High blood pressure: what it is, types, causes and treatment

Although it is a highly preventable, modifiable and controllable disease, millions of people around the world do not know they have this disease and do nothing to improve it.

Considered one of the major medical problems of the developed world, Hypertension is something that, if left unchecked, can lead to serious damage to the circulatory system, bringing with it diseases such as heart attacks and strokes. Below, we will dive deeper into this medical issue.

    What is hypertension?

    High blood pressure is the medical condition in which the blood vessels have persistently high blood pressure., so much so that it can damage them. Blood pressure is the force exerted by blood against the walls of blood vessels (arteries) as it is pumped by the heart. The higher the blood pressure, the harder the heart has to pump.

    Even though it may not look like it, hypertension is a life-threatening condition because it has no clear symptoms and these can take a long time to appear. This is really dangerous, because people with high blood pressure may not know that their body is suffering from the effects of high blood pressure, damaging their circulatory system and increasing the risk of cardiovascular disease, the leading cause of death in developed countries. .

    The first consequences of high blood pressure are suffered by the arteries. These vessels harden as they continually resist high blood pressure. This makes the arteries thicker, making it harder for blood to pass through them. This damages the walls of blood vessels, which also promotes the deposition of cholesterol and triglycerides in them, which is why hypertension has a high risk of developing arteriosclerosis.

    Hypertension is a highly treatable disease. Despite this, high blood pressure in developed countries is very common. Putting the data as a reference, about 40% of the Spanish population is hypertensive and it is estimated that about 40% of these people are undiagnosed. Considering its health consequences and its frequency, it can be said that hypertension is a silent epidemic that has become a very important public health problem.

      Types of hypertension

      Hypertension is classified into several types. To do this, you must first know that blood pressure has two components:

      1. Systolic blood pressure

      systolic blood pressure is the highest voltage number. Represents the tension caused by the heart as it pumps blood to the rest of the body.

      2. Diastolic blood pressure

      Diastolic blood pressure is the lowest number of blood pressure. This value represents the pressure in the blood vessels between each heartbeat.

      Blood pressure is measured in millimeters of mercury (mmHg) and is diagnosed as high when diastolic, systolic, or both have high numbers. Blood pressure is classified as follows (The first value represents systolic blood pressure and the second represents diastolic blood pressure. So having a normal blood pressure of 125/82 means that we have a systolic blood pressure of 125 and a diastolic blood pressure of 82).

      • Normal: 120/80* to 129/84 mmHg.
      • Normal high: 130/80 to 139/89 mmHg.
      • Grade 1 hypertension: 140/90 to 159/99 mmHg.
      • Grade 2 hypertension: 160/100 to 179/109 mmHg.
      • Grade 3 hypertension: greater than 179/109 mmHg.

        Symptoms

        The biggest problem with hypertension is that, in addition to presenting a great risk for the cardiovascular health of the person affected, in most cases there are no symptoms and, therefore, the condition goes unnoticed. This means that if the patient does not discover it at their doctor’s office during a routine examination, they will not know that they have hypertension and will not do anything to change the situation, thus increasing the risk of developing diseases such as than a stroke or heart attack. attacks.

        Always, it is possible to talk about some non-specific symptoms such as headaches, which help to detect hypertension which, frightened, decides to go to the doctor or visit his pharmacy so that they take his blood pressure. There may also be nausea, vomiting, confusion, changes in vision and nosebleeds, symptoms of malignant hypertension.

          Main causes of high blood pressure

          The specific causes of high blood pressure are not known today, but the onset of this condition is attributed to a number of factors shared by most people with high blood pressure. Talking about these causes, we can separate those that are not very modifiable (genetics, sex, age and race, medical diseases) from those that can be modified or associated with bad habits and highly treatable medical conditions.

          1. Genetic factors

          Genetics, as in virtually all diseases, is a factor that influences high blood pressure. The predisposition to develop this condition is greater if you have a first-degree hypertensive relative. Although the exact mechanism is not known, it is known that if one or both parents have hypertension, the chances of developing hypertension are twice as high as those whose parents do not have hypertension.

          2. Sex

          Men are more likely to suffer from it than women before menopause. When they reach this stage, the frequency of hypertension between men and women is equal. This is explained by the fact that female hormones are a protective factor against hypertension in childbearing age, thereby reducing the risk of cardiovascular disease.

          3. Age and race

          Age is another factor that influences blood pressure, as the older you are, the more likely you are to have hypertension. As for race, it has been seen that there are differences in the presentation of this condition, with people of African descent having the highest risk of being hypertensive (twice as much as whites), in addition to have the worst prognosis.

          4. Overweight and obesity

          Overweight and obesity are two highly modifiable medical conditions that are associated with a higher risk of developing hypertension than people of normal weight. The heavier you are, the higher your blood pressure. Regardless of age, the risk of becoming hypertensive and obese is two to three times higher compared to overweight people.

          Although it is a fact that obese people tend to be hypertensive, it is unclear if obesity itself is the cause of hypertension or if there is a factor associated with increased blood pressure. arterial pressure. Obesity is also attributed to other medical conditions that are thought to be, at least in part, responsible for the increase in blood pressure, conditions that decrease or disappear when you lose weight.

            5. Bad Habits

            The main bad habits associated with increased blood pressure are:

            • Consume alcohol
            • Being a smoker
            • Take illicit substances
            • Don’t exercise
            • Have bad eating habits
            • Salt abuse
            • Abuse fats

            6. Drugs that increase blood pressure

            The drugs most likely to cause high blood pressure are:

            • Ciclosporin, tacrolimus
            • Nonsteroidal anti-inflammatory drugs
            • Erythropoietin
            • Adrenergic drugs
            • Decongestants containing ephedrine
            • Herbal Remedies Containing Licorice

            7. Kidney Disease

            Between 2 and 7% of kidney problems can affect the onset of high blood pressure.. The main renal vascular pathologies observed in people with hypertension are:

            • Polycystic kidney disease.
            • Chronic kidney disease.
            • Renin-producing tumors.
            • Liddle’s Syndrome.
            • Renal artery stenosis.

            8. Endocrinological problems

            Endocrinological causes represent 1 to 2% of hypertension problems. These would include exogenous hormonal imbalances, such as taking oral contraceptives, corticosteroids, and medications. nonsteroidal anti-inflammatory drugs (NSAIDs) and endogenous, such as the following diseases:

            • Primary hyperaldosteronism
            • Cushing’s syndrome
            • Pheochromocytoma
            • Congenital adrenal hyperplasia

            Diagnostic

            The main way to diagnose hypertension is to take blood pressure. This is done by sphygmomanometers, commonly known as sphygmomanometers. The first line of detection of hypertension is made up of primary care teams, including doctors and nurses. Community pharmacists also contribute to the detection, measurement and control of high blood pressure.

            Routine checks that are done in companies or when patients are checked because they want to start practicing a federated or semi-professional sport are also environments in which hypertension is diagnosed. It is precisely these measurements that are very important, since they are carried out in patients who rarely go to the doctor because they feel healthy at all times or who do not like health environments.

              Prevention

              Hypertension is the type of medical condition that gives rise to the saying “prevention is better than cure”. Being hypertensive is highly controllable and can be improved, especially if you have not yet had any illness resulting from this condition.. That is why, whether you know you are hypertensive or not, do your best to avoid this condition, such as avoiding overweight and obesity, in addition to having a healthy lifestyle and avoiding drug addiction. .

              Eat healthy and exercise regularly can help prevent high blood pressure. Quitting smoking is essential to avoid becoming hypertensive, as tobacco increases blood pressure. If there is a history of hypertension in the family, it is crucial to measure blood pressure regularly because being a parent of a hypertensive person is a risk factor for ending up like him.

              Processing

              The first course of treatment for hypertension is improve the patient’s lifestyle. Because it is a highly treatable condition that in most cases leads to an unhealthy lifestyle, it is generally considered the best way to start lowering a patient’s blood pressure.

              You need to eat a healthy diet, reduce your intake of sugars, salt and fats, as well as reduce your calorie intake and exercise more. If the patient is obese, weight loss is recommended. Alcohol and tobacco must be completely eliminated.

              However, pharmacology can also be used, particularly if the hypertension is due to more difficult to control factors such as age or family history and lifestyle changes have not taken effect. Initially, drug treatment begins with a single drug, although in some cases this measure is not enough and it is necessary to combine several of them to control blood pressure. The main drugs used in the treatment of high blood pressure are:

              • Diuretics (thiazides, chlorthalidone and indapamide).
              • Beta-blockers.
              • Calcium antagonists.
              • Angiotensin converting enzyme inhibitors (ACE inhibitors).
              • Angiotensin II receptor antagonists (ARA-II).

              Despite the fact that there are treatments and lifestyle changes that help improve the condition, the truth is that High blood pressure is a chronic and relapsing disease which, although modifiable, must be very well kept in check. Unfortunately, 90% of diagnosed patients do not follow doctors’ recommendations to treat it and 50% do not follow the treatments prescribed to them at all.

              As this is a disease that has been around for many years, patients tend to relax over time, taking your doctor’s instructions less seriously. This means that all the progress made over the years will be wasted in a few months, with serious consequences. The main one is that hypertension will be poorly controlled, leading to an increased risk of cardiovascular problems such as myocardial infarction, kidney failure, strokes or leg circulation.

              Bibliographic references

              • Calhoun, DA, Jones, D., Textor, S., et al. (2008). Resistant hypertension: diagnosis, evaluation and treatment. A scientific statement from the American Heart Association Professional Education Committee of the Council for High Blood Pressure Research. Hypertension, 51(6), 1403-1419.
              • Diao, D., Wright, JM, Cundiff, DK and Gueyffier, F. (2012). Pharmacotherapy for mild hypertension. The Cochrane Database of Systematic Reviews, 8(8), CD006742.
              • Henry, CJ, Nemkov, T., Casás-Selves, M., Bilousova, G., Zaberezhnyy, V., Higa, KC,… DeGregori, J. (2017). Dietary folate insufficiency and folic acid supplementation also impair metabolism and compromise hematopoiesis. Haematologica, 102 (12), 1985–1994. doi:10.3324/hematol.2017.171074.
              • Lackland, DT and Weber, MA (2015). Global burden of cardiovascular disease and stroke: hypertension in the heart. The Canadian Journal of Cardiology, 31(5), 569–571.
              • O’Leary, F., & Samman, S. (2010). Vitamin B12 in health and disease. Nutrients, 2(3), 299–316. doi:10.3390/nu2030299.
              • Omar, HR, Komarova, I., El-Ghonemi, M., Fathy, A., Rashad, R., Abdelmalak, H. D, Camporesi, EM (2012). Licorice abuse: it’s time to send a message of warning. Therapeutic Advances in Endocrinology and Metabolism, 3(4), 125–138. doi:10.1177/2042018812454322.

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