HYPERTENSION

1. What is blood pressure?

Blood pressure is the force of blood against your blood vessels, i.e. arteries.  It varies depending on the strength of heart function, arterial elasticity, overall amount of circulating blood. Accordingly, blood pressure depends on the overall health, age, physical fitness and lifestyle, i.e. habits.

Blood pressure is measures in millimeters of mercury in the column:

  • optimum blood pressure is up to 120/80 mmHg
  • normal blood pressure is between 120-129/80-84 mmHg
  • high normal blood pressure is between 130- 139/85-89 mmHg
  • elevated blood pressure is over 140/90

2. What is hypertension?

Hypertension is one of the main risk factors for the occurrence of atherosclerosis and consequent cardiovascular, cerebrovascular and renal diseases that are among the leading causes of morbidity and mortality in our country and in most of developed countries, as well.

According to the 2018 European Guidelines, hypertension or elevated arterial blood pressure is a condition when the pressure values exceed 140/90mmHg (the top number exceeding 140mmHg or the bottom number exceeding 90mmHg or both exceeding 140/90mmHg).

The higher the pressure, the higher the risk of cardio-vascular complications.

3. Incidence - epidemiology

Arterial hypertension is one of the most common diseases of modern times. It is believed that one third of adult population has elevated blood pressure that should be treated, and the percentage changes by regions, depending on the dietary habits, level of fitness and age.

Most probably, everybody has had a blood pressure related problem at least once. The fact that people tend not to comply with prescribed treatment (skipping doses or taking insufficient doses) is an additional problem in treatment of hypertension

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Types of elevated blood pressure

  • Primary (essential) hypertension
  • Secondary hypertension
  • White coat hypertension
  • Resistant hypertension
  • Occupational hypertension

1. Primary (essential) hypertension

Arterial hypertension may be essential – without a known cause and it accounts for 95% of all cases of hypertension.

Primary hypertension may occur due to:

  • Genetic factors
  • Intrinsic factors (neurohumoral system)
  • External factors (high salt intake, stress, obesity, lack of exercise, alcohol, smoking and other factors)

 

2. Secondary hypertension

Secondary hypertension, i.e. with a known cause, results from a kidney disease, renovascular etiology, endocrine origin or sleep apnea. In 5 – 8% of patients it is possible to establish the presence of a disease within which hypertension has developed.

4. White coat hypertension

We should not overlook the „white coat hypertension”, i.e.  it is a phenomenon in which patients exhibit automatic rise in the blood pressure value in the doctor’s office.

5. Resistant hypertension

This type of hypertension accounts for only about 9% of all hypertensions, meaning that the values of blood pressure remain elevated  >140/90mmHg, although the patient takes 3 medicines and a diuretic.

6. Occupational hypertension

In cases of occupational hypertension, the blood pressure is elevated at work, but at home it is normal. It results from stress at work, i.e. increased sympathetic activity.