What does it mean if I have high blood pressure (hypertension)?

Symptoms of high blood pressure

High blood pressure can increase your risk of heart disease and stroke, however many people with high blood pressure don't have signs or symptoms and it can only be detected when a reading is conducted. A few people may exhibit symptoms such as:

• Shortness of breath
• Nosebleeds
• Headaches

However, these symptoms are not specific and usually only occur when the blood pressure has reached a life-threatening level. If you know that you suffer from high blood pressure and experience any of these symptoms, or a combination thereof, visit or call your doctor immediately.

Types of hypertension

There are two main types of hypertension. There is also prehypertension, which is basically a warning that you may be at risk for hypertension – view it as a warning sign.

Elevated blood pressure (Prehypertension)

If you have prehypertension, which is now known as elevated blood pressure, then your blood pressure reading is a systolic pressure between 120 to 129 mmHg and diastolic below 80 mmHg. Elevated blood pressure is seen as a precursor to more severe and chronic hypertension (high blood pressure) and should not be overlooked as it raises your risk of potential health complications.

Should you have elevated blood pressure then your treatment plan is likely to depend on lifestyle changes and not necessarily medications. Some lifestyle changes include:

• Diet – A healthy diet is vital to your health. There are a number of diets that may be recommended to you for elevated blood pressure, most doctors recommend an eating plan that cuts down on sodium (salt) intake and one that also involves a healthy amount of protein, fats and carbohydrates. It may be beneficial for you to see a dietitian for an eating plan that is specifically designed for you.
• Exercise – A study conducted in 2005 reported that just a moderate amount of exercise was viewed as more effective when it came to lowering blood pressure in those with elevated blood pressure in comparison to those with normal blood pressure. Exercise may be able to lower your systolic number by 4 to 9 mm Hg².
• Moderate alcohol consumption – Drinking small amounts of alcohol is unlikely to have a significant effect on your blood pressure, however, it is advised that you limit your alcohol intake to one to two drinks a day. Drinking moderately and responsibly will have positive effects on your blood pressure.
• Stress control – There are several studies that suggest that various relaxation techniques such as meditation and breathing exercise may lower blood pressure².
• Stop smoking tobacco products – While smoking only affects your blood pressure when you are actually smoking a cigarette or tobacco product, if you are smoking 20 to 30 cigarettes daily, then the duration of time in which your blood pressure is raised due to smoking will begin to accumulate, putting you at a greater risk for heart disease, stroke and other complications³.
• Medication – Some doctors may recommend that you take medications such as the angiotensin receptor blocker candesartan (Atacand) to prevent elevated blood pressure from progressing to hypertension, however, most doctors will recommend that you adhere to the above-mentioned lifestyle factors.

Primary (essential) hypertension

This type of high blood pressure doesn’t have a known cause and is believed to be linked to a poor diet, genetics and lack of physical activity. There are only treatments for this kind of hypertension, there is no cure.

Possible Causes and Risks

• Genetic factors
• Unhealthy diet
• Stress
• Being overweight – this increases vascular resistance as having more fatty tissue increases the amount of work the heart has to do in order to pump blood to the body.

Treatment

• Losing weight if one is overweight
• Eating a healthy diet with a good amount of fibre and potassium, as well as drink plenty of water. It will also help to eat whole grains, fish and low-fat dairy as well as fruits and vegetables.
• Exercising for at least 30 minutes a day.
• Limiting salt intake to 1,500mg per day.
• Quitting smoking.
• Limiting alcohol intake to one unit per day.
• Reducing stress levels.

There is also medication available such as:

• Beta-blockers like Metoprolol (Lopressor / Toprol XL)
• Calcium channel blockers
• Diuretics
• Renin inhibitors

These should be taken under the advisement of your doctor.

Long-term effects

Your doctor may need to put you on a variety of medications in order to find the right mix that works for you to lower your blood pressure. You will also need to make conscious, healthy choices to improve your lifestyle as this could result in you not even needing medication in future.

You have a good chance of naturally combatting your blood pressure condition just through diet and lifestyle. However, this is not to say that you should not consult with your doctor, it is always best to get a professional opinion.

Secondary hypertension

This type of blood pressure has a direct cause. It is generally caused by other medical conditions that normally affect the heart, kidneys or endocrine system. It can also occur during pregnancy.

Secondary hypertension is also something that does not have any specific symptoms, but if you have been diagnosed with high blood pressure by your doctor, it is important to know the following as these symptoms may mean you have secondary hypertension (please note: this is especially important for those who have been diagnosed with high blood pressure at a young age):

• High blood pressure that does not respond to any blood pressure medication (this is referred to as resistant hypertension).
• Your blood pressure reading is over 180/120.
• You experience a sudden onset of high blood pressure after the age of 55 or before the age of 30.
• You have no family history of high blood pressure – secondary hypertension is not linked to genetics.

Possible Causes and Risks

The biggest risk for having secondary hypertension is having a medical condition that causes the high blood pressure.

 There are several things that can cause secondary hypertension, these can include:

• Diabetes can damage the filtering system of your kidneys.
• Cushing's syndrome is a condition where the medication may cause secondary hypertension.
• Polycystic kidney disease is an inherited condition where cysts in the kidneys stop them from working properly and can raise blood pressure.
• Glomerular disease is where the kidneys filter waste and sodium by the use of tiny sized filters called glomeruli, if these do not work properly and become swollen, it might raise  blood pressure.
• Renovascular hypertension is caused by the narrowing of one or both of the arteries leading down to the kidneys.
• Aldosteronism is a condition where a tumour in the adrenal gland as well as an increased growth of the cells in the adrenal gland cause the glands to release a large amount of the hormone called aldosterone. This results in the kidneys retaining salt and water, and they will therefore lose a lot of potassium, spiking blood pressure.
• Thyroid disorders wherein the thyroid gland is overactive and this results in the thyroid producing too much of its hormones, which in turn, can cause the heart to beat faster than normal and ultimately raise blood pressure.
• Coarctation of the aorta is a defect present at birth. The body’s main artery, the aorta, is narrowed and forces the heart to pump at a higher pressure.
• Hyperparathyroidism is a condition wherein the parathyroid glands which regulate levels of calcium in the body secrete too much  parathyroid hormone. This causes calcium levels to rise and triggers a rise in blood pressure. The exact mechanism of how this conditions causes high blood pressure is still being debated, one thought is that it is due to kidney damage as the kidneys play a vital role in controlling blood pressure.
• Sleep Apnoea is often described as severe snoring, wherein breathing stops and starts during sleep, this causes a lack of oxygen which may result in damage to the lining of the blood vessel walls, stopping them from being effective in regulating blood pressure.
• Obesity is a large contributing factor to high blood pressure. The heavier one is, the more blood there is circulating in the body, putting more pressure on the artery walls which will increase blood pressure.
• Pregnancy may also cause high blood pressure.

There are many things that may cause your secondary hypertension, it is always best to consult with your doctor in order to treat any symptoms you may be experiencing. Medications and supplements such as painkillers, birth control pills as well as antidepressants may also cause secondary hypertension.

The most common cause of secondary hypertension is kidney disease, have a look at our article on this as well as the relevant articles to the above-mentioned diseases.

Possible complications

• Arterial damage which can lead to a heart attack or stroke.
• Increased blood pressure can cause the blood vessels to lose their strength, causing a bulge which could lead to an aneurysm.
• Having trouble with your memory from the high blood pressure affecting your ability to think.
• Metabolic syndrome is basically a condition where your body has a collection of metabolic disorders – disorders directly associated with your metabolism.
• Weak and narrow blood vessels in your kidneys which prevents them from working properly.
• Torn, narrowed, thickened or damaged blood vessels in your eyes which results in vision loss.

Other types of hypertension

There are various types of hypertension, read more about them in our articles on malignant and renal hypertension.

 

References

^{2. Harvard Health Publishing School. 2007. Prehypertension. Available: https://www.health.harvard.edu/heart-health/prehypertension-does-it-really-matter [Accessed 07.08.2019]}

^{3. University of Rochester. Managing Prehypertension Without Medicines. Available: https://www.urmc.rochester.edu/encyclopedia/content.aspx?contenttypeid=1&contentid=2221 [Accessed 07.08.2019]}