High blood pressure (hypertension), causes, sign, symptoms, treatment

Blood pressure in a nutshell

Blood pressure is elevated when the upper value is 140 or the lower value is more than 90 or higher. High blood pressure damages arteries and causes strokes and heart attacks. Everyone can lower their blood pressure by reducing salt and exercising adequately, quitting a smoker, and losing weight by being overweight. If your means do not lower your blood pressure enough, you need anti hypertensive drugs. Anti hypertensive drugs are intended for regular use.

Introduction

Blood pressure is normal when it is less than 130/85 mm Hg (millimetres of mercury). The blood pressure level must be satisfactory between 130 and 139/85 and 89 and elevated when the pressure is 140/90 or more. The larger number is the systolic, or upper pressure, which indicates the pressure inside the artery during heart contraction. The lower number is diastolic. It indicates pressure during the resting phase of the heart.

Hypertension is very common, especially in middle-aged and older people. In young and middle-aged people, where the walls of the artery are elastic, the first to rise is the negative pressure. In the elderly, where the walls of the arteries are stiffer, the lower pressure is often normal, but the upper pressure easily rises too high.

In Finland, about a million people use anti hypertensive drugs. In adolescents, high blood pressure is quite rare. With age, its prevalence increases, especially from the age of 40 upwards.

Measuring blood pressure

Blood pressure varies in different situations. The effect of random changes on the measurement results is reduced by always measuring as follows:

Before a previously healthy person is diagnosed with hypertension, double blood pressure measurements taken in the morning and evening of 4 to 7 days are needed to determine the true blood pressure level. The final result is the average of all measurements taken.

Blood pressure is usually higher as measured by your doctor than others due to tension and other causes (“white coat blood pressure”). Therefore, the measurements are usually made by the nurse or patient himself or herself or by a health center meter. Properly done, a home measurement is a good help in monitoring blood pressure. Upper arm meters are more reliable than wrist meters. If you use a wrist meter, make sure that your wrist and meter are at heart level, for example, when resting on a slightly raised table.

Causes of high blood pressure

Most high blood pressure is due to lifestyle, but can also be caused by a hereditary predisposition. The reasons that can be influenced by yourself are the following:

About five percent of high blood pressure is caused by another illness. This is said to be a secondary increase in blood pressure, i.e. the increase in pressure is secondary to other illnesses. Blood pressure can be raised by kidney disease and narrowing of the arteries in the kidneys (see Chronic renal failure (uremia) ). Overproduction of adrenal cortical hormones, cortisol and salt hormone (aldosterone), causes an increase in blood pressure (see Adrenal disorders ). A rare tumor of the adrenal nucleus, pheochromocytoma, results in intermittent increases in blood pressure and other symptoms (see Pheochromocytoma (tumor of the adrenal nucleus) ).

Symptoms and consequences of blood pressure

Usually the blood pressure does not “feel”, it can only be measured with a blood pressure monitor. If your blood pressure is very high, ie your upper pressure is over 200 and your lower pressure is over 130, you may feel a headache or a feeling of dizziness. Even at such high pressures, there are no symptoms, so blood pressure can be very high without knowing it without measurement.

High blood pressure is treated because it strains the arteries and heart over the years. This results in arterial disease (see Arterial disease ( atherosclerosis) ), which can cause a heart attack (see Myocardial infarction and heart attack ) or stroke (see Stroke (cerebral infarction and bleeding) ).

The effect of high blood pressure on the risk of these diseases depends largely on other risk factors for arterial disease. The risk of high blood pressure is greatly increased if a person smokes, has high blood cholesterol (see Cholesterol ) and has diabetes (see Diabetes ) or other disorders of sugar metabolism.

For example, in 60-year-old men with a hypertension of 180 mmHg but no other risk factors, three out of 100 will develop a stroke in eight years. If a man has the above-mentioned risk factors in addition to blood pressure, 16 out of 100 will get a stroke.

High blood pressure puts a strain on the heart, which constantly has to work more than normal. This causes the heart muscle to thicken and eventually become tired, resulting in heart failure.

Examination and monitoring of blood pressure

Once the blood pressure is persistently elevated, your doctor will still determine if it may be due to another illness. For this reason, some laboratory tests are usually performed. If the high blood pressure is due to an illness, its treatment often normalizes the blood pressure and no continuous anti hypertensive medicine is needed. Preliminary medical examinations also include an assessment of whether high blood pressure has already caused arterial disease and damage to the heart muscle.

Because blood pressure usually rises due to unhealthy eating habits and lack of exercise, the primary treatment is self-care, i.e., making habits healthier. If blood pressure does not fall sufficiently with self-treatment, medication is needed.

Necessary measures at different blood pressure levels:

• less than 120 (high pressure) and 80 (low pressure): very good. Re-measurement is only required after 5 years.
• less than 130 and 85: normal. Re-measurement after 2 years.
• 130-139 and 85-89: satisfactory. Check measurement every year. Reason to try to influence blood pressure yourself; see self-care. Medication is considered in diabetics and patients with kidney disease.
• 140-159 or 90-99: slightly elevated. Self-care in full followed for 2 months. If still elevated, medication is likely to be needed
• 160-179 or 100-109: moderately elevated. The effectiveness of self-care can be monitored for a month, usually, in addition to self-care, medication is needed.

Self-treatment of blood pressure

Because high blood pressure is most often associated with lifestyles, anyone can treat it by influencing them.

• For overweight people, losing weight by 4 to 8 percent (for one hundred kilograms, 4 to 8 pounds) reduces both overweight and lower pressure by 3 to 4 “steps” (millimeters of mercury, mmHg).
• In smokers, stopping smoking is the most important treatment to reduce the risk of arterial disease associated with high blood pressure.
• Salt reduction. If the amount of salt drops to 5 grams per day, the upper blood pressure drops by an average of 6 and the lower value by 4 notches. Finnish men use an average of 8.4 grams of salt and women 6.1 grams a day. Eighty percent of the amount of salt received by Finns comes from salt added to food at the manufacturing stage. For information on salt and how to find out about your salt use: see.
• The addition of dietary fiber in the form of wholemeal bread, cereals, flakes, etc. lowers the average blood pressure by 6 mmHg and 3 mmHg compared to cereal products made from refined white flour.
• Increasing your intake of potassium and magnesium also lowers your blood pressure. Adequate potassium intake is ensured by using plenty of vegetables, fruits, and vegetables.
• Avoid licorice products.
• Exercise has a beneficial effect on blood pressure. The minimum goal is brisk walking (or similar exercise) for at least 30 minutes a day on most days of the week. For more information on blood pressure and exercise: see Exercise and high blood pressure.
• Reducing heavy alcohol consumption.

Note! Salt reduction and other self-care are also necessary when initiating medication for hypertension. The anti hypertensive effect of drugs is improved if, at the same time, lifestyle changes are made.

Treatment of blood pressure

Drug therapy for blood pressure aims to bring the upper pressure below 140 millimetres and the lower pressure below 85 millimetres of mercury (mm Hg). Patients with diabetes (see Diabetes ) can have mildly high blood pressure, which can lead to even lower levels of kidney damage. If blood pressure is not very high, one can look in peace at what lifestyle changes will bring. The higher the blood pressure, the faster the medication is started.

There are several types of anti hypertensive drugs. The choice is influenced by the patient's age and other diseases. Many anti hypertensive drugs also have beneficial effects on other diseases. Sometimes they can be harmful in the context of another illness, for example, beta-blockers can make asthma worse.

Dehydration drugs, or diuretics, are suitable as first-line drugs, especially for the elderly. Beta-blockers are used in adolescents and those with coronary artery disease. ACE inhibitors and angiotensin receptor blockers are particularly suitable for those with diabetes or heart failure. Calcium channel blockers are useful in patients with angina pectoris.

Often, one drug is not enough to return blood pressure to normal, requiring two or three drugs at a time. A low dose of two drugs provides better efficacy with fewer side effects than increasing the dose of one drug to the maximum allowed.

Anti hypertensive drugs do not cure hypertension itself, but lower the pressure and thereby reduce the risk of diseases caused by high pressure. If lifestyle changes are not enough to restore blood pressure to normal and medications are needed to treat them, they will have to be used for years, often for a lifetime.

Prevention of high blood pressure

The increase in blood pressure can be effectively prevented by the lifestyle changes mentioned in Self-Treatment for Blood Pressure.

1. Why is the limit for high blood pressure so strict?

High blood pressure is harmful to blood vessels and predisposes to atrial fibrillation, coronary heart disease, memory disorders, cerebral infarction, and bleeding, among others. High blood pressure is dangerous because it does not feel. Symptoms only come when blood pressure is already at critical readings. This can lead to headaches and dizziness.

Studies have not been able to determine the exact cut-off value at which vascular changes are initiated, and therefore there are different target values ​​for blood pressure. Blood pressure is ideal when the upper pressure is less than 120 millimetres of mercury (mm Hg) and the lower pressure is less than 80 mm Hg. A rise of as much as 20 units in the upper and 10 units in the lower pressure doubles to three times the risk of coronary heart disease or cerebral death. Normal blood pressure is less than 130/85, satisfactory 130-139 / 85-89, and elevated above 140/90 mm Hg.

If a person has other risk factors for arterial disease, the target blood pressure is lower. Risk factors include diabetes, smoking, high cholesterol, and related arterial diseases.

2. What dietary changes lower blood pressure?

Salt is the most significant booster of blood pressure, so it is worth pruning. Ideally, it would consume less than 5 grams per day. In Finland, men consume 10 grams of salt and women 7–8 grams per day

Most of the salt is obtained as hidden salt, i.e. with food. Bread, ready meals, cheeses, and condiments often contain a lot of salt. The amount of salt can be found in the product information on food packaging. If reading them feels tedious, the Heart Mark makes selection easier. The product marked with it has less salt compared to other products in the product group.

An abundant amount of vegetables makes it easier to control weight, and being overweight raises blood pressure.

3. Should sauna beer be given up?

For the sake of vascular health, there is no need to become absolutist, but moderation is in place. In men, the limit for risk use is considered to be 14 doses of alcohol per week, in women seven.

A single dose, IE one sauna beer or a glass of wine with food, does not affect blood pressure. Admittedly, people are individuals, and the effects of alcohol on different people are different. The use of tobacco products is reflected in blood pressure, as they increase the activity of the sympathetic nervous system and thereby raise blood pressure. Snuff is as dangerous as tobacco.

4. Does dietary supplements lower high blood pressure?

Omega-3 fatty acids can lower blood pressure, but studies show that high doses of omega-3 are needed for this. The good effects have come mainly from elderly people who already have hypertension. However, the drop in blood pressure has been so small that it is not worth starting to eat supplements.

Omega-3 fatty acids affect platelets, or blood clots, so their high use can increase the risk of bleeding.

5. The harder you workout, the better your blood pressure will drop, or what?

Exercise raises blood pressure momentarily, but when done regularly it lowers it. It is true that high-intensity interval training, or HIIT training, has been effective in lowering blood pressure and blood fat values ​​in subjects. Still, because of blood pressure, there is no need to feed at the extremes.

High blood pressure drops with all kinds of exercise, from walking, running, exercising to gym workouts - and just about everyday activity: raking and snowing. The most important thing is that exercise is regular and is done in some form, preferably every day.

6. How much weight should I drop?

If your blood pressure is high and the person is significantly overweight, weight loss is beneficial: after weight loss, any medications you may already be taking can often be reduced, or the patient can get rid of them altogether. For this, a weight loss of five to ten percent is usually enough.

Significant overweight is when the body mass index is 30 or more.

7. Are stress management skills useful?

Momentary rush and quarrel are not a danger. But if work stress or even relationship problems last for a long time, blood pressure can rise. Prolonged mental pressure causes cortisol stress, in which the secretion of the cortisol hormone, which accelerates the body, is increased. A stressed person cannot take care of himself and his lifestyle, which is also reflected in blood pressure.

The various relaxation methods are not directly visible in blood pressure. They can be useful if they can be used to control the feeling of urgency.

8. How fast and effective are lifestyle changes?

In general, changes in exercise, weight, and diet will show up in measurable values ​​after a few months. If blood pressure is only slightly elevated, the lifestyle effect can be expected in half a year.

If a person has other risk factors for arterial disease in addition to high blood pressure, the lifestyle change may be monitored for a couple of months. It is then considered whether there is a downward trend or whether drugs are needed.

9. How often should blood pressure be measured?

If blood pressure has been measured in your thirties and has been ideal, the next time it can be seen in five years. So far, it doesn’t get better to wait if lifestyles become unhealthy or weight gain.

Blood pressure tends to rise with age, and therefore in middle age, measurement intervals shorten to a couple of years. If your blood pressure is high, your doctor will tell you the correct measurement interval.

About two million Finns have high blood pressure. Since high blood pressure is common and not symptomatic, it is a good idea to get a blood pressure monitor for every home. It also measures your heart rate and reveals atrial fibrillation in the heart that predisposes you to a stroke. Pharmacies and health centers have blood pressure monitors for use by customers.

Slightly elevated blood pressure does not need to be measured daily: a weekly period every couple of months is a good pace. The measurement is made in the morning and evening.

10. When are anti hypertensive drugs needed?

Medication is needed when, despite lifestyle repairs, the upper pressure repeatedly exceeds 140 mm Hg or the lower pressure exceeds 90 mm Hg.

A healthy lifestyle is relevant even if the patient is taking anti hypertensive medications. It is better to reduce bad lifestyles than to increase the number of tablets. The whole body thanks for exercise and a healthy diet.