What is blood pressure?
Blood pressure is the force that blood exerts on the walls of the blood vessels as it is pumped through the body. You can think of it like water flowing through a hose. When the heart beats, blood is pumped into the vessels, creating pressure.
Blood pressure is measured in two values:
- Systolic Pressure: This is the higher value and indicates the pressure when the heart beats and blood is pumped into the vessels.
- Diastolic Pressure: This is the lower value and indicates the pressure when the heart is relaxed between beats.
Blood pressure is expressed in millimetres of mercury (mmHg), for example, 120/80 mmHg. A normal blood pressure is typically around 120/80 mmHg. High blood pressure (hypertension) can cause health problems, while low blood pressure (hypotension) can also be uncomfortable. Fluctuations in blood pressure are normal and important. The contraction and relaxation phases of the heart muscle, as well as the narrowing and widening of the vessels, are regulated by various body systems. This regulation allows the heart and vessels to respond to internal and external influences, ensuring that blood circulates efficiently. Blood pressure automatically increases during pain or exertion and decreases during sleep. Short phases of high blood pressure are normal, but persistently high blood pressure can cause damage to the heart and vessels.
Definition of High Blood Pressure
Hypertension, also known as high blood pressure, is a condition where the pressure in the blood vessels is persistently elevated at rest. The blood pressure thresholds were adjusted in 2024 by the European Society of Cardiology (ESC) based on current medical knowledge about hypertension and its consequences. Normal blood pressure at rest is below 120/70 mmHg. Hypertension is diagnosed when the values at rest are persistently above 140/90 mmHg. During stress, physical exertion, pain, or similar situations, it is normal and important for blood pressure to temporarily rise above 120/70 mmHg.
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Systolic (mmHg)
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Diastolic (mmHg)
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Blood Pressure Category
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< 120
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or/and < 70
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Normal Blood Pressure
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120-139
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or/and < 70-89
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Elevated Blood Pressure (Pre-Hypertension)
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> 140
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or/and > 90
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Hypertension
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Initiation of Therapy and Blood Pressure Target in Hypertension
Regardless of whether your blood pressure is normal, elevated, or already classified as hypertension, you should always take measures to optimize your lifestyle. This includes a balanced diet, regular physical activity, stress reduction, and avoiding smoking. More information on a healthy lifestyle can be found here.
Elevated Blood Pressure: For elevated blood pressure, lifestyle improvements can often be sufficient to achieve normal values. However, if the blood pressure has not decreased below 130 mmHg after three months, additional medication therapy is recommended.
Hypertension: If hypertension is already present, medication treatment should be started immediately, complemented by lifestyle changes.
Blood Pressure Targets: The target blood pressure, if well tolerated, is between 120-129/70-79 mmHg. If the systolic value is below 129 mmHg, the diastolic value can be accepted up to 90 mmHg, except in younger patients. Exceptions apply to individuals with high frailty, those over 85 years old, or with repeated collapse conditions.
Causes
High blood pressure can be caused by various factors, including:
- Genetic Predisposition: A family history of high blood pressure can increase risk.
- Overweight: Excess weight puts strain on the heart and can lead to increased blood pressure.
- Lack of Exercise: An inactive lifestyle can raise the risk of high blood pressure.
- Unhealthy Diet: A diet high in salt, saturated fats, and sugar can promote high blood pressure, as can a high consumption of liquorice.
- Alcohol and/or Drug Use: Excessive alcohol consumption, as well as cocaine, ecstasy, and amphetamines, can elevate blood pressure.
- Smoking: Tobacco use damages blood vessels and can increase blood pressure.
- Stress: Chronic stress can lead to temporary or permanent increases in blood pressure.
- Age: The risk of high blood pressure increases with age.
- Certain Conditions: Conditions such as diabetes, kidney diseases, adrenal gland disorders, thyroid disorders, parathyroid disorders, or sleep apnea can also contribute to high blood pressure.
- Medications: Some medications, such as certain pain relievers (e.g., ibuprofen, diclofenac), contraceptives, appetite suppressants, or decongestants, can raise blood pressure.
However, in most people, no clearly identifiable cause can be found; this form of high blood pressure is called essential or primary hypertension. Nearly one in three adults suffers from this condition.
Symptoms
High blood pressure is often referred to as the «silent killer», as many people do not notice any symptoms. When symptoms do occur, it is usually because there has already been damage to the kidneys, eyes, brain, or cardiovascular system. Possible symptoms may include:
- Headaches
- Dizziness, vision disturbances
- Shortness of breath, chest pain
- Nosebleeds
Risks
Untreated high blood pressure can lead to serious health problems, such as:
- Heart diseases (e.g., heart attack, heart failure)
- Stroke
- Kidney damage
- Eye damage
Diagnosis
Diagnosis is typically made through:
- Blood Pressure Measurement: Multiple measurements at different times.
- Additional Tests: Blood tests, ECG, echocardiogram to identify possible causes. However, in 9 out of 10 patients, no cause can be found, and essential or primary hypertension is present.
Treatment
The treatment of high blood pressure includes:
- Lifestyle Changes:
- Healthy diet (e.g., Mediterranean diet, low salt)
- Regular exercise (at least 150 minutes of moderate activity per week)
- Weight management
- Stress management techniques (e.g., yoga, meditation)
- Avoidance of alcohol and tobacco
If lifestyle changes do not sufficiently lower blood pressure within three months or if there is already an increased cardiovascular risk from the outset, medication therapy will be added. However, this does not replace lifestyle changes, which should always be pursued and form the basis of treatment.
- Medication Therapy:
- Various medications may be prescribed, including diuretics, ACE inhibitors, beta-blockers, and calcium channel blockers.
Self-Management
- Regular Blood Pressure Monitoring: Monitor your blood pressure at home.
- Lifestyle Changes: Healthy diet, sufficient and regular exercise, stress management, weight normalization, avoidance of harmful substances.
- Keep a Blood Pressure Diary: Record your values and lifestyle changes.
- Regular Doctor Visits: Schedule regular appointments to monitor your blood pressure and adjust treatment as necessary.
- If applicable, Regular and Reliable Intake of Prescribed Medications
When to Contact Medgate or See a Doctor
If you experience symptoms such as:
- Chest pain and tightness, palpitations
- Shortness of breath
- Headaches and pressure, especially in the morning
- Nausea, dizziness, lightheadedness
- Nosebleeds, tinnitus, vision disturbances
- Feelings of heat, sweating, flushed face
- Irritability, nervousness, sleep disturbances
- If your blood pressure does not decrease despite treatment.
If you are currently suffering or have suffered from one or more of these symptoms in the last few days, please call us immediately on 080 789 789 or book an emergency consultation via the app.
Conclusion
High blood pressure is a treatable condition. Through early diagnosis, lifestyle changes, and possibly medication therapy, you can significantly reduce your risk of serious complications. Talk to your doctor about the best strategies to control your blood pressure.
Do you have questions on this topic? Feel free to make an appointment with your Medgate Tele GP by calling 0800 789 789.
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