Your guide to hypertension: what it is, causes, treatments & tests

The guide you need to learn more about hypertension and high blood pressure

Want to learn more about hypertension? We’ve got it covered.

In this comprehensive guide we’ll cover:

• Definitions, concepts and terms of hypertension
• How to measure blood pressure
• Why is hypertension dangerous
• The most common symptoms
• How to cure and prevent hypertension

Let’s get started.

Part 1: The basics of hypertension

Why is hypertension an important topic?

Good question. Hypertension is a very common illness today, with the stats painting an incredible picture:

1. In 2017, 11.8 million people in England who were 16 or older were projected to have hypertension.
2. Approximately 26.2% of the adult population is included. The predicted prevalence of hypertension at the CCG level ranges from 16% to 33.8%.
3. The clinical management of hypertension accounts for 12% of visits to primary care and up to £2.1 billion of healthcare expenditure.

So why is hypertension taking so many public resources and involving such a large population?

Unfortunately, a lot of us in the UK smoke tobacco, drink excess amounts of alcohol and intake excess amounts of junk food, causing obesity which is a trigger for hypertension.

Other individuals have chronic conditions that also increase the risk of high blood pressure.

Also, hypertension doesn’t always show and it has no symptoms which makes it difficult to identify.

So the questions are:

1. How can we identify hypertension?
2. What can we do to cure it?

That is what we’ll discuss in this article, then we’ll break down some options for preventing it and conducting a healthy lifestyle.

But before we dive into the specifics, let’s take a look at the history, definitions and notions connected to high blood pressure and hypertension.

A very brief history of hypertension

According to Wikipedia, the understanding of the circulatory system built on the writings of physician William Harvey (1578-1657).

He explained the circulation of blood in his book 'De motu cordis', which marks the contemporary history of hypertension.

In 1733 Stephen Hales for the first time published the measurement of blood pressure.

However, the Italian Scipione Riva-Rocci's developed the cuff-based sphygmomanometer in 1896, which made it possible to monitor blood pressure in the clinic, and this contributed to the development of hypertension as a medical condition.

Lastly, in the XX century, hypertension was divided into two separate entities: benign and malignant. The former is referred to as non life threatening while the latter can be.

What is hypertension?

Hypertension (commonly known also to as 'high blood pressure') is referred to your blood pressure when it’s higher than normal.

Your blood pressure is the measure of the strength your heart is putting when pumping blood around your body.

That is why maintaining a normal blood pressure is so important for your wellbeing.

Your heart pumps blood into the arteries with each heartbeat. If your heart is beating and pumping blood at a fast rate, your blood pressure will be at its maximum.

Why is high blood pressure dangerous?

A prolongued hypertension leads to serious damage to the blood vessels.

This deep vascular damage has negative repercussions on the blood supply of the organs of the body.

In the heart, prolonged hypertension can cause problems such as heart attack and heart failure.

Also, the persistence of high blood pressure can be responsible for peripheral arterial disease.

High blood pressure impairs kidney function too. It causes weakening and narrowing of the renal arteries, the arterial vessels that carry blood to the kidneys.

The narrowing of the renal arteries leads to a reduced blood supply to the the kidneys, which.

It impairs the kidney's filtering abilities, resulting in the accumulation of dangerous substances in the kidneys or transfer of useful substances in the urine.

Why do we measure high blood pressure?

The only method to determine whether you have high blood pressure is to measure it.

Most often, high blood pressure has no symptoms or warning indications, and many individuals are unaware they have it.

What is a good blood pressure?

Generally speaking:

The recommended range for blood pressure is 90/60 mmHg to 120/80 mmHg.

Low blood pressure is defined as 90/60mmHg or below, while high blood pressure is defined as 140/90mmHg or more.

What is more common?

Less people experience low blood pressure. Low blood pressure is an adverse effect of several drugs.

Dehydration and heart failure are two more underlying disorders that might contribute to it.

Low blood pressure is not always a problem, but sometimes it can cause dizziness and fainting and, in the worst case, it can be also life-threatening.

Part 2: Blood pressure tests: how and when to do them

In order to identify whether you suffer from hypertension, you need to know how testing your blood pressure works.

The first advice we would give is also the most obvious: know your body!

What do we mean by that?

Your body should have symptoms of high blodd pressure that you can identify yourself even without a test.

The typical 5 symptoms of high blood pressure are the following:

• Blurry or double vision
• Fatigue
• Headache
• Earth palpitations
• Shortness of breath

This is not an exhaustive list of course, because they are the most common symptoms.

Human bodies are more complex than that but if you are experiencing them, our advice is to consult with your doctor immediately.

Can I have hypertension without these symptoms?

The simple answer is 'Yes'.

In fact in the U.K., over 4 million individuals suffer of hypertension but don’t treat it,mostly because they are unaware.

That’s why we advice to take regular hypertension tests at your local doctor.

When to conduct a blood pressure test?

If you are ever concerned about your blood pressure, you should have a blood pressure check.

Every five years, people in England between the ages of 40 and 74 are eligible for an NHS Health Check, which includes this test if they are over 40.

You could require more regular blood pressure checks if you have been diagnosed with high or low blood pressure, or if you have a high risk of developing either.

Where to conduct a blood pressure test?

There are several locations where you may get your blood pressure checked, including:

• local medical centre
• some workplaces
• some pharmacies

Can I conduct my blood pressure test at home?

If you wish to monitor your blood pressure at home on a regular basis, you can purchase a digital blood pressure machine.

Select a machine that takes your blood pressure at your upper arm rather than your wrist or finger.

But make sure you let your GP know you are doing this.

Here are more guides if you want to test at home:

• How to choose your blood pressure monitor
• How to measure your blood pressure at home

How is the blood pressure measured?

To understand your blood pressure results, you first need to know the measures.

The blood pressure is measured through two numbers called systolic and diastolic.

Systolic pressure - also called maximum pressure or simply 'maximum' - is the value of blood pressure when an individual's heart contracts.

In other words, it is the value that the arterial pressure assumes with each heartbeat, necessary to send the blood into circulation.

The systolic pressure acts as a counterbalance to the diastolic pressure, which instead represents the value of the arterial pressure when the heart of an individual relaxes, therefore the pressure value between two heartbeats.

For example, 120/80 means a systolic of 120 and a diastolic of 80.

What is an optimal blood pressure?

The measurement of blood pressure in an individual in excellent health can have systolic pressure values ​​between 80 and 120 mmHg, and diastolic pressure values ​​between 60 and 80 mmHg.

That’s why the so-called normal systolic pressure falls within a range of values ​​not lower than 90 mmHg and not higher than 120 mmHg.

Is prehypertension dangerous?

Introduced after the new classification of blood pressure values ​​(see the table above), prehypertension should not cause particular concerns, but it should be seen as a warning sign for normalising your lifestyle, paying attention to:

• Food and diet
• Stress levels
• Smoking
• Alcohol consumption
• Physical activity

This means people with prehypertension are not in real danger and they don’t need any medical treatment, especially after 50 years old of age.

Part 3: What are the hypertension most common causes?

The reasons of high blood pressure are diverse.

And depending on which root problem causes the hypertension, we can split the high blood pressure in two types:

• Essential hypertension
• Secondary hypertension

Causes of essential hypertension

Also known as primary hypertension, essential hypertension is caused a wide list of factors, as it is impossible to establish with certainty a precise triggering cause.

Essential hypertension is due to a combination of different situations and not to a single circumstance, such as an illness, taking a certain drug, etc.

According to the most reliable studies, among the possible factors that seem to contribute in an important way to essential hypertension, there are:

• A certain genetic predisposition to high blood pressure (genetic factors);
• Familiarity with high blood pressure;
• Certain eating habits, such as the use of too much salt to season foods, the consumption of large quantities of coffee and the reduced intake of vitamin D;
• Aging;
• Being overweight;
• A sedentary lifestyle;
• Some hormonal imbalances;
• Depression. The influence of depression on blood pressure levels is currently under study.

Essential hypertension is the most common type (more than 90%) of high blood pressure in the adult and elderly population, making it the most common form by far.

Causes of secondary hypertension

Secondary hypertension starts as a consequence of a specific disease or circumstance.

In other words, secondary hypertension is the type of high blood pressure due to a well-defined and easily recognizable cause.

The list of diseases / conditions that can give rise to secondary hypertension include:

• Severe kidney diseases, such as chronic kidney disease, glomerulonephritis, polycystic kidney etc .;
• Severe heart disease;
• Endocrine diseases, such as Cushing's syndrome, pheochromocytoma, hypothyroidism, hyperaldosteronism, hyperparathyroidism, hyperthyroidism, acromegaly and Conn's syndrome;
• Diabetes;
• Sleep apnea syndrome;
• A pregnancy;
• The use of certain drugs, such as the contraceptive pill, nasal decongestants, some antitussives, antidepressants;
• Scleroderma;
• The use of drugs, such as cocaine and amphetamines;
• The abuse of alcohol (alcoholism);

Secondary hypertension is not very common and, in fact, constitutes the remaining 5-10% of cases not related to essential hypertension.

Risk factors

In the list of factors that can cause hypertension, doctors include:

• Advanced age;
• A certain hereditary or family predisposition to hypertension;
• Excess salt in the diet;
• Vitamin D deficiency;
• A sedentary lifestyle;
• Overweight and obesity, both in the adult human being and in the child;
• Regular consumption of large amounts of alcohol;
• Smoking;
• Overcoming menopause in women;
• Insomnia and a reduced number of hours devoted to night sleep;
• Stress;
• The presence of chronic diseases, such as diabetes, certain kidney diseases or sleep apnea syndrome.

As you can see from this list, several risk factors for hypertension are behaviors that are the opposite to a healthy lifestyle.

Therefore, we should not be surprised that one of the main rules for the prevention of hypertension is precisely conducting a healthy lifestyle.

Inheritance and familiarity

According to some scientific studies, hereditary predisposition and family predisposition to high blood pressure could increase the risk of hypertension by up to 30%.

That’s why subjects with hypertensive family members should follow the rules of prevention of hypertension, in order to limit the aforementioned risk as much as possible.

Old age

The new knowledge related to high blood pressure has led to debunking the idea that hypertension is an unavoidable and harmless event of old age.

Today, in fact, experts confirm that, for the elderly population, an increase in maximum pressure between 10 and 20 mmHg is acceptable.

Excessive consumption of salt, alcohol abuse and overweight

To get an idea of ​​how influential excessive salt consumption, alcohol abuse and overweight / obesity are, you need to know that in the early stages of hypertension, therapy is about correcting these three wrong behaviors, through the adoption of healthy dietary habits.

Strictly combined with regular physical activity, for a mild hypertensive person, and for anyone who wants to prevent high blood pressure, the ideal diet should be:

• Rich in fiber (therefore, conspicuous intake of vegetables and fruit, and preference for wholemeal cereals and pasta rather than refined cereals and pasta);
• Low in fat, especially saturated fat;
• Low in salt (in grams, the salt taken daily should not exceed 5-6 grams).

Sedentary lifestyle

Sedentary lifestyle and reduced physical activity are probably among the most important risk factors for high blood pressure, regardless of the age group considered.

To learn more about this topic, you can consult the article on hypertension and sport.

Smoking and tobacco addiction

Cigarette smoking increases blood pressure because it is a powerful vasoconstrictor.

Also, it promotes the formation of atherosclerotic plaques (atherosclerosis) inside the arteries.

Responsible for the thickening and hardening of arterial vessels, atherosclerosis is a phenomenon closely linked to hypertension, being both a cause and an effect.

Stress levels

In some cases, for example when mental stress is very high, it can become the main actor starting hypertension.

Circumstances that can cause mental stress so high that it raises blood pressure include:

• episodes of restrained anger
• great anger
• intense emotions
• serious work responsibilities
• excessive commitment to study and / or work.

Vitamin D deficiency

Currently, thanks to some doubts in this regard, several studies are underway aimed at understanding whether the deficiency of vitamin D can be fully included among the risk factors and among the causes of hypertension.

Part 4: Curing hypertension

When it comes to curing hypertension, doctors recommend two approaches: the natural approach and the pharmacological approach.

The main difference between the two approaches is that one requires medications and the other (natural approach) doesn’t.

They also share one common basic rule: both approaches need a healthy lifestyle to begin with. This means that neither of them will work if your lifestyle is a cause for concern.

But let’s go into the details for each.

Medications against hypertension

Medicines for hypertension, or antihypertensives, are are recommended to people with high blood pressure because of their hypotensive power (i.e. that lowers blood pressure).

Please note that we only recommend medications in two cases.

First, when the non-pharmacological approach has proved to be ineffective.

Second, when hypertension, at the time of diagnosis, is already so serious that it is unlikely to be cured it by adopting a healthy lifestyle only.

Key point of the pharmacological approach to hypertension

Doctors are keen to clarify that the use of drugs for hypertension must not become an excuse to abandon or avoid healthy habits.

In other words, a hypertensive person undergoing drug treatments must not rely only on medications, but should continue to stick to a healthy lifestyle, which includes:

• Reduction of the intake of salt in the diet;
• Regular practice of physical activity;
• An adoption of the so-called DASH diet;
• Stop smoking;
• A limitation of alcohol consumption;
• Reduction of body weight.

How long does it take for medications to take effect?

The simple answer is, it depends on many factors. However, generally medicines can take between 4 to 6 weeks to take effect.

That’s why we recommend not to see your doctor before this period of time is completed because you need to wait for the effects of your therapy.

What are the medications for hypertension?

Currently, the pharmacological treatment of hypertension includes several categories of drugs, including:

• Diuretics;
• Beta blockers;
• Calcium blockers;
• ACE inhibitors;
• Direct-acting vasodilators;
• Angiotensin receptor blockers (or sartans);
• Medicines for hypertensive emergency.

These antihypertensive drugs have a great therapeutic response time ranging from 2 to 6 weeks.

This means, in other words, that hypertension medications take between 15 and 45 days to fully release their hypotensive effects.

That’s why it is useless (as it was in the case of non-drug therapy) to rush to the doctor a few days after the start of antihypertensive drug therapy, complaining of its lack of efficacy.

On the contrary, it is highly recommended to consult a doctor immediately, if, after 5-6 weeks, the blood pressure tests do not detect any pressure drop or detect a limited decrease.

In case of ineffectiveness of an antihypertensive drug, doctors may choose to:

• Prescribe the patient an additional antihypertensive drug;
• Change medication. The change of the drug obviously requires an accurate evaluation of the possible side effects, taking into consideration the general state of the patient.

Diuretics

Diuretics are drug substances that increase diuresis, which is the expulsion of urine from the body.

They are considered antihypertensives because, by increasing the volume of urine, they reduce the blood volume (i.e. the total volume of blood circulating in the body).

Most important examples of diuretics: thiazide diuretics, chlorthalidone and indapamide.

Main side effects: dizziness when getting up, need to go to the toilet often, skin rash and increased thirst.

Beta blockers

Beta-blockers reduce blood pressure by acting on the vessels of the skeletal muscles.

They are responsible for vasodilation (the widening of blood vessels as a result of the relaxation of the blood vessel's muscular walls) and a consequent decrease in pressure.

Most important examples of beta blockers: bisoprolol and atenolol.

Main side effects: dizziness, headache, fatigue, nausea, vomiting, diarrhea and insomnia.

Calcium channel blockers

Calcium channel blockers reduce blood pressure because they have a vasodilatory effect.

After all, while vasoconstriction has a hypertensive effect, it also has an opposite effect, ie hypotensive.

Most important examples of calcium channel blockers: amlodipine, felodipine, nifedipine, verapamil and diltiazem.

Main side effects: constipation, headache, dizziness, confusion, palpitations, tachycardia, pulmonary edema and ankle edema.

Part 5: The natural approach to curing hypertension

What is the non-pharmacological theurapetical approach?

The natural approach to curing hypertension can be recommended during the initial phases of the disease.

In fact, it’s much easier to control high blood pressure by introducing small changes in a person’s lifestyle, without using medications.

The most important element for the success of this approach is patients’ motivation to change their lifestyle and their bad habits.

How successful is the natural approach?

It’s important to say that the natural approach to reduce hypertension can work not just during the initial stages, but also during the advanced stages of hypertension.

The only difference is that, in the second stage, it’s absolutely necessary adding (not replacing!) the natural approach to medications.

How long does it take to see the effects of the non-pharmacological treatment?

The non-pharmacological approach doesn’t have immediate effects. In order to see some benefits, the patients should wait 4 to 6 weeks.

That’s why it’s wrong building any concerns if the change in lifestyle didn’t produce any benefit in reducing the high blood pressure.

On the other side, it’s recommended to speak to a doctor when, after 30 days, there isn’t any tangible improvement.

Written by Natasha Edwards