value of 140/90 mm Hg or higher, this is considered hypertension. Values ranging from 140-159/90-99 mm Hg are considered mild hypertension, 160-179/100-109 mm Hg as moderate, and 180/110 mm Hg as severe hypertension.

Symptoms of hypertension

The main symptoms of hypertension include:

• heart pounding,
• headaches,
• dizziness,
• fatigue,
• chest pain,
• shortness of breath.

“Hypertension is unfortunately tricky in that it often does not manifest itself at all and only comes to attention when a serious event such as stroke or myocardial infarction happens. That’s why prevention is so important and not skipping regular preventive check-ups at the general practitioner, which includes measuring blood pressure,” warns MUDr. Zuzana Hansová, general practitioner for adults and occupational physician at EUC PLS.

Measuring blood pressure

The key to early diagnosis and managing good treatment is measuring blood pressure correctly; this alerts us to the need to start or adjust treatment. Even in a home environment, measurements must be taken under standard conditions – in a noiseless environment, at least after 5 minutes at rest, seated, with your upper arm resting approximately at the level of the heart, taking the measurements 3 times in a row and taking the average of the 2^nd and 3^rd measurements. The highest pressure values are in the morning between 4 and 6 am and before noon – this is also the time that cardiovascular events are most likely to happen.

Causes of hypertension

Hypertension can be divided into primary and secondary causes. Most patients have primary (essential) hypertension, about 90% of which cannot be traced to a specific cause.

The risk of developing hypertension, however, is increased by an unhealthy lifestyle – lack of exercise, obesity, alcohol, smoking, excessive salt consumption, stress, or lack of sleep. Genetic predispositions also play a role.

About 5-10 % of cases are secondary hypertension. This is caused by other diseases or other detectable influences. The most common are:

• Renal and renovascular hypertension – an increase in blood pressure occurs to partial or complete closure of one or both renal arteries or their branches. Treatment is performed operatively by PTRA: percutaneous transluminal renal angioplasty. In the case of renal hypertension, other renal diseases, most often inflammatory, are the cause.
• Endocrinal – diseases of the adrenal glands, thyroid gland, central nervous system, etc.
• Drug-induced – for example, painkillers of the non-steroidal antiphlogistic type – Brufen, Diclofenac, hormones, psychostimulants, etc.
• Neurogenic – coincidental with brain tumors
• During sleep apnea syndrome or during pregnancy

Treating hypertension

Various types of blood pressure lowering drugs are used to treat hypertension. These include diuretics, ACE inhibitors, beta-blockers, calcium channel blockers, centrally acting antihypertensives, and others. In the case of secondary hypertension, blood pressure is reduced as a result of successful treatment of the disease that caused the hypertension.

Hypertension can not be treated without lifestyle changes. Most of all, patients must limit the amount of salt in their food, reduce alcohol consumption, and stop smoking. Hypertension is also improved by a regular leisurely diet with plenty of vegetables and fruits, limiting sugars and fats, getting enough exercise, getting quality sleep, limiting stress, and reducing weight.

Hypertension in pregnancy

Although hypertension affects only about 10% of pregnant women (low blood pressure tends to be a problem in pregnancy), it is a life-threatening risk to both mother and baby. There is a risk of developing pre-eclampsia, the most common manifestation of hypertension in pregnancy, the accompanying symptoms of which include pressure, swelling, excessive weight gain, protein in the urine, and headaches. Imminent pre-eclampsia can be detected at the first screening performed between 11 and 14 weeks of pregnancy. Blood pressure is also checked at every preventive examination.  If blood pressure is repeatedly elevated (diastole above 95), medical treatment is initiated in addition to regimen measures.

Hypertension in children

Hypertension rarely affects children. This is usually secondary hypertension accompanying diseases of the kidneys, renal arteries, endocrine glands, heart and blood vessels, etc. A hypertension diagnosis in children is complicated by the fact that it often doesn’t show any symptoms, and its detection is therefore only possible at a later, more advanced stage. This is why your pediatrician should measure blood pressure at every preventive check-up from the age of 3 years.

Are you suffering from hypertension? You can contact the doctors at the EUC:

General practitioners EUC