One in five people suffer from high blood pressure. The medical name for high blood pressure is hypertension. Why do people suffer from high blood pressure and what can be done about it? This medical methodology on hypertension discusses, among other things, the causes, the consequences of high blood pressure and what can be done about it.
Introduction
Hypertension is the medical term for high blood pressure.
- Hyper = to a very strong degree
- Tension = pressure
Epidemiology
Of all adults in the Netherlands aged 20-60 years, 1 in 5 has elevated blood pressure. In the Netherlands, with a population of 16 million, this means that more than 1 million people have hypertension. High blood pressure rarely occurs in children (exceptions are children with obesity, for example) and in the elderly it is normal to have higher blood pressure. High blood pressure is most common in men up to the age of 55, from 55 to 75 the percentage of women with high blood pressure is higher (after menopause) and in the age category 75+ the percentage is much higher in women than in men. . According to the WHO (World Health Organization), 62% of strokes and 49% of heart attacks are caused by high blood pressure.
Etiology (causes)
In 95% of cases there is no clearly identifiable cause. This is called essential or primary hypertension . In 5% of cases, a cause can be identified. This is called secondary hypertension .
The causes of secondary hypertension can be:
- kidney diseases
- hormone balance disorder
- narrowing of the aorta
- birth control pill
- hyperinsulinemia (metabolic disorder in which insulin levels in the blood are chronically elevated)
There is often no clear cause for hypertension, but a number of factors can be mentioned that increase the risk:
- smoking
- overweight
- excessive use of licorice (salt)
- too much salt
- little exercise
- stress
- excessive use of alcohol
- too high cholesterol
- diabetes
- heredity
- use of certain medications
- eat a lot of saturated fats
Pathophysiology
The heart in the body alternately contracts and relaxes, creating pressure in the blood vessels. The force with which the heart pumps blood into the blood vessels affects blood pressure.
- Systolic pressure → upper pressure → the heart contracts
- Diastolic pressure → negative pressure → the heart relaxes
Symptomatology
In the first 15 to 20 years, high blood pressure causes few or no complaints, it is a dormant condition. In the meantime, various organs can become damaged, such as:
- eyes
- heart
- kidneys
- brain
Symptoms that may occur include:
- dizziness
- headache
- seeing spots before the eyes
- tinnitus
- palpitations
- nosebleeds
- shortness of breath
- cramps
- muscle weakness
The symptoms are often only noticed when there is extremely high blood pressure.
Research/diagnostics
Blood pressure can be measured with a mercury sphygmomanometer or a spring manometer. A cuff is placed on the upper arm and is then inflated until the arteries in the arm are completely closed (temporarily no more blood flows through the arm, which after some time can be experienced as a tingling feeling, as if your arm is asleep) When not
on If the arms can be measured, a measurement can also be made on the leg. Using a stethoscope, you can listen to the sounds the blood makes as it flows through the arteries. When the doctor or nurse slowly deflates the cuff, this sound can be heard through the stethoscope. These are the so-called Korotkow tones.
Measuring blood pressure using a spring manometer / Source: Caremate, Wikimedia Commons (CC BY-SA-3.0)
The doctor can read on the meter at which value he heard the tones (systolic number). The cuff is then slowly emptied, when the tones are no longer audible, the blood can flow freely through the veins again. The value when the tones were no longer audible (diastolic number) is recorded together with the systolic number. The measurement is always taken several times at different times when the patient is at rest. So don’t cycle hard after 10 minutes because then your blood pressure will be higher.
Blood pressure is expressed in millimeters of mercury (mmHg)
- An optimal blood pressure value is: <120/80 mmHg
- On average, blood pressure is below 140/90 mmHg (Dutch Association of General Practitioners)
- There is hypertension: >140/90 mmHg (up to 60 years)
- There is hypertension: >160/90 mmHg (over 60)
- Different values apply for people with diabetes, kidney disease, and people who are pregnant.
If it has been determined that there is indeed high blood pressure, additional research will be necessary before treatment can be started. The blood and urine will then be examined, an ECG (ECG) will be made and an X-ray of the heart and lungs. This is necessary to determine whether it is a primary or secondary form of hypotension and to see whether any damage has already been done.
Therapy
Non-drug therapy:
The adverse lifestyle and eating habits that people have must change, such as quitting smoking, eating healthy, exercising sufficiently, losing weight, etc.
Drug therapy:
If drug therapy has been chosen, the patient will have to take his medication one or more times a day.
There are 7 groups of medications for hypertension:
- Diuretics (water tablets)
- Beta blockers
- Calcium channel blockers
- ACE inhibitors
- Angiotensin II antagonists
- Alpha blockers
- Centrally acting antihypertensive agents
Of these groups, diuretics and beta blockers are most commonly prescribed by the doctor.
If a prescribed medication does not help enough, the dose can be increased or another medication from a different group can be added.
Prognosis/course
High blood pressure in itself is not life-threatening, but it can cause damage to the heart and blood vessels. This places the patient at an increased risk of cardiovascular disease, heart failure, kidney failure, stroke, heart attack or eye damage. This risk can be reduced by using both medicinal and non-medicinal therapy. The medication is lifelong, when you stop taking the medication, the blood pressure will rise again and the risks increase again. Regular blood pressure checks are necessary. In these ways, the medication can be adjusted if changes occur.
Complications
The prescribed medication can cause various side effects. This strongly depends on the type of medication.
If blood pressure is too high for a long period of time, it can damage many organs:
- Heart (narrowing of the coronary arteries which can cause a heart attack)
- Blood vessels (the blood vessels can become dilated and have a chance of rupturing)
- Brain (a cerebral infarction or cerebral hemorrhage)
- Legs (a narrowing in the blood vessels that can cause pain when walking, called clatter legs)
- Kidneys (damage to the kidneys, causing it to function less effectively)