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According to the World Health Organization (2023), hypertension (high blood pressure) is when the pressure in your blood vessels is too high. Blood pressure is measured using a sphygmomanometer. A reading of 130/80 mmHg or higher is considered hypertension. You can’t always tell if your blood pressure is high just by how you feel, so the only way to know is to get checked by the doctor and continue monitoring with a portable blood pressure device. It is a common condition but can get severe if not treated. Hypertension can be primary Hypertension if it develops gradually over many years with no identifiable cause, or Secondary Hypertension, if caused by underlying conditions such as kidney disease, hormonal disorders, certain medications, or sleep apnea.
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What do Blood Pressure numbers mean?
Blood pressure is recorded as two values:
- Systolic pressure (the top number) indicates the force exerted on blood vessels when the heart contracts. Normal range is between 110-130mmHg.
- Diastolic pressure (the bottom number) measures the pressure within the vessels when the heart is at rest between beats. Normal range is 70-90mnHg.
Understanding hypertension and how to manage it
Hypertension doesn’t develop overnight. Several factors both within and beyond our control can contribute to it but many of these risks can be minimized through healthy habits, regular exercise, and medical guidance.
- Advancing Age
As people get older, their arteries naturally become less flexible, making it harder for blood to flow smoothly. Over time, this can cause an increase in blood pressure. This is why regular health check-ups become more essential as you age.
A slight extra increase in systolic pressure usually occurs beyond the age of 60 years. This increase results from hardening of the arteries, which is often a result of atherosclerosis (Hall & Guyton, 2016).
- Genetic Predisposition
Hypertension tends to run in families, meaning if your parents or close relatives have it, your risk increases. While genetics play a role, lifestyle choices can still make a significant difference in managing blood pressure.
- Excess Body Weight or Obesity
Carrying extra weight forces the heart to work harder to pump blood throughout the body, leading to higher blood pressure. Fat accumulation can also trigger inflammation and hormonal imbalances that further contribute to hypertension. Losing even a small amount of weight can make a big impact on heart health.
- Lack of Regular Physical Activity
A sedentary lifestyle weakens the heart and blood vessels, making them less efficient. Exercise helps keep blood vessels flexible and strengthens the heart, reducing hypertension risk. Even small daily movements, like walking or stretching, can bring long-term benefits.
- High-Salt Diet
Too much sodium causes the body to retain water, increasing the volume of blood flowing through the vessels. This raises blood pressure. Many processed and fast foods contain hidden sodium, so choosing fresh, home-cooked meals can help control intake.
- Excessive Alcohol Consumption
Drinking alcohol frequently can damage blood vessels and disrupt the balance of hormones that regulate blood pressure. While some studies such as those published in the New England Journal of Medicine and The Lancet suggested that moderate alcohol intake, particularly red wine, may offer limited cardiovascular benefits, the risks often outweigh the advantages. Research from the Global Burden of Disease Study (2018) concluded that no level of alcohol consumption improves health overall, as it increases the risk of hypertension, certain cancers, liver disease, and stroke. Even small amounts may raise blood pressure over time. The safest and healthiest approach is to avoid alcohol altogether or limit it.
Since lifestyle choices can either increase or decrease hypertension risk, making small but consistent changes can significantly improve blood pressure levels.
RISK FACTORS FOR HYPERTENSION
Risk factors can be categorized into two types – modifiable and non-modifiable risk factors.
Modifiable risk factors (which can be improved with lifestyle changes) include:
- Poor diet (high salt intake, excessive saturated and trans fats, low fruit and vegetable consumption)
- Physical inactivity
- Tobacco and alcohol use
- Being overweight or obese
- Environmental factors like air pollution
Non-modifiable risk factors (which cannot be changed) include:
- Family history of hypertension
- Age over 65
- Pre-existing conditions such as diabetes or kidney disease
SYMPTOMS OF HIGH BLOOD PRESSURE
Many individuals with hypertension experience no noticeable symptoms. However, severely high blood pressure can trigger:
- Headaches
- Blurred vision
- Chest pain
- Dizziness
Regular blood pressure monitoring is crucial, as untreated hypertension can lead to serious complications such as kidney disease, heart disease, and stroke.
When blood pressure spikes to 180/120 mmHg or higher, symptoms may include:
- Severe headaches
- Chest pain
- Nausea or vomiting
- Shortness of breath
- Anxiety and confusion
- Vision disturbances
- Nosebleeds
- Irregular heart rhythms
If you notice these symptoms alongside high blood pressure, seek immediate medical attention.
DIAGNOSIS AND TREATMENT
Hypertension is diagnosed if, on two separate occasions, the systolic pressure is 140 mmHg or higher, and/or the diastolic pressure is 90 mmHg or higher. The only way to confirm high blood pressure is by having a professional check it. While home monitoring is helpful, a health professional’s evaluation ensures an accurate assessment of risks.
Treatment Options
- Lifestyle adjustments play a crucial role in managing high blood pressure:
- Eating a balanced, low-salt diet
- Losing excess weight
- Engaging in regular physical activity
- Quitting tobacco
If necessary, doctors may prescribe medication, with treatment goals depending on individual health conditions. For those with heart disease, diabetes, or chronic kidney disease, the recommended blood pressure target is below 130/80 mmHg, while most people aim for below 140/90 mmHg.
Common medications include:
- ACE inhibitors (e.g., enalapril, lisinopril) – relax blood vessels and protect kidney function.
- Angiotensin-2 receptor blockers (ARBs) (e.g., losartan, telmisartan) – reduce blood vessel tension.
- Calcium channel blockers (e.g., amlodipine, felodipine) – improve blood circulation.
- Diuretics (e.g., hydrochlorothiazide, chlorthalidone) – help remove excess fluids to lower blood pressure.
PREVENTING HYPERTENSION
While lifestyle changes can help manage high blood pressure, some individuals may still require medication. The following habits can promote better heart health:
What to Do:
- Increase vegetable and fruit intake
- Reduce sedentary time and be physically active (walking, swimming, dancing, weightlifting)
- Aim for at least 150 minutes per week of moderate aerobic exercise or 75 minutes of vigorous activity
- Strength train at least twice a week
- Maintain a healthy weight
- Follow prescribed medications
- Attend medical check-ups regularly
What to Avoid:
- Excessive salt intake (keep it below 2 grams daily)
- Foods rich in saturated or trans fats
- Tobacco use and smoking
- Heavy alcohol consumption (limit to one drink per day for women, two for men)
- Skipping or sharing prescribed medications
By managing hypertension, individuals lower their risks of heart attacks, strokes, kidney damage, and other health complications.
To further reduce risk:
- Manage stress effectively
- Check blood pressure regularly
- Address medical conditions that impact blood pressure
- Minimize exposure to pollution
COMPLICATIONS OF UNCONTROLLED HIGH BLOOD PRESSURE
Hypertension can significantly impact heart health. Excessive pressure in the arteries reduces oxygen and blood supply, leading to:
- Angina (chest pain)
- Heart attacks (caused by blocked blood flow, leading to heart tissue damage)
- Heart failure (where the heart struggles to pump efficiently)
- Irregular heart rhythms, which may result in sudden cardiac events
- Strokes: hypertension can cause strokes by obstructing or bursting arteries that deliver oxygen to the brain.
- Kidney/renal diseases: hypertension increases the risk of kidney disease, potentially leading to kidney failure.
Prioritizing blood pressure control helps prevent these complications, ensuring a healthier and longer life. Regular monitoring, lifestyle improvements, and proper medical care make all the difference.
REFERENCES
GBD 2016 Alcohol Collaborators. Alcohol use and burden for 195 countries and territories, 1990-2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2018 Sep 22;392(10152):1015-1035. doi: 10.1016/S0140-6736(18)31310-2. Epub 2018 Aug 23. Erratum in: Lancet. 2018 Sep 29;392(10153):1116. doi: 10.1016/S0140-6736(18)32338-9. Erratum in: Lancet. 2019 Jun 22;393(10190):e44. doi: 10.1016/S0140-6736(19)31050-5. PMID: 30146330; PMCID: PMC6148333.
