High Blood Pressure | Causes, Symptoms, Treatment

Table of content

1. An overview

A normal regulated high blood pressure is most desirable to stay active, healthy, and happy. Blood pressure is the outcome of the pumping of blood by the heart into the blood vessel. Hypertension is measured with an instrument (called a Sphygmomanometer). The pressure is measured in mm Hg (millimeter of mercury) and recorded in systolic number first (followed by the diastolic number)

The pressure varies

• From time to time (it remains the lowest during sleep at night and rises sharply after waking up in the morning)
• On account of mood (blood pressure rises when one feels angry, anxious, stressed, emotional, frightened, or shocked)
• On account of speedy action (Diastolic pressure rises during the fighting, boxing, wrestling, horse ride, and outdoor games involving stress and physical activity).
• And On account of movement (as compared to standing position, blood pressure gets higher while walking and it reaches the highest while running).

Perfectly normal blood pressure usually lies more or less around 120 / 80 mm Hg. Any significant deviation from the demarcation line will invite either low pressure or high pressure which is harmful to health. Of the two, high blood pressure is worse and more dangerous.

The blood pressure readings have 2 numbers. For example, 120 / 80 mm (millimeter) Hg. The top number indicates Systolic arterial pressure (it is the amount of pressure the heart generates while pumping and pushing the blood into the body through the arteries). And the bottom number indicates Diastolic blood pressure (it refers to the amount of pressure in the arteries when the heart is at rest between the beats). On average, (for all ages including male and female) Pre-hypertension is indicated by systolic reading (120- 129) and diastolic reading (around 80). And hypertension is indicated by the diastolic pressure reading (130 / 80 and higher).

Heart attack

In fact, the higher the blood pressure, the higher is the risk of heart attack, heart failure, stroke, and kidney disease (Heart attack is the death of a segment of heart muscle caused by the loss of blood supply. Heart failure occurs when the heart muscle does not pump blood. Stroke is the sudden death of a brain cell due to the lack of oxygen caused by blockage of blood flow to the brain). Hypertension is the gateway to entry for most malignant and life-threatening diseases.

2. High Blood pressure chart

Range indicating healthy and unhealthy blood pressure

Chart-A: Blood pressure reading in mm Hg

Advice: Emergency medical help

Chart- B: Normal Blood pressure (By age and gender)

3. Complications:

Blood pressure if higher puts additional strain on the heart and blood vessels. Over time, this extra strain increases the risk of heart attack and stroke. Heart attack can also deteriorate to heart failure and kidney disease which is closely linked to some form of dementia (It is a chronic or persistent disorder of the mental processes caused by brain disorder or injury. The disorder is often marked by memory disorder, personality changes and impaired arguing skill).

4. High blood pressure (by stages)

5. Blood Pressure Symptoms:

For some people, excessively high blood pressure signals the following problems, some of which may crop up with unimaginable heights

5.1) Severe headache

The resulting headache caused by high blood pressure feels unlike any other type of migraine or head pains (Traditional head pain killers, such as aspirin are ineffective in such cases). Severe headaches caused by excessive hypertension are also associated with other symptoms, such as:

• Vision problems
• Chest problems
• Nausea, etc.

5.2) Vision problem

It is the loss of sharpness and accuracy of eyesight making the objects appear hazy and out of focus. The primary factor in creating a vision problem is a refractive error. (Nearsightedness or farsightedness). A vision problem can affect one or both eyes. 

5.3) Nausea

It is a feeling of sickness with an inclination to vomit.

5.4) Fatigue

It refers to extreme tiredness resulting from mental or physical exertion or overwork or diseased health.

5.5) Confusion

Forces creating confusion and preventing concentration on deep thought, reading, writing, working, or properly performing daily home and job responsibilities are stress/ strain/ anxiety that affects the brain to confuse.

5.6) Chest pain

Pain or pressure in the chest is the most common symptom of a heart attack. However, pain or discomfort in the arms, back, or jaw can also be a sign.

5.7) Difficulty while breathing

Over time, high blood pressure can cause thickness and stiffening of the heart wall and eventually results in shortness of breath. The shortness of breath occurs when the blood comes back into the lungs.

5.8) Irregular heartbeat

Eventually, hypertension can cause damage to the heart and its electrical system leading to a rapid irregular heartbeat.

5.9) Blood in the urine (Hematuria)

This is a condition and is more common in the case of high blood pressure and kidney disease patients since the rupture or cysts in the small blood vessels cause blood in the urine. Blood in the urine is visible only under the microscope.

5.10) Pounding in the neck and ear

High blood pressure resulting from stress can cause vascular neoplasm (pressing blood vessels in the head, neck, and ear).

6. High Blood Pressure Diagnosis:

Besides recording the family history in general and the patient’s history in particular, the Doctor is likely to take 2—3 diastolic pressure readings each at 3 or more separate appointments before diagnosing with high blood pressure. This is because arterial pressure normally varies throughout the day and it may be elevated while visiting the doctor. Additionally, the doctor may recommend the following tests for diagnosis and effective treatment.

6.1) Blood test

The test can get information about the overall health condition of the patient and detect whether the important blood components influencing heart health as well as the condition of kidney and other organs lie within the normal range, such as:

a) Electrolytes (These are salts and minerals, such as sodium, potassium, and bicarbonate which are found in the blood. They can conduct electrical impulses in the body. An electrolyte test can also be used to monitor the effectiveness of treatment on account of an imbalance in the electrolyte that affects the functions of an organ), 

b) Blood urea nitrogen (Its level indicates how well the kidneys are working. If the kidneys are not able to remove the urea from the blood through the normal procedure, the blood urea nitrogen level rises leading to dehydration, heart failure, etc) and

c) Creatinine (The test ascertains the level of creatinine in blood and tells how well the kidneys filter).

6.2) ECG (Electro-cardiograph)

During the painless, non-invasive test, soft sticky patches (electrodes) are attached to the skin of the chest, arms, legs. The patches detect the heart’s electrical signals while the ECG machine records them on graph paper or displays them on a screen.

The ECG machine records the irregularities in the heart rhythms, structural irregularities in the heart, and problems in connection with the supply of blood as well as oxygen to the heart muscles. The test can also reveal the fact about whether the patient is having a heart attack or experienced the same before.

6.3) Lipid profile

The test is conducted for assessing the level of various kinds of cholesterol (It is a waxy fat-like substance that is found in all the cells within the body. The body needs cholesterol to make some hormones, vitamin- D, and other substances that help digest food. But a high level of cholesterol can increase the risk of heart disease)

6.4) Special tests

The tests are conducted for hormones of adrenal glands (located at the top of each kidney, the adrenal glands produce hormones that help the body control blood sugar, burn protein and fat, regulate blood pressure level and react to stressors like a major illness or injury) or thyroid glands. The 2 main thyroid gland hormones are:

1. T3 = Triiodothyronine
2. T4 = Thyroxine

T3 and T4 regulate body temperature, metabolism, and heart rate. Metabolism is a biochemical process that occurs in living organisms including man and animals. It allows us to grow, reproduce and repair the damage and thus maintain a nice environment-friendly life. The amount of thyroid hormone secretion is controlled by another hormone called TSH = Thyroid Stimulating Hormone which is released from the pituitary gland in the brain.

7. Causes and risk factors of High Blood Pressure:

Causes are the agents directly responsible for the occurrence of the disease. On the other hand, a risk factor is not necessarily a cause. A risk factor may be anything that increases the likelihood for a patient to develop the disease. (For instance, age is a vital risk factor for any malignant disease. But it is not a cause)

7.1) Causes 

7.1.1) Stress

It is the prime cause of hypertension (hypertension) that makes the heart work harder to pump blood to the body resulting in hardening of the arteries and ultimately leading to stroke/kidney disease/ heart failure.

7.1.2) Overweight and obesity

It is both a cause as well as a great risk factor for high blood pressure. The greater the body weight, the more blood flow is needed to supply oxygen and nutrients to the tissues. As the volume of blood (circulating through the blood vessels) increases, so does the pressure.

7.2) Blood Pressure Risk factors

High blood pressure can arrive in case of anybody irrespective of time, place, gender, and age. Still, the following risk factors play a dominant role in inviting hypertension.

7.2.1) Salt (Sodium chloride)

Daily 1 teaspoonful salt (in the total volume of diet) is needed for a healthy adult. But for high blood pressure patients, salt consumption should be minimized to the lowest possible level as it triggers the symptoms of hypertension. Too much salt can cause the body to retain food and make the arteries constrict. Both outcomes raise the risk of hypertension.

7.2.2) Potassium deficiency

Potassium is needed for relief from high diastolic pressure, stroke, heart and kidney disorder, stress, and anxiety. It helps muscle strength, water balance and causes smooth muscle cells in the arteries to relax which lowers the blood pressure level.

7.2.3) Vitamin- D deficiency

Research studies reveal the fact that higher consumption of vitamin- D can help lower the blood pressure level and as such, reduce the risk of hypertension.  

7.2.4) Sedentary and inactive life

Veritably, physical activity increases blood flow through the arteries of the body. This helps the release of natural hormones that relax blood vessels which in turn brings down blood pressure to a normal level. As such lack of physical activity increases the risk of hypertension.

7.2.5) Alcohol and smoking

The 2 expensive bad habits trigger hypertension by activating the adrenergic nervous system (It is a group of organs and nerves in which adrenaline act as neurotransmitters. Adrenergic nervous system is considered as one of the main neurohormonal systems that regulate cardiovascular function) leading to constriction of blood vessels and consequently push up blood flow and heart rate.

7.2.6) Non-steroidal inflammatory drug

Non-steroidal inflammatory drugs (such as ibuprofen) can lead to the worsening of existing hypertension or developing new high blood pressure. Additionally, it can invite a heart attack or stroke.

7.2.7) Stress

Stress is both a cause as well as a risk factor inviting hypertension. So Stress, if paired with shock, anxiety, trauma, and overwork can lead to a temporary but sudden rise in blood pressure.

8. High Blood Pressure Types

8.1) Types by causative factors

Primary high blood pressure: Hypertension is not related to any medical condition.

Secondary high blood pressure: It is related to the medical conditions occurring in the heart/ kidneys/ arteries/ endocrine system (It is the collection of glands that produce hormones to regulate metabolism/growth/development/issue function/sexual function/reproduction/mood etc.).

Examples include sleep problems, such as sleep apnea (During sleep the breathing cycle stops for a while).

8.2) Types by risks

8.2.1) Malignant hypertension

It is also called silent killers. It is extremely high blood pressure that develops rapidly causing some organ damage. 

8.2.2) Resistant hypertension

It is the diastolic pressure that remains above the goal to be achieved (despite concurrent use of anti-hyper-intensive different classes of 4 or more medicines).

8.2.3) Pulmonary hypertension

It is a high blood pressure occurring in the lungs- which is a serious condition as the heart has to work harder to pump blood.

8.2.4) Pseudo hypertension

It is a condition in which the blood pressure is indirectly measured by the cuff method that overestimates true intra-arterial venous pressure. It should be suspected if the patient develops dizziness (after taking the anti-hyper- intensive drug).

8.2.5) White coat hypertension

It is a syndrome whereby the patient’s feeling of anxiety in a medical environment results in an abnormally high blood pressure reading (when measured).

8.2.6) Isolated systolic hypertension

It can occur due to underlying conditions (such as artery stiffness, overactive thyroids, diabetes or heart valve problem).

9. High Blood Pressure Treatment

9.1) Natural ways (without medication)

Treatment of high blood pressure by applying the following natural procedures is often considered effective.

9.1.1) Physical activity

Physical exercise is the best natural way to reduce hypertension. Regular exercise with a morning walk makes the heart stronger and more active in pumping blood of the right amount to the right part of the body. Physical activity is essential to regulate blood pressure to the desired level. Weekly minimum of 150 minutes (2.5 hours) moderate exercise is essential to improve heart health and venous pressure level.

Additionally, meditation and deep breathing help activate the parasympathetic nervous system, keep the body relaxed, slow the heart rate and improve diastolic pressure level.

9.1.2) Reduce salt consumption

Salt (sodium chloride) triggers the symptoms of high blood pressure. In many research studies, salt has been found linked to heart problems including hypertension.

9.1.3) Avoid unhealthy foods and drinks

Before starting the use of anti-hypertension drugs, consumption of all unhealthy foods and drinks (including the expensive bad habits: smoking and alcohol) should be stopped.

9.1.4) Increase the consumption of calcium, potassium, and magnesium

Calcium, potassium, and magnesium are essential minerals to control and regulate blood pressure levels. It is, therefore, recommended to take foods rich in these 3 minerals. Daily intake of calcium should be a minimum of 1000 mg (in case of an adult) and 1200 mg (in case of a man over 70 years and a woman over 50 years).

9.1.5) Take natural supplements

High blood pressure can be effectively controlled by the consumption of natural supplements, such as aged garlic (it has been successfully used along with conventional therapies to reduce hypertension) / Barberini (traditionally used in Ayurvedic and Chinese medicine/whey protein (it is a protein supplement that comes from milk)/fish oil (it benefits heart health and improves blood pressure level)

9.1.6) Manage stress

When one is chronically stressed, the body is in constant ‘fight mode’. The implication is that the body function deteriorates with a faster heart rate and constricted blood vessels. To mitigate the problem, it is well-advised to work less as well as abstain from stressful work.

9.1.7) Maintain a healthy weight

For overweight and obese people, losing weight is essential for heart health. In a recent research study, it was revealed that losing 17 pounds of weight was found linked to lowering systolic blood pressure by 8.5 mm Hg and diastolic pressure by 6.5 mm Hg. A healthy weight gain will be indicated by a healthy blood pressure reading around 120/80.

9.2) Treatment with medication

High blood pressure can be treated with different categories of medicines as listed below.

9.2.1) ACE (Angiotensin-Converting Enzyme) inhibitors

It is a hormone that causes the blood vessels to relax and allow blood to flow more freely and thus help reduce high pressure

9.2.2) ARB (Angiotension- 2 Receptor Blockers)

Like ACE, it also causes blood vessels to relax and thus helps control and regulate hypertension.

9.2.3) Beta Blockers

It works to limit and restrict the nerve impulses to exert a salutary impact on the heart and the blood vessels. The medicine works to ease high blood pressure.

9.2.4) CCB (Calcium Channel Blockers)

It blocks the calcium from entering the muscle cells of the heart and the blood vessels. This ultimately relaxes the blood vessels to reduce hypertension.

9.2.5) Diuretics (water pills)

It lowers excessive blood pressure by working in the kidneys to flush excess water and salt (sodium) from the body.

9.3) Treatment during emergency

In case of emergency (if acute heart failure occurs in the wake of severe high blood pressure), the preferred medications are:

4-Nitroglycerin/sub-lingual Nitroglycerin/ Enalapriate.

Additionally, ‘Vasodilator’ is recommended (in the case of systolic blood pressure 140 mm Hg or more).

If blood pressure remains elevated (even after taking beta-blockers), an intravenous Nitroglycerin or Nitroprusside may be administered.

9.4) Treatment during the hyper intensive crisis

The condition includes a spectrum of clinical presentations in which uncontrolled blood pressure leads to progressive or end-organ dysfunction. In these conditions, the blood pressure should be lowered aggressively.

Conclusively, emergency medical help is needed for instantaneous control over the crisis.

10. High blood pressure during pregnancy

A pregnant hypertension patient is burdened with double tensions (one is the high diastolic pressure. And the other being pregnancy, till a healthy delivery occurs). During the pregnancy period, blood pressure is an important indication of the health condition of both the pregnant mother as well as the unborn baby.

Even though hypertension during pregnancy is not dangerous, sometimes it can cause severe health complications for both the pregnant mother and the unborn baby.

The causes, as well as the risk factors for hypertension in the case of the pregnant woman, are more or less the same as others. Additional risk factors include a) Pregnancy-related hypertension, b) First-time pregnancy, c) Maternal age (over 40 years ) and d) Pregnant women carrying twins or multiples ( They are more likely to develop hypertension as the body is under additional stress).

10.1) Types of pregnancy-related high blood pressure and treatments

10.1.1) Chronic hypertension

It is hypertension existing before pregnancy. It is usually treated with blood pressure medications. The doctors consider the’ chronic hypertension’ occurring only during the 1st 20 weeks of pregnancy.

10.1.2) Gestational hypertension

The condition develops after the 20th week of the pregnancy period. It usually resolves automatically after delivery. If diagnosed before the 30th week of pregnancy period, there is a higher risk to invite preeclampsia (it is a serious condition where the woman develops hypertension in addition to a high level of protein in the urine, although they had no high blood pressure previously).

10.1.3) Chronic hypertension (with superimposed preeclampsia)

The condition is still worse, as the woman had both hypertension as well as high protein in the urine (before pregnancy).

10.2) Tracking blood pressure during pregnancy

For a pregnant woman, the doctor is likely to measure baseline venous pressure at every visit that follows. Normal venous pressure during the pregnancy period is the same as others (around 120/80 mm Hg). And the high blood pressure during the pregnancy period is 140/90 mm Hg or more, which depicts a matter of concern.

11. Key global information:

High blood pressure affects I out of 3 people in the USA and me billion people worldwide.

Elevated (High) venous pressure is a global major risk factor for cardiovascular disease and chronic kidney disease.

Over the past 4 decades, the highest level of diastolic pressure events shifted from high-income countries to low and middle-income countries (particularly to South Africa and sub-Saharan Africa)

Among the high-income nations -- Portugal, Finland, Norway exhibit the highest blood pressure events

Globally, about half of the hypertension patients are found sensitive to the consumption of salt (which is the prime food ingredient to trigger symptoms of hypertension).

12. Concluding remarks:

12.1) For the treatment of hypertension, medication has side effects, but a healthy and befitting lifestyle has none. So it is wise to meticulously abide by the health rules (such as shifting from sedentary inactive to a healthy and active lifestyle with regular physical exercise, preferably morning walk, taking healthy foods and drinks of the right amount at right time and more importantly, check-up venous pressure and administer other tests under a physician on regular basis. Veritably, there are 2 mighty events which arrive without any notice- one is dead, the other being hypertension)

12.2) There may be plenty of medicines to treat high blood pressure. It is the doctor who will decide which medicine or combination of medicines will work the best for a particular patient. A particular medicine or a combination of medicines is just a part of the ‘Blood pressure management plan’

Conclusively, a complete plan also covers the lifestyle/hobby/diets/physical activity/ gender/age/profession etc. Each part of the management plan is complemented each other to attain the goal.

13. TIPS:

• H = HIGH (Blood pressure invites the malignancies: heart disease/kidney disease/stroke)
• I = Initially (A high blood pressure patient may not experience any obvious symptoms) 
• G=GLOBALLY (High blood pressure is a major risk factor for cardiovascular/kidney diseases) 
• H=HYPERTENSION (And overweight are highly correlated)
• P = PRESSURE ( Occurs when blood is pumped by the heart into the blood vessels)
• R = RIGHT (Food at the right time and of the right amount should be taken)
• E = EAT ( More vegetables and the least fat and salt)
• S = SEVERE ( High pressure can be life-threatening)
• S = STRESS (Is the prime cause of hypertension)
• U = UNHEALTHY ( Foods and drinks should be avoided )
• R = ROUTINE (Test is essential for hypertension pregnant women until delivery of the baby)
• E = EMERGENCY (Medical help is needed during the hyper-intensive crisis)