Hypertension: when to worry about high blood pressure?

By Cristiano Antonino On May 13, 2023

Hypertension is one of the main risk factors for cardiovascular diseases and it is therefore essential to follow proper prevention, especially by individuals in the most at-risk categories

To date, awareness of this condition is still low and, consequently, individual prevention activities are still limited.

There are different types and levels of severity of high blood pressure, so it is essential to have a thorough understanding of the risk factors, the causes, who are the people most at risk, what are the symptoms and what is the treatment to follow.

It is also known as the ‘silent killer’, precisely because of its dangerousness, combined with the fact that it is very often not diagnosed quickly

Hypertension or high blood pressure: what is it?

High blood pressure is a condition in which the blood pressure in the arteries, at rest, is higher than the physiological standard.

The presence of blood pressure levels above normal standards must be a constant condition to be defined as hypertension.

It is very important to emphasise its constancy, because blood pressure in all individuals undergoes changes during the day, determined by several factors, including

the time of day at which you are: generally, blood pressure is highest in the morning, peaks at midday and then starts to fall;
if you do physical activity, your blood pressure rises;
if you are agitated, anxious or under stress, your blood pressure rises.

It is equally important to know the reference values that define a person as hypertensive and these are

a minimum blood pressure, also known as diastolic, greater than or equal to 90 mm/hg;
a maximum blood pressure, also known as systolic, greater than or equal to 140 mm/hg.

The rise in blood pressure results from the amount of blood being pumped by the heart and the resistance exerted by the arteries slowing the flow of blood.

Obviously, each individual with his or her own physical characteristics and lifestyle may have a different level of severity of hypertension and it is therefore essential to know the differences.

On speaks of mild hypertension or pre-hypertension when levels are between 130/85 mm/hg and 139/89 mm/hg.

On the other hand, one speaks of moderate hypertension when the levels are between 140/90 mm/hg and 159/99 mm/hg, while if the levels are between 160/100 mm/hg and 179/109 mm/hg, the degree is considered between moderate and high.

Lastly, there is high hypertension, also known as hypertensive crisis when values are above 180/110 mm/hg: in this case, the patient must obviously follow immediate and prompt treatment in order to avoid complications that could jeopardise his or her health.

Finally, there are some particular forms of hypertension, such as

labile hypertension which consists of a sudden change from pressure at normal levels to elevated levels;
pure diastolic hypertension in which the increase only affects the minimum pressure;
pure systolic hypertension, where the increase only affects the maximum pressure.

Causes and symptoms of hypertension

It is essential to know that hypertension is not a disease, but a risk factor that can trigger various types of cardiovascular diseases.

This does not mean that it is less risky.

There are indeed several causes that lead an individual to experience this condition, but first of all it is necessary to distinguish hypertension into two main types: primary and secondary hypertension.

Primary hypertension has no specific cause. The rise in blood pressure levels in this case results from an intrinsic alteration in the mechanisms that regulate pressure.

Secondary hypertension, on the other hand, is the consequence of congenital or acquired diseases related to the kidneys, heart or blood vessels. Obviously in this case, as there is an identifiable trigger cause, it is also much easier to treat and, if diagnosed correctly, its treatment can bring blood pressure back to normal values.

The diagnosis of hypertension is not always easy to make, primarily because it is usually asymptomatic and has no obvious physical symptoms.

In fact, the body is able to gradually get used to the increase in pressure, without immediately suffering any visible consequences.

This leads to a general underestimation of the condition, which can prove particularly risky.

When present, symptoms of hypertension include the following:

morning headaches
dizziness;
ringing in the ears, such as tinnitus;
visual field alterations;
cold sweating;
dyspnoea or heart palpitation;
nausea;
feeling of anxiety;
nosebleeds.

However, these symptoms are non-specific and rarely occur; they are therefore difficult to detect and correlate with a hypertensive condition.

If, on the other hand, a patient suffers from high arterial hypertension and is therefore in hypertensive crisis, dangerous complications may occur, such as angina pectoris, loss of consciousness, stroke, pulmonary oedema, heart attack, kidney problems and aortic dissection.

Who are those most at risk?

There are certain conditions that predispose some individuals more than others to this condition, and these include age, family history, the presence of pre-existing pathologies, and an unhealthy lifestyle.

As far as familiarity is concerned, it is common to find multiple cases of people with hypertension within the same family strain.

Blood pressure rises with age, so it is more likely to occur in older individuals than in younger ones.

Those suffering from diabetes may also see a related increase in blood pressure.

Finally, there are all those triggering factors that mainly relate to an unhealthy lifestyle, such as smoking, eating too much salty food, alcohol, stress, being sedentary and obesity.

These are all conditions that contribute, especially when combined, to increased blood pressure levels.

This is why it is essential, both when young and old, to follow a healthy and balanced lifestyle, in which diet plays a key role.

Therapy and prevention

The aim of treatment for hypertension is to restore blood pressure to normal levels.

Depending on the level of severity of hypertension, a different therapy may be determined: in some cases, it is sufficient to change the wrong lifestyle habits that are the cause of the increase in blood pressure; in others, drug therapy is required.

If the doctor prescribes drug therapy, it will be chronic and must be taken consistently for years.

The drugs taken will therefore control blood pressure levels and generally do not cause serious side effects, as they are safe therapies.

Among the most commonly used antihypertensive drugs are

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ACE inhibitors
Calcium antagonists
Diuretics
Alpha and beta blockers
centrally acting sympatholytics.

In some patients, unfortunately, the therapies, even if administered with different types of drugs concomitantly, have not proved effective: in this case we speak of resistant hypertension.

However, there are many cases in which hypertension is controlled through a change in lifestyle or the elimination of the main triggers.

In general, avoiding the abuse and excessive consumption of alcohol, smoking and drugs helps to limit the risk of hypertension.

This, of course, must be combined with a healthy and balanced lifestyle, based on a low-sodium diet, rich in fruit, vegetables and fibre. In general, a diet against hypertension must be absolutely low in sodium and rich instead in potassium, magnesium and omega-3.

It must also be low in hydrogenated fats and low in cholesterol.

Equally important is physical activity: sedentariness and being overweight are among the main triggers of high blood pressure. Exercise helps keep the body healthy and lowers blood pressure levels.

Although it is not a disease, high blood pressure is a serious condition that should not be underestimated, which is why it is essential to start at a young age to follow a healthy lifestyle that will, more often than not, prove to be the best ally in preventing high blood pressure.

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