What is hypertension? And what causes it?

Hypertension, also known as high blood pressure, is a common condition in which the force of blood against the walls of the arteries is consistently too high.

Blood pressure is measured using two numbers: systolic pressure, which is the pressure in the arteries when the heart beats, and diastolic pressure, which is the pressure in the arteries when the heart is at rest between beats. A normal blood pressure reading is typically around 120/80 mmHg. However, a blood pressure reading of 130/80 mmHg or higher is considered hypertension.

There are several factors that can contribute to the development of hypertension, and some of the most common causes of hypertension include:

Genetics: Hypertension can run in families, suggesting that there may be a genetic component to the condition.

Lifestyle factors: Certain lifestyle factors such as a diet high in salt, alcohol consumption, lack of physical activity, and smoking can increase the risk of developing hypertension.

Age: As people age, their risk of developing hypertension increases. Medical conditions: Certain medical conditions such as diabetes, kidney disease, and sleep apnea can increase the risk of developing hypertension. Stress: Chronic stress can cause an increase in blood pressure.

Medications: Certain medications such as birth control pills, decongestants, and nonsteroidal anti-inflammatory drugs (NSAIDs) can raise blood pressure levels.

It’s important to note that: hypertension may not cause any noticeable symptoms, which is why it’s often referred to as the “silent killer”, However, if left untreated, hypertension can lead to serious health complications such as heart disease, stroke, and kidney failure.

Regular blood pressure checks and lifestyle modifications can help to prevent and manage hypertension.

ESC Guidelines for Hypertension

The European Society of Cardiology has developed comprehensive guidelines for the management of hypertension.

Guidelines provide evidence-based recommendations for the prevention, diagnosis, and treatment of hypertension, with the goal of improving patient outcomes and reducing the risk of complications.

Here are some of the key aspects of the ESC guidelines for hypertension:

1.Blood pressure targets:

The ESC guidelines recommend a target blood pressure of less than 140/90 mmHg for most people with hypertension. However, for people with certain medical conditions or at high risk of cardiovascular disease, a lower target of less than 130/80 mmHg may be recommended.

2.Lifestyle modifications:

The ESC guidelines recommend lifestyle modifications such as reducing salt intake, increasing physical activity, maintaining a healthy weight, limiting alcohol consumption, and quitting smoking as first-line therapy for hypertension.

3.Medications:

The ESC guidelines recommend medications such as diuretics, ACE inhibitors, ARBs, and calcium channel blockers as first-line therapy for hypertension in most people.

Combination therapy may be recommended for people with more severe hypertension or those who do not respond to initial monotherapy.

4.Diagnosis and monitoring:

The ESC guidelines recommend regular blood pressure monitoring and diagnostic tests such as blood tests, electrocardiogram (ECG), and echocardiography to assess cardiovascular risk and monitor the effectiveness of treatment.

5.Special populations:

The ESC guidelines provide specific recommendations for the management of hypertension in pregnant women, children, older adults, and people with comorbid conditions such as diabetes and chronic kidney disease.

6.Patient education:

ESC guidelines emphasize the importance of patient education and self- management in the prevention and management of hypertension. Patients are encouraged to be actively involved in their care, including monitoring their blood pressure at home, adhering to medications and lifestyle modifications, and reporting any symptoms or concerns to their healthcare provider.

Note that: the ESC guidelines for hypertension are regularly updated to reflect the latest research and clinical evidence, healthcare providers may use these guidelines as a framework for developing individualized treatment plans for their patients with hypertension.

If you have been diagnosed with hypertension or are concerned about your blood pressure, it’s important to speak with your healthcare provider to develop a plan that is right for you.

Prevention of hypertension

Prevention of hypertension is key to reducing the risk of serious health complications such as heart disease, stroke, and kidney failure.

While some risk factors for hypertension such as age and genetics cannot be controlled, there are several lifestyle modifications that can help to prevent or delay the onset of hypertension.

Here are some of the most effective strategies for preventing hypertension:

Maintain a healthy weight: Being overweight or obese can increase the risk of hypertension.

Maintaining a healthy weight through a balanced diet and regular physical activity can help to reduce this risk.

Follow a healthy diet: Eating a diet rich in fruits, vegetables, whole grains, and lean proteins can help to reduce the risk of hypertension.

Limiting salt intake to less than 2,300 milligrams per day (or less than 1,500 milligrams per day for people at high risk of hypertension) can also help to lower blood pressure.

Exercise regularly: Regular physical activity can help to reduce blood pressure and improve overall cardiovascular health.

Aim for at least 150 minutes of moderate-intensity exercise per week or 75 minutes of vigorous-intensity exercise per week.

Limit alcohol consumption: Drinking too much alcohol can increase the risk of hypertension (The recommended limit is no more than one drink per day for women and no more than two drinks per day for men).

Quit smoking: Smoking can raise blood pressure and increase the risk of heart disease and stroke, and quitting smoking can help to reduce this risk. Manage stress: Engaging in stress-reducing activities such as yoga, meditation, or deep breathing exercises can help to manage stress and reduce the risk of hypertension.

Get enough sleep: Sleep is important for overall health, including blood pressure regulation (Aim for at least 7-8 hours of sleep per night).

Monitor blood pressure regularly: Regular blood pressure checks can help to identify hypertension early, allowing for prompt treatment and management.

It’s important to note that: prevention of hypertension may not always be possible, and some people may still develop hypertension despite following these strategies.

However, by adopting healthy lifestyle habits, you can significantly reduce your risk of developing hypertension and other cardiovascular diseases.

Diagnosis of hypertension

Diagnosis of hypertension involves measuring blood pressure levels and assessing cardiovascular risk factors.

Blood pressure is typically measured using a sphygmomanometer, which consists of an inflatable cuff that is wrapped around the upper arm and a pressure gauge that measures the pressure in the cuff.

Here are some of the key aspects of the diagnosis of hypertension: Blood pressure measurement:

Blood pressure should be measured at least once a year in adults who are at low risk of hypertension.

For people with high blood pressure or at high risk of hypertension, blood pressure should be measured more frequently.

Blood pressure readings should be taken in both arms and the average of two or more readings should be used to determine blood pressure levels. Diagnostic criteria:

Hypertension is typically diagnosed when blood pressure readings are consistently higher than 130/80 mmHg, however, the diagnostic criteria may vary depending on individual risk factors and comorbid conditions.

Cardiovascular risk assessment:

In addition to measuring blood pressure, a healthcare provider may also assess other cardiovascular risk factors such as age, gender, family history, smoking status, cholesterol levels, and diabetes status.

This assessment helps to determine the overall risk of cardiovascular disease and inform treatment decisions.

Diagnostic tests:

In some cases, diagnostic tests such as blood tests, electrocardiogram (ECG), and echocardiography may be used to assess cardiovascular risk and identify underlying conditions that may be contributing to hypertension. Ambulatory blood pressure monitoring:

In some cases, a healthcare provider may recommend ambulatory blood pressure monitoring (ABPM) which is a method to measure your blood pressure on a continuous basis for 24 hours. Your blood pressure is measured even as you sleep. The ongoing data helps your healthcare provider get a more accurate picture of your blood pressure numbers.

Which involves wearing a portable blood pressure monitor that takes readings over a 24-hour period.

ABPM can provide a more accurate assessment of blood pressure levels and help to identify “white coat hypertension,” which is when blood pressure readings are elevated in a healthcare setting but normal outside of it.

Home blood pressure monitoring: Home blood pressure monitoring involves using a home blood pressure monitor to measure blood pressure at regular intervals, this can help people with hypertension to monitor their blood pressure levels and track the effectiveness of treatments.