Very often, people do not feel their high blood pressure and find out about it by accident. Hypertension which is left untreated for years leads to heart and blood vessels damage, brain strokes or  cardiac failures. Hypertension patients have a higher risk of myocardial infarction and renal failure. Arterial hypertension complications can be avoided thanks to a proper treatment. 

When do we deal with hypertension? 

For an adult, the average level of systolic blood pressure at rest is below 140 mmHg, and diastolic blood pressure – below 90 mmHg. If systolic pressure is at the level of 140 mmHg or over, and diastolic pressure - 90 mmHg or over, we deal with hypertension. It is enough if one of these values is raised.

Where do these two values of blood pressure come from? 

The top value, known as systolic blood pressure, represents the pressure generated when the heart contracts to pump blood to vessels, and the bottom value, known as diastolic pressure, is generated when the heart expands. Thus, during every heartbeat the pressure in the vessels ranges between the top and the bottom value.

Arterial hypertension can only be confirmed when at three consecutive medical visits, BP measurements show raised values. In case of a healthy person BP measurements are not always the same. Normally, blood pressure at night is a little lower than during the day, and physical work or emotional stress may raise your blood pressure in a couple of minutes. In a healthy person, however, blood pressure raises only for a short time, e.g. during physical effort, and then falls to its normal level. 

Blood pressure cannot be ‘felt’ – it must be measured! There are no symptoms specific for hypertension. Hypertension patients may sometimes suffer from pains in the heart area, headaches, dizziness or breathlessness. These symptoms, however, can also appear when blood pressure is normal. 

Blood pressure measurement is a test which is the most common and, at the same time, the most important for the analysis of a patient’s prognosis. At present, there are three techniques of blood pressure measurement used in clinical practice: 

• blood pressure measurement during a medical visit at doctor’s office,
• circadian ambulatory blood pressure monitoring (ABPM), commonly referred to as the Holter’s method, 
• home blood pressure monitoring(HBPM).

Comparative tests of measurement readings obtained by means of these methods show that blood pressure values tend to be higher when measured at the doctor’s office than in the two remaining situations. Home blood pressure measurements give similar results to those provided by the Holter’s method.

The advantage of home blood pressure monitoring is that numerous measurements can be made at different times of the day and during normal activities.

Home BP monitoring carried out by the patient can be an important, if not crucial, source of information about the efficacy of medication and the relation between symptoms (the above mentioned headaches or dizziness) and blood pressure value. They may also show whether the patient is following doctor’s recommendations.

At present, there are many BP monitors available on the market. They differ in the way and place of BP measurement, the degree of automation and price. Unfortunately, a vast majority of them do not have an international validation, i.e. a certificate attesting the quality of the device and its suitability for clinical practice. Such validations are granted by hypertension associations, such as the British Hypertension Society (BHS) and the Association for the Advancement of Medical Instrumentation (AAMI). The UA-767 and UA-787 monitors are among thefew which are validated and fully conform to BHS and AAMI criteria.

Wrist or finger BP monitors, which have recently become popular in Poland, do not meet the above mentioned criteria. Comparative tests of wrist monitors and traditional mercury measurement devices show big discrepancies in the accuracy of measurement. Thus, the readings of these devices cannot be used for hypertension diagnosis and treatment!

Can arterial hypertension be lowered without medication?

YES! The best methods include: excessive body weight reduction, reduction of alcohol and kitchen salt intake, and increased  physical activity.

Undoubtedly, the most important element of treatment is losing weight. Hypertension affects twice as many overweight people as those with normal body weight. Very often, the reduction of weight gives such good results in lowering blood pressure values that it is no longer necessary to introduce medication.  What is more, when body weight is reduced, medication works moreeffectively. Obviously, the best method to lose extra weight is  to lower your calorie intake and increase physical activity!

The next information will surely be good news for our Readers. It appears that coffee drunk in moderation is not contraindicated in hypertension. On the other hand, it is very important to reduce the consumption of alcohol, which raises blood pressure. When we  cut down on alcohol, our blood pressure falls, and, what is more, it is easier to lose weight!

We can also try to lower blood pressure by limiting the intake of kitchen salt. However, unlike excessive weight reduction and alcohol intake reduction, the limitation of salt consumption gives very individual results – it is not possible to foresee whether and, if yes, how much it will lower blood pressure. If we try to cut down on salt, we must remember that particularly great amounts of kitchen salt are added to tinned and ready-made food.

When is medication absolutely necessary? 

The answer is simple – when non-pharmacological (without medicines) treatment is not effective enough to regulate arterial hypertension.

Untreated arterial hypertension is much more dangerous than possible side-effects of well-tested medicines. If side-effects occur, they regress once the medicine is stopped. 

Regardless of the type and number of taken anti-hypertension medicines, it is always necessary to remember that non-pharmacological treatment(i.e. excessive weight reduction, limitation of alcohol and kitchen salt intake, increased physical activity) should be continued.  If hypertension is well-treated, there are no obstacles to practicing sports or doing physical work. Dynamic sports, such as cycling or swimming, are particularly recommended.

Regulating arterial hypertension can also cause ailments, which have nothing to do with a particular group of medicines, but is connected with lowering blood tension which has been raised for a long period of time. Very often, it is necessaryto re-adjust to normal blood pressure!

However, it is good to remain patient – arterial hypertension takes long to appear and it also takes long to make it disappear!

 Thanks to hypertension treatment you can stay in good condition for years and years.

Dr n. med. Radoslaw Szczech