High Blood Pressure

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High blood pressure (hypertension) is responsible for approximately 50% of cardiovascular incidents, leading to nearly 10 million deaths annually, making it one of the main risk factors for premature death (before the age of 65).

A Growing Issue

Currently, over 30% of the global population suffers from hypertension, a number that continues to rise.

In the early 2000s, this rate was around 25%, and projections for the coming years indicate an upward trend.

Major Consequences

Hypertension is involved in about 50% of severe cardiovascular incidents, contributing to nearly 10 million deaths each year.

It stands as the leading risk factor for premature death, affecting people before the age of 65.

In Canada

In Canada, hypertension affects more than 45% of women and 40% of men over the age of 60 who are currently undergoing treatment.

The Tip of the Iceberg

It is important to note that many people with high blood pressure are not on treatment, while others remain unaware of their condition due to lack of diagnosis.

This situation makes hypertension an even greater concern, intensifying the public health challenge associated with this condition.

Pressure in the Pipes

Blood pressure functions similarly to water pressure in a house’s plumbing system.

It ensures a steady and consistent flow of blood throughout the body, allowing organs to receive oxygen and nutrients regardless of their location.

Previous Chapter: Understanding Blood Pressure

The Blood Pressure Monitor

The device used to measure blood pressure is known as an oscillometer, but it’s commonly referred to as a blood pressure monitor. This device displays three numbers.

Example Reading:
If your blood pressure monitor shows 124-78, 72, each number has a specific meaning:

  • 124 mmHg: The systolic blood pressure, representing the peak pressure during the heart’s contraction.
  • 78 mmHg: The diastolic blood pressure, indicating the minimum pressure between two beats, when the heart is at rest.
  • 72: The heart rate, or the number of heartbeats per minute.

When to Diagnose High Blood Pressure

A diagnosis of hypertension is not based on a single reading but rather on multiple measurements taken over weeks or months.

Blood pressure consistently above 135/85 mmHg when measured at home is now considered a health risk.

For diabetic patients, blood pressure readings above 130/80 mmHg in a medical setting are concerning, with a target of around 125/75 mmHg or lower recommended for home measurements.

Proactive Management and Continuous Monitoring

Once hypertension is diagnosed, it is crucial to adhere to the prescribed treatment and regularly monitor blood pressure levels.

Remember that hypertension is common: about one-third of the adults around you live with this condition.

White Coat Syndrome

For some patients, measuring blood pressure in a medical office can be problematic. This temporary elevation is often due to unconscious stress associated with the medical environment.

Although many patients claim they don’t feel particularly anxious during the measurement, white coat syndrome affects nearly one in five people.

Masked Hypertension

Opposite to white coat syndrome, masked hypertension occurs when blood pressure appears normal during medical visits but is elevated in familiar environments, such as at home.

The precise mechanisms behind this phenomenon remain unknown, but it appears to be more common than white coat syndrome, especially among those already diagnosed with hypertension and diabetic patients.

A Family Affair

Most individuals with high blood pressure develop it largely due to genetic predisposition.

Different Types of Hypertension

Hypertension can be classified as either essential or primary. In some cases, it stems from specific medical conditions, such as certain kidney or endocrine disorders, and is then referred to as secondary hypertension.

Essential Hypertension

This diagnosis is made when high blood pressure persists without an identifiable cause. It is the most common form of hypertension, often linked to family history.

Although this condition has been known for centuries, its exact origins remain poorly understood. Initially, it was thought to be mainly due to high sodium intake, but research has shown a complex interaction of various factors.

Age, male gender, heredity, alcohol consumption, smoking, diabetes, stress, a sedentary lifestyle, and obesity are all factors that increase the risk of essential hypertension by interacting with each other.

Secondary Hypertension

On rare occasions, an underlying cause for high blood pressure can be identified, referred to as secondary hypertension.

Underlying causes include certain kidney diseases, adrenal gland disorders, and pregnancy-related hypertension.

A rarer cause is a congenital malformation of the thoracic aorta, especially in adolescents or young adults, particularly if there is a notable difference in blood pressure between the two arms. Normally, blood pressure is slightly higher in the right arm (about 5 mmHg) than in the left.

Certain classes of medications can also increase blood pressure, especially in individuals already diagnosed with hypertension. Nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen and ibuprofen, available over-the-counter, are common examples. Cortisone is another medication that may cause an increase in blood pressure.

Long-Term Issues

Prolonged high blood pressure can damage arteries over time and lead to serious health consequences.

Major Complications

High blood pressure is a leading risk factor for:

  • Sudden death,
  • Myocardial infarction (heart attack),
  • Strokes.

 

It also contributes to the development of conditions such as heart failure, kidney failure, and atrial fibrillation in individuals who either do not receive adequate treatment or whose condition is not effectively managed.

The Impact of Therapy

Treating high blood pressure has a significant impact. It reduces the risk of heart failure by 50%, lowers the likelihood of stroke by 40%, and decreases the incidence of myocardial infarction by 15%.

These figures highlight the importance of managing hypertension to prevent severe complications.

Possible Catastrophic Events

High blood pressure acts somewhat like excessive pressure in the pipes of your home. Although it is often asymptomatic in the early years, it can lead to sudden and severe consequences.

Just as high pressure can cause water leaks, hypertension can result in serious complications, such as heart attack, stroke, or even sudden death.

The Silent Killer

Hypertension is often referred to as a “silent killer” because of its discreet and insidious nature.

Often Symptom-Free

In most cases, hypertension does not exhibit symptoms.

If signs do appear, they are usually vague: headaches, dizziness, fatigue, or increased shortness of breath. It is also essential to note that any pain, regardless of its source, can temporarily raise blood pressure.

Identifying Aggravating Factors

Once hypertension is diagnosed, the physician assesses the presence of additional risk factors that could worsen the condition. These include diabetes, high cholesterol levels, a sedentary lifestyle, obesity, smoking, and a family history of heart disease.

The likelihood of a cardiac event or stroke increases proportionally with the number of risk factors present.

Additional Tests to Conduct

Additional tests may be needed to assess the impact of high blood pressure.

An electrocardiogram (ECG) records the heart’s electrical activity, helping to identify any abnormalities linked to elevated blood pressure. Blood tests are also conducted to check for any organ damage caused by hypertension.

These tests enable the physician to gain a clearer understanding of the condition’s impact and adjust treatment accordingly.

Monitoring Blood Pressure at Home

The measurement of the blood pressure must be taken twice a day.

Blood pressure measurement is to be made twice, first thing in the morning and a few minutes apart, before taking any medication, coffee or breakfast. It should be checked twice also before going to bed, a few minutes apart.

You must record each of the 2 measurements, even those that seem too high or too low or are not to your liking. If you choose to test your blood pressure a third time, you do not have to write down these results. When the day is over, average these 4 values.

The average of the last 6-day measurements before your medical appointment gives a reasonably accurate estimate of the real values of your blood pressure.

Ambulatory Blood Pressure Monitoring (ABPM)

In certain cases, ambulatory blood pressure monitoring (ABPM) may be prescribed to measure blood pressure continuously over a 24-hour period.

This device, attached to the arm and waist, records blood pressure at regular intervals, providing a comprehensive view of blood pressure fluctuations throughout the day and night.

Non-Pharmacological Treatment Measures for Hypertension

Adopting Healthy Lifestyle Habits

It has been demonstrated that our daily habits can significantly influence the onset and progression of cardiovascular diseases.

Adopting healthy behaviors, such as quitting smoking, engaging in regular physical activity, consuming a diet rich in fruits, vegetables, and fibers, effectively managing stress, and ensuring restorative sleep is crucial for the prevention of cardiovascular diseases.

Suggested reading: Healthy lifestyle habits

Support is Available

Making and maintaining these lifestyle changes can be challenging, but professionals are available to support you in this process toward better blood pressure management.

Medication for Hypertension

When Medication Becomes Necessary

If blood pressure remains elevated despite lifestyle changes, medication is often required to reach a healthy level. It’s common for multiple medications to be used in combination for optimal control.

Types of Medications Available

Several classes of medications are available for hypertension, and the doctor will aim to select the most effective options with the fewest possible side effects.

Monitoring Treatment

It is essential to take medication regularly, even if you feel well. Be sure to renew prescriptions on time to avoid any interruptions in treatment.

Health Benefits of Treatment

Effective treatment of hypertension can extend life by reducing the risks of stroke, myocardial infarction, heart failure, and angina, while also preventing kidney complications.

Diligence: A Key Factor

Even in the absence of symptoms, untreated hypertension can progress and lead to complications.

Regular follow-ups are essential to adjust treatment as needed and to monitor for any signs of angina or other concerning symptoms.

Goal: Control Hypertension

Rigorous follow-up allows for effective hypertension management, preventing serious complications and ensuring a better quality of life.

Hypertension can and should be controlled!