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Hypertension Causes, Symptoms and Treatment

The high blood pressure or high blood pressure, is characterized by an abnormally high pressure of the blood on the walls of arteries. In stressful situations or during physical exertion, it is normal for blood pressure to rise. But in people with hypertension, the tension remains high at all times , even at rest or in the absence of stress.

In the long term, high blood pressure is an important risk factor for many diseases.

  • Cardiac and vascular disorders (angina, myocardial infarction and stroke ). High blood pressure means that the blood exerts greater pressure on the artery walls, which makes them more fragile and increases the risk of the artery being blocked by atherosclerosis .
  • Heart failure. By imposing extra work on the heart, high blood pressure can cause depletion of the heart muscle.
  • Kidney (kidney failure) and eye problems ( retinal damage that may lead to loss of sight). Again, because of the weakening of the blood vessels.

Since high blood pressure is usually not accompanied by any symptoms , a significant number of hypertensives are unaware of their condition – this is why it is dubbed the “silent killer”.

Prevalence

According to the World Health Organization , 30% of men and 50% of women aged 65 to 75 have high blood pressure . Its frequency increases with age, but nowadays it affects younger and younger populations. According to Hypertension Canada, more than 9 out of 10 Canadians will suffer from high blood pressure if they do not change their lifestyle . If the situation does not improve, it is estimated that in 2025, the number of hypertensives in the world will have reached 1.56 billion individuals, an increase in prevalence of 60%.

Types of high blood pressure and their causes

  • Primary (or “essential”) hypertension accounts for about 90% of cases. It is caused by a multitude of factors whose effects accumulate over the years. The main ones are related to age , heredity(especially for men) and lifestyle habits . For example, obesity, sedentary lifestyle, smoking, alcohol abuse and stress contribute to high blood pressure. This type of hypertension usually appears gradually from age 50, but can also occur before this age.

    High salt intakeis also associated with a rise in blood pressure. Now, according to a survey conducted by Statistics Canada, more than 85% of men and 60% of women have a salt or sodium intake exceeding the recommended upper limit of 2300 mg per day. See the complete table of the maximum tolerated intake of sodium .

  • The secondary hypertension may result from another health problem, such as a kidney or endocrine problem or birth defect of the aorta. It can also come from frequent use of certain drugs , for example anti-inflammatories, which create a retention of water and salt, bronchodilators, which have a stimulating effect on the heart and nasal decongestants, because of the ephedrine they contain (a substance whose effect resembles that of adrenalin secreted under stress). It can also come from the use of illegal drugs, such as cocaine and amphetamines. Secondary hypertension appears more suddenly and blood pressure is often higher.

Better understand the measurement of blood pressure

The blood pressure consists of systolic and diastolic pressures, which are measured in millimeters of mercury, or mmHg .

  • The systolic pressure is the pressure of the blood when the heart contracts and sends the blood into the arteries. It ensures blood supply throughout the body.
  • The diastolic pressure is the pressure that continues to exert on the arteries between each contraction. At this point, the heart relaxes and regains its volume, allowing the heart chambers to fillwith blood. This pressure tends to increase with age, but past the age of 60, it gradually decreases due to the weakening of the blood vessels of the body.

Thus, when one speaks of a tension of 120/80, 120 corresponds to the systolic pressure, and 80 to the diastolic pressure.

Diagnostic of Hypertension

Before making a diagnosis of high blood pressure , the doctor measures the blood pressure a few times, during successive visits. Indeed, it can vary during the day depending on the activities, and vary from one time to another. It is quite common that, under the effect of stress or nervousness, the tension climbs significantly when a patient enters the office of his doctor and his tension goes down when it comes out. This is called “white coat syndrome”. To avoid this type of reaction, the doctor can suggest to the patient to measure himself blood pressure, at home, using a blood pressure monitor . The doctor can also prescribe an ambulatory blood pressure monitor (ABPM) to the patient.MAPA is a compact device that records the measurement of blood pressure at specific times over a 24-hour period.

Once the reliable values ​​are obtained, the doctor can make a diagnosis: a person whose pressure is equal to or greater than 140/90 suffers from high blood pressure . It should be noted that people with diabetes or kidney disease should ideally maintain a blood pressure of no more than 130/80 .

The table of blood pressure levels that follows presents the standards in force in North America and England . They set the normal voltage to  120/80 or less, and the optimal voltage to  115/75 . This classification applies to adults who do not take medication to treat high blood pressure and who do not have diabetes or kidney disease. In Europe, the voltage is considered optimal if it is less than 120/80.

Level of blood pressure  Measurement of systolic pressure    Measurement of diastolic pressure 
optimal  115 mmHg AND 75 mmHg
par  less than 120 mmHg AND less than 80 mmHg
prehypertension  120-139 mmHg OR 80-89 mmHg
high 

– Light stage

– Moderate stage

– Advanced stage

 

140-159 mmHg

160-179 mmHg

180 mmHg and more

 

OR

 

90-99 mmHg

100-109 mmHg

110 mmHg and more

Note
If the measurement of systolic and diastolic pressure is at two different levels, the physician considers the level corresponding to the higher value to assess the state of the blood pressure.

Symptoms of high blood pressure

The blood pressure is usually asymptomatic, that is to say, it does not cause any symptoms. However, very high (moderate or advanced) and sustained blood pressure can cause the following symptoms.

  • Headaches with fatigue (these headaches are often located at the nape of the neck and occur very early in the morning).
  • Vertigo or tinnitus.
  • Of palpitations .
  • Bleeding nose
  • Confusion or drowsiness.
  • Numbness or tingling in the feet and hands.

People at risk for Hypertension

  • People over 55 years old. Blood pressure tends to increase from this age.
  • In young adults, the percentage of hypertensives is higher in men than in women. Among people aged 55 to 64, the percentage is roughly the same for both sexes. For people over 64, the percentage is higher among women.
  • Americans of African descent.
  • People with a family history of early hypertension.
  • People with certain diseases, such as diabetes, sleep apnea, or kidney disease.

Risk factors

  • General obesity, abdominal obesity and excess weight 76 .
  • A diet rich in salt and fat and low in potassium.
  • An excessive consumption of alcohol.
  • Smoking.
  • Physical inactivity
  • The stress.
  • Regular consumption of black licorice or black licorice products, such as non-alcoholic pastis.

Prevention of high blood pressure

Why prevent?
  • Because the risk of cardiovascular disorders doubles every time the systolic pressure increases by 20 mmHg and the diastolic pressure increases by 10 mmHg.
  • Because controlling blood pressure reduces the risk of stroke by 35% to 40%, and also reduces the risk of kidney disease, predominantly vascular dementia and vision problems.
  • Finally, because most people who adopt a healthy lifestyle will never have high blood pressure unless they have a hereditary component or secondary hypertension.
Screening measures
  • The measurement of your blood pressure should be done once a year by a family doctor (at the time of your periodic health examination).
Basic preventive measures
Maintain a healthy weight Ideally, combining regular physical exercise with good eating habits.

To be active. Practicing moderate-intensity physical activity for at least 20 minutes, 4 to 7 times a week, is recommended to prevent and treat cardiovascular disorders. In a study of more than 6,000 men aged 35 to 60, those who walked 11 to 20 minutes a day had reduced their risk of developing high blood pressure by 12% compared to those who did not. had not worked. Better yet, those who had walked more than 20 minutes a day had reduced their risk by 30%.

Pay attention to signs of chronic stress. The relationship between stress and hypertension is complex. However, everything indicates that the adrenaline secreted under stress raises the blood pressure because of its vasoconstrictor effect. When the stress becomes chronic, it damages in the long run the arteries and the heart. It is important to understand the source of stress so you can better control it.

Consume moderately very salty foods. Maintaining a good balance between sodium (contained in salt) and potassium (found in fruits and vegetables) is important for maintaining normal blood pressure. A sodium / potassium ratio of 1/5 would be ideal for maintaining good blood pressure. However, the average American diet contains 2 times more sodium than potassium.

It is advisable to limit sodium intake to a maximum of 2,300 mg per day. The latest recommendations from the Canadian Hypertension Education Program even advise a dietary sodium intake of 1,500 mg per day for adults aged 50 years or less, 1,300 mg per day for people aged 51 to 70 , and 1,200 mg per day if the age is greater than 70 years. A good way to reduce your sodium intake is to avoid all prepared foods, cold cuts, sauces, chips, fast food and some canned foods – including soups that are often very salty.

You must also be careful to eat foods rich in potassium . Cantaloupe, baked potato with peel, winter squash, bananas and cooked spinach are excellent sources.

Consume 2-3 fish meals a week. The omega-3 they contain provide cardiovascular protection, according to many studies (see the sheet Fish oils). Focus on oily fish such as herring, mackerel, salmon, sardines and trout.

Consuming fruits and vegetables in abundance . For their beneficial contribution in dietary fiber, antioxidants and potassium.

Limit your fat intake . To maintain good cardiovascular health.

Moderate your alcohol consumption . It is recommended a maximum of 2 drinks per day (2 beers or 2 glasses of wine) for men, and 1 consumption per day for women. Some will have an interest in completely abstaining from alcohol.

Medical treatments for high blood pressure

There is no treatment that can permanently cure high blood pressure. The treatment is intended to artificially lower blood pressure to prevent possible damage to organs (heart, brain, kidneys, eyes). When these organs are already affected, the treatment of arterial hypertension becomes even more important. In people with diabetes, treatment goals are higher because the risk of complications is increased.

In case of mild hypertension , adopting healthier lifestyle habits may be sufficient to normalize blood pressure.

In case of moderate or advanced hypertension , adaptation of lifestyle habits is essential; it will reduce the consumption of drugs. In any case, a comprehensive approach has an even greater effect on blood pressure than just medication.

pharmaceuticals

Several types of prescription medications can provide adequate control of high blood pressure. The majority of patients require 2 or more medications to reach blood pressure targets. Here are the most commonly used.

  • Diuretics . They promote the elimination of excess water and salt through the urine. There are several types, which have various modes of action.
  • Beta-blockers . They reduce the heart rate and blood ejection force through the heart.
  • Calcium inhibitors . They cause dilation of the arteries and decrease the cardiac effort.
  • Inhibitors of angiotensin converting enzyme . They also have a dilating effect on the arteries, countering the production of a hormone (angiotensin).
  • Blockers of angiotensin receptors (also called sartans). Like the previous drug class, they prevent angiotensin from contracting the blood vessels, but by another mechanism of action.
  • If treatment fails with a combination of several of these medications, the doctor may prescribe other drugs, such as alpha blockers, alpha-beta blockers, vasodilators, and centrally acting agents.
Warning. Some over-the- counter medications , such as nonsteroidal anti-inflammatory drugs (ibuprofen, for example), can increase blood pressure in people with hypertension. Always seek advice from your doctor or pharmacist before taking any medicine.

Food

For more tips, check out our special high blood pressure diet .

Diet

It is possible to lower your blood pressure by applying the following tips:

  • Consume a lot of fruits and vegetables .
  • Limit salt intake  : Studies indicate that 30% of hypertensive patients (especially those that react readily with sodium) can control blood pressure by reducing their salt intake 11 . If necessary, to cook or season, replace table salt, sea salt or fleur de sel with potassium salt.
  • Moderate alcohol and caffeine consumption (a maximum of 4 cups of coffee per day).
  • Increase its intake of omega-3 marine origin, especially found in mackerel, salmon, trout, herring and cod.
  • Eating garlic: Although its virtues are not proven rigorously, many doctors recommend garlic for its vasodilator properties (see Complementary Approaches).

The DASH diet

In the United States, the National Institutes of Health (NIH) advocates the Dietary Approaches to Stop Hypertension ( DASH ) regime . This diet is specially designed to treat high blood pressure. It is similar to the Mediterranean diet. Research has been shown to be effective and, in the case of mild hypertension, it can even replace the usual medications. Regular monitoring of this diet can reduce systolic blood pressure from 8 mmHg to 14 mmHg, and diastolic blood pressure from 2 mmHg to 5.5 mmHg.

In this diet, the focus is on fruits and vegetables , whole grains , nuts , fish , poultry and low-fat dairy products . The consumption of red meat, sugar, fat (and more particularly saturated fat) and salt is reduced.

                                 THE DIET DASH at 2,000 kcalories
Recommended portions per day Examples of portions
Whole grain cereal products
7 to 8
– 1 slice of whole grain bread
– 125 ml or 1/2 cup of fiber-rich dry cereal
– 125 ml or 1/2 cup of brown rice, high fiber pasta or whole grain cereals (barley, quinoa, etc.) .)
Vegetables
4 to 5
– 250 ml lettuce or other hardwoods
– 125 ml or 1/2 cup vegetables
– 180 ml or 3/4 cup vegetable juice
Fruits
4 to 5
– 1 medium fruit
– 125 ml or 1/2 cup fresh, frozen or canned fruit
– 180 ml or 3/4 cup fruit juice
– 60 ml or 1/4 cup dried fruit
Low fat dairy products
2 to 3
– 250 ml or 1 cup of skim milk or 1%
– 180 ml or 3/4 cup of skim yogurt
– 50 g or 1 1/2 ounces of partly skimmed or skimmed cheese
Meat, poultry and fish
2 or less
– 90 g or 3 ounces of lean meats, poultry, fish or seafood
Fat
2 to 3
– 5 ml or 1 tsp. oil or margarine
– 5 mL or 1 tbsp. regular mayonnaise
– 15 ml or 1 tsp. mayonnaise reduced in fat
– 15 ml or 1 tsp. regular vinaigrette
– 30 ml or 2 tbsp. low calorie vinaigrette
Legumes, nuts and seeds
4 to 5 a week
– 125 ml or 1/2 cup cooked legumes
– 80 ml or 1/3 cup walnuts
– 30 ml or 2 tbsp. at the table of sunflower seeds
Snacks and sweets
5 a week
– 1 medium fruit
– 250 ml or 1 cup fruit yogurt
– 125 ml or ½ cup frozen yogurt
– 200 ml or 3/4 cup pretzels
– 125 ml or ½ cup fruit gelatin
– 15 ml or 1 tsp. maple syrup, sugar or jam
– 3 hard candies

Physical exercise

The cardiovascular type exercises (fast walking, running, biking, dancing, swimming) are recommended. It is suggested to do at least 20 minutes a day , but any physical exercise, even less intense, is beneficial. In the long term, regular physical exercise can reduce systolic pressure from 4 mmHg to 9 mmHg, even without weight loss.

However, be careful with exercises that require lifting weights (at the gym, for example). They become contraindicated when blood pressure is high.

In any case, it is best to seek the advice of your doctor before starting an exercise program. View our Be Active: The New Lifestyle! See also our Fitness series.

Weightloss

In case of excess weight , losing weight is the most effective way to reduce blood pressure. On average, losing 2 ½ kilograms (5 pounds) causes a decrease in systolic pressure of 5 mmHg and diastolic pressure of 2.5 mmHg.

Anti-stress measures

The stress , the impatience and hostility play an important role in the onset of hypertension. Some experts believe that stress can vary blood pressure by 10%. Many doctors recommend approaches such as meditation, relaxation or yoga. Practiced regularly (at least 2 or 3 times a week), these can give good results. Hypertension patients can hope to reduce their systolic pressure by 10 mmHg and their diastolic pressure by 5 mmHg, for example.

Along with these practices, we will avoid unnecessary hassles. It’s about learning to reduce lifestyle stressors: better time management, prioritizing, and so on.

See also the section on Complementary approaches.

In order to ensure a better follow-up and to help the doctor to adjust the treatment, it is recommended to measure his blood pressure from 1 to 2 times per week using a blood pressure monitor. To do this, you can get a device that will be first checked in a clinic to ensure its accuracy. At each reading, write down the values ​​obtained and inform your doctor at the next visit. Once the voltage is stabilized, it can be measured less frequently.

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