High blood pressure is a very common and widespread disease. Depending on the causes that cause it, high blood pressure is divided into hypertension and symptomatic (secondary) hypertension.
Hypertension (primary, essential hypertension) is a separate disease. Secondary (symptomatic) hypertension is a consequence of other diseases (kidney, endocrine, cardiovascular, etc.).
Measurement of blood pressure in the morning after waking up, on an empty stomach, and after spontaneous urination gives the values of basal blood pressure. According to the standard of the World Health Organization, the values of normal blood pressure are 135-140/85-90 mm/Hg.
Hypertension is more common in people engaged in mental work, accompanied by neuropsychiatric stress. In women, the disease often occurs during and after menopause. Hereditary factors are of significance for the development of hypertension. Predisposing factors include smoking and alcohol abuse, as well as being overweight.
The incidence of the disease is higher in men (in a ratio of 2.6:1 compared to women). In recent years, there has been an increase in the incidence of the disease among younger age groups (between 25 – 40 years of age).
There are no complaints in the initial stage. Hypertension is usually found by accident upon medical examination on another occasion or during preventive tests. The only sign is the presence of elevated blood pressure above normal values. These values are initially incidentally elevated, higher in the evening or upon neuropsychiatric stress. Gradually, the increased blood pressure values become permanently maintained.
Early complaints are headache, disturbed sleep, tinnitus, palpitations, mild mental and physical fatigue. The headache is more pronounced in the morning after sleep and in the evening after work. It is usually localized in the frontal and occipital areas and has a “tightening” nature. In the later stages of the disease, the complaints become permanent, and blood pressure values stabilize in the range of 150-180/95-110 mm/Hg.
In the course of the disease, hypertensive crises often occur, with a rapid and sharp rise in blood pressure up to and above 190/115 mm/Hg and more severe headaches. The crisis has a different duration – from 1-2 hours to 3-4 days and is accompanied by severe headache, frequent nausea, and vomiting, dizziness, impaired vision and hearing, palpitations, tremors, etc.
Sometimes there is epileptic-like seizure with temporary loss of consciousness, hearing, and vision. Seizures are due to transient cerebral edema. In the course of a more severe hypertensive crisis, complications can occur – stroke or heart attack. In the later stages of the disease, vital organs can be damaged. The so-called hypertensive heart with hypertrophy and sclerotic changes mainly of the left ventricle and heart vessels, with the development of left ventricular failure. Renal sclerosis with renal failure can also develop.
The so-called hypertensive encephalopathy with inadequate hemorrhage and stroke can occur in the brain. Retinal hemorrhage and impaired vision may occur. Heart attack and stroke are much more common in patients with hypertension than in people with normal blood pressure (approximate ratio of 6:1).
Treatment is usually conservative. Patients without complaints are usually reluctant to seek drug treatment. The goal of treatment is to permanently lower blood pressure until it reaches normal or close to normal values (up to and below 140/90 mm/Hg). An appropriate diet is prescribed, limiting salt and fat intake.
A suitable and rational work rhythm, 8-hour night’s sleep, prevention procedures, controlled exercise, avoidance of strong emotions, and mental stress are recommended. Smoking and alcohol abuse are strictly prohibited.
Drug treatment involves the use of a number of medications that lower blood pressure to normal or close to normal levels. All these antihypertensive drugs are taken only with a doctor’s prescription and constant monitoring of blood pressure. In addition, diuretics, hypnotics, neuro-sedatives, and other drugs may be prescribed.
The most appropriate antihypertensive drugs are clarified during treatment. Drug treatment is long and difficult, and the dosage must be constantly adjusted and monitored in view of the course of the disease. There is currently a large selection of effective medications that affect high blood pressure.
Prevention of hypertension consists in maintaining a healthy diet, hygiene, and occupational schedule, avoiding smoking and alcohol abuse, exercising active sports, including hiking, eliminating conditions leading to emotional stress. It is appropriate and reasonable to maintain appropriate underweight and monitor blood pressure values.