THE HEALTH BLOG High Blood Pressure: Common Causes, Diagnosis, And Treatment NOVEMBER 02, 2020 – BY DR. Miguel Antonatos

I f you are looking for information about high blood pressure, chances are that you or your loved one have been recently diagnosed with it. Also called hypertension, high blood pressure is a condition that is characterized by an increased value of blood pressure in your body. The Center for Disease Control and Prevention has stated the normal range of blood pressure to be less than 120/80.

However, there are different categories of high blood pressure conditions.

Elevated BP – The systolic BP ranges from 120 to 129 mmHg, while the diastolic BP remains less than 80 mmHg. Generally, clinicians do not give hypertension medication to patients with elevated BP. Rather, they recommend lifestyle modifications to bring your blood pressure down while also keeping a blood pressure check.

Stage 1 hypertension – The blood pressure range between 130-130/80-89 mmHg is categorized as Stage 1 hypertension.

https://www.cdc.gov/bloodpressure/about.htm#:~:text=High%2520blood%2520pressure%252C%2520also%2520called,blood%2520pressure%2520(or%2520hypertension).

Stage 2 hypertension – A blood pressure of 140/90 mmHg or higher comes in stage 2 hypertensive type.

Hypertensive crisis – Considered as a medical emergency, the BP greater than 180/120 mmHg is the hypertensive crisis. You should immediately visit emergency care if you or a loved one develops symptoms of headache, shortness of breath, chest pain, or visual changes with high blood pressure.

What Are The Common Causes Of High Blood Pressure? The causes of hypertension depend upon its type. These can be primary or secondary.

Primary hypertension

Also called essential hypertension, primary hypertension progresses over time. It has no recognizable cause and is commonly found in many people. Studies haven’t clearly identified the mechanisms behind primary hypertension. However, several factors, when combined, are considered to give rise to the condition. These factors include:

Genes

Offsprings of parents diagnosed with hypertension are more likely to develop high blood pressure. This is because they have a higher genetic predisposition to hypertension due to their inherited genetic makeup.

Physical changes

Any underlying changes in your body can gradually give rise to other health issues like high blood pressure. Any alterations in kidney function with age, for example, may also disturb the natural salt and fluid balance of your body, thereby, elevating your body’s blood pressure.

Environment

Environmental factors contributing to high blood pressure over time, include unhealthy lifestyle habits such as reduced physical activity, poor diet and routine as well as lack of exercise can affect your blood pressure balance system. Being overweight, overeating, too much drinking, and smoking increase the risk of developing hypertension.

Secondary Hypertension

Secondary hypertension is a condition that develops rapidly and can have a greater severity as compared to primary hypertension. It can develop secondary to conditions like:

• Side effects of medication

• Long-term or overuse of alcohol • Thyroid problems • Kidney disease • Obstructive sleep apnea • Congenital heart diseases • Using illegal drugs • Adrenal gland issues • Certain endocrine tumors

Sleep apnea plays a significant role in high blood pressure. Source: Freepik.com

How Do You Feel When You Have High Blood Pressure? In general, hypertension is considered to be a condition without any salient symptoms. Mostly, it doesn’t have any manifestations until it causes an emergency condition like hemorrhage. This is why it is called a silent killer. Many people won’t experience any symptoms. However, some people who are suffering from chronic hypertension may feel a few characteristic symptoms, such as:

• dizziness • headache • chest pain • shortness of breath • nosebleeds • flushing • visual disturbances • blood in the urine

https://www.freepik.com/free-photo/beautiful-asian-young-woman-sitting-bed-take-sleeping-pill-night-medicine-bedroom-unhealthy-sick-indian-female-suffers-from-insomnia-headache-depressed-girl-holds-antidepressant-meds_6139093.htm#page=1&query=insomnia&position=0

When these symptoms occur, you should immediately visit your doctor for prompt medical intervention. However, you shouldn’t wait for symptoms to appear to consult a doctor. Regularly check your blood pressure and keep a record, as hypertension is mostly symptomless yet can be fatal.

Management Of High Blood Pressure Diagnosis

High blood pressure can be diagnosed simply by taking a blood pressure reading. Generally, when you visit a doctor for a checkup, your BP is measured by the paramedical staff before you see your doctor. However, if your BP is not taken, you should ask for it.

Your doctor will not diagnose hypertension after a single reading. The clinician might ask you to keep a record of your blood pressure at home for a couple of days at different intervals in a day. This is because you might have a high BP due to a temporary environmental factor such as the stress and may not be persistent.

On the contrary, if your blood pressure consistently remains high, your physician may recommend other tests to identify other underlying conditions.

• Blood tests, including cholesterol screening: • Urinalysis • Cardiac function tests – electrocardiogram (ECG), echocardiogram, etc. • Ultrasound of your heart or kidneys

Along with these tests, your doctor might prescribe hypertension medication so prevent associated health complications and organ damage due to high blood pressure.

Treatment

The choice of treatment for high blood pressure varies between individuals depending upon the type of hypertension and the underlying cause.

Primary Hypertension

For primary hypertension, your doctor will suggest lifestyle modifications and dietary changes in order to deal with high blood pressure at first. Later, if this approach is less effective, then, hypertensive medications may be prescribed.

Secondary Hypertension

If any other underlying condition is identified that can be the cause of elevated BP, your doctor might treat that condition predominantly, while also managing your blood pressure check and adding hypertensive drugs when there’s a need.

Medication for high blood pressure include Diuretics, Beta-blockers, Angiotensin II receptor blockers (ARBs), angiotensin-converting enzyme (ACE) inhibitors, Alpha-2 agonists, and Calcium channel blockers. These medications work by various mechanisms; some work on the heart, others on Calcium channels.

Lifestyle modifications and home remedies can also help control high blood pressure.

1. Taking a healthy diet – to keep your cholesterol level low. These can contain a. Vegetables and fruits b. Whole grains c. Lean proteins, e.g. fish

2. Regular exercise – can help you stay physically active, reduce stress, maintain weight, reduce high BP and keep your heart healthy.

3. Lose weight – if you are obese, losing weight will help you reduce the cholesterol level; thus, you’re your arteries and heart and keep blood pressure in control.

4. Managing stress – practice meditation, deep breathing, yoga or tai chi to keep your stress levels low.

5. Adopt a healthy lifestyle – wake up early in the morning and go to bed on time at night. This will keep your overall body function in check and will not trigger blood pressure disturbances. Try to quit smoking if you smoke and reduce or eliminate alcohol intake.

Increasing Use Of Telemedicine For Patient Monitoring Aside from standard treatment in the doctor’s office, the use of telemedicine for patient monitoring for high blood pressure is a growing practice in the healthcare industry. Research has shown that there is no significant difference between the patient outcomes from in-office treatments or through telemedicine, including telephone, internet and video conferencing. If you are interested to learn more about Hypertension or searching to manage your hypertension through telemedicine, the physicians at Text2MD can assist you with any questions you might have and can help you improving your blood pressure with the latest technology.

Hypertension is a silent condition and can cause damage to your blood vessels and heart and pose a serious threat to your life if left untreated. Thus, early detection and prompt treatment are crucial. Regular blood pressure checks and maintaining records will save you from any untoward health emergency.

References:

1. Anonymous. The Facts About High Blood Pressure. Heart. Nov, 2017. https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure

2. Anonymous. Health Threats From High Blood Pressure. Oct, 2016. https://www.heart.org/en/health-topics/high-blood-pressure/health-threats-from-high-blood-pressure

3. Anonymous. High blood pressure (hypertension). Mayoclinic. May, 2018. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/symptoms-causes/syc-20373410

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4. Kim YN, Shin DG, Park S, Lee CH. Randomized clinical trial to assess the effectiveness of remote patient monitoring and physician care in reducing office blood pressure. Hypertens Res. 2015;38(7):491-497. doi:10.1038/hr.2015. https://pubmed.ncbi.nlm.nih.gov/25787041/

5. Anonymous. High Blood Pressure Symptoms and Causes. CDC. May, 2020. https://www.cdc.gov/bloodpressure/about.htm

6. Mayo Clinic Staff. 10 Ways To Control High Blood Pressure Without Medication. 2015. mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974

7. Anonymous. Types of blood pressure medications. 2017. heart.org/HEARTORG/Conditions/HighBloodPressure/PreventionTreatmentofHighBloodPressure/Types-of-Blood-Pressure-Medications

https://pubmed.ncbi.nlm.nih.gov/25787041/https://www.cdc.gov/bloodpressure/about.htmhttps://www.cdc.gov/bloodpressure/about.htmhttp://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/high-blood-pressure/art-20046974