High blood pressure is also called a silent killer. Anyone with chronic high blood pressure does not notice the serious damage that their heart and blood vessels have to endure until the day it is too late. Adjusting or drastically changing lifestyle habits in time can prevent a lot of suffering and sometimes blood pressure-lowering medications are the appropriate route. Low blood pressure is the opposite: The patient can consider himself lucky, despite weakness and dizziness. Always keep track of your blood pressure.
- What is blood pressure?
- Measuring bloodpressure
- Raised blood pressure
- Decreased blood pressure
What is blood pressure?
The heart muscle contracts 60 to 80 times per minute. The heart pumps blood through the arteries and the force of this blood flow exerts pressure on the walls of the arteries, comparable to a tire with air being pumped into it. The higher this pressure, the more damaging it is to the walls of the arteries. If the force with which the heart pumps the blood through the circulation is greater than necessary to maintain this blood circulation, then we speak of high blood pressure. And that affects the entire body.
Blood pressure changes constantly. This varies from person to person and even in different parts of the body. For example, the blood pressure in the legs is higher than in the arms. One of the large arteries in the arm is used to measure blood pressure . Two types of pressure are measured, an upper and a lower pressure. The upper pressure is also called the systolic pressure , the blood pressure at the moment when the heart contracts when pumping out the blood. The negative pressure is also called the diastolic pressure . This pressure indicates the moment when the heart relaxes again to allow blood to flow in. The systolic pressure is always higher than the diastolic value. For example, if you hear that your blood pressure is 110 over 75, this means that the systolic pressure is 110 mm of mercury and the diastolic pressure is 75. This is within the normal range.
Measuring bloodpressure
Just as you probably have a modern wrist blood pressure monitor at home, the doctor often still works with the old-fashioned blood pressure monitor. It works as follows: The doctor pumps a soft rubber cuff around your upper arm until it constricts the blood flow. The cuff is then slowly deflated until the doctor, listening with the stethoscope, hears the blood returning to the large artery in the arm. This is the upper pressure. The air then continues to flow out of the cuff until the point is reached that the blood flows normally through the open artery again. This is the underpressure.
Raised blood pressure
High blood pressure, also called hypertension , is not a static condition, but its determination partly depends on the medical assessment for each individual. In older people, a blood pressure of, for example, 140/90 is normal, because it always rises somewhat with age. However, for younger people this blood pressure is used as the upper limit, while the upper margin for people over 60 is 160. Typically, a blood pressure of 120 over 80 is considered average. In tense situations, excitement, sports, talking or exertion, blood pressure rises. Body position also has an influence. However, if you are relaxed, a blood pressure of around 150 over 100 is cause for concern. A systolic pressure of 180 is called seriously elevated.
A single measurement never provides a definitive answer, which is why repeated measurements are always taken under various conditions and times each day to get a good picture. Home measurements are more reliable because there is no tension at doctors and in hospitals. If blood pressure remains elevated, further tests are performed such as an ECG, chest X-rays, and urine and blood tests to rule out kidney problems. The eyes can also be examined because the blood vessels in the retina can provide important information about the effects that (already) occur due to high blood pressure.
Causes of high blood pressure
High blood pressure is divided into ‘essential hypertension’ and ‘secondary hypertension’. Essential hypertension is high blood pressure that is elevated due to an unknown cause. This is the most common, especially in the Western world. The percentage of adults who have high blood pressure to some extent varies from ten to fifteen percent. Children are rarely affected and it is less common in women than in men. Sometimes the condition is familial.
Secondary hypertension is the result of a certain disease, including kidney diseases such as renal inflammation, congenital cystic kidneys and diseases of the adrenal glands. Pill use, medication (some painkillers and prednisone) and pregnancy can also negatively affect blood pressure, as can lifestyle habits such as too much salt intake, smoking and obesity. The nicotine in cigarettes narrows the vessels (vasoconstriction), which is of course undesirable. Sodium in salt also has a blood pressure-raising effect. A relatively large amount of sodium and a relatively small amount of potassium, as usually occurs in Western menus, causes the smooth muscle tissue of the blood vessels to contract more strongly. To continue pumping blood through the blood vessels, the heart will generate higher blood pressure.
If hypertension occurs during pregnancy, it must be treated because the function of the placenta decreases and important nutrients no longer reach the baby.
Symptoms of high blood pressure
If your blood pressure is elevated, you will usually not notice it. However, if blood pressure becomes dangerously high, symptoms such as headache, palpitations, tinnitus and/or a feeling of being unwell occur. In that case, malignant hypertension is usually present and medical intervention is required. Fortunately, this situation is quite rare.
Risks of high blood pressure
Even slightly elevated blood pressure can eventually cause damage and shorten lifespan. The heart and brain suffer most, but the kidneys, eyes and other organs can also be affected. If untreated, malignant high blood pressure can be fatal within eight months, because the increased pressure in the blood circulation forces the heart to do much more work, causing damage to the coronary arteries. A fatty material called atheroma adheres to these lesions, causing the veins to narrow and even close. A consequence of this situation is a thrombosis of the coronary arteries or heart insufficiency , which means that the heart is no longer able to pump sufficient blood, also called heart failure. Blood pools in the veins leading to the heart. Another risk is the occurrence of a stroke . In that case it concerns the veins that supply the brain with blood. A narrowing or blockage occurs, resulting in brain failure. Risks of developing a myocardial infarction, cardiac arrhythmias and angina pectoris are also increased. Finally, the kidneys can also fail. High blood pressure causes protein in the urine, which indicates kidney damage. Kidney tissue hardens, causing kidney function to deteriorate. Progressive kidney failure is the underlying cause of ten percent of high blood pressure deaths.
Medicines for high blood pressure
In many cases, lifestyle changes are enough to improve blood pressure. If this is not possible, the doctor will prescribe blood pressure lowering agents. These medications each have a different mechanism of action. The five main classes of antihypertensives are: ACE inhibitors, Beta blockers, Angiotensin II antagonists, Calcium channel blockers and Diuretics (water tablets). Sometimes a combination is given to lower blood pressure. Which group of drugs to choose from depends on the underlying cause of high blood pressure. If the above medications do not help enough, other means are often used to control blood pressure. These can be divided into three groups: Vasodilators, Alpha blockers and Centrally acting medicines.
Decreased blood pressure
While chronically elevated blood pressure is serious, chronically lower than average blood pressure is not. In most cases, it is also not noticed that the blood pressure is low, except in certain situations. The sudden drop in blood pressure due to a change in position is known to cause dizziness, weakness, light-headedness and fainting. This phenomenon is known as postural or orthostatic hypotension . It occurs, for example, when getting up from a lying or sitting position. It occurs because the blood vessels have to constrict to maintain normal blood pressure in the new position. This process is carried out by a reflex of the nervous system. If this reflex is disturbed, blood pressure decreases as well as blood flow to the brain. The reduced oxygen supply can cause a spinning, strange feeling and in more serious cases even short-term unconsciousness. A lying position relieves the symptoms. Blood pressure is called low if it is less than 90/60.
Causes of low blood pressure
Low blood pressure is usually due to an overdose of high blood pressure medications. In that case, reducing or spreading the dose is indicated. It can also occur with pregnancy, diabetes, arteriosclerosis (hardening of the arteries) or an obstruction in the blood flow. It also occurs as a physical reaction to sudden emotions, malnutrition or extreme heat. Other reasons include a decrease in the amount of fluid in the body (dehydration), reduced heart function, strong emotions, alcohol consumption, major burns, stomach/intestinal problems, a severe allergic reaction, severe blood loss and dilated blood vessels. Low blood pressure is sometimes also noticeable: The patient becomes pale, has dilated pupils and a weak pulse. Even if one regularly faints due to low blood pressure, this is rarely a cause for concern. Only a very seriously lowered blood pressure can be significant and indicates, for example, shock. This is a medical emergency. Young women often have low blood pressure.
“If you don’t know your blood pressure, it’s like not knowing the value of your company.” ~ Mehmet Oz