HYPERTENSION: QUESTIONS AND ANSWERS

Why does blood pressure rise and what are the main risk factors for the occurrence of hypertension?

Elevated arterial blood pressure is caused by numerous risk factors such as:

  • obesity,
  • elevated values of fats in the blood i.e. cholesterol, triglycerides,
  • high intake of dietary salt,
  • active smoking,
  • lack of exercise,
  • increased intake of alcohol,
  • intake of energy drinks,
  • stress.

 

These are the factors that we can influence and thus prevent the development of elevated blood pressure.

In addition to these factors, we should not overlook genetic factors, i.e. inheritance:

If parents suffered from hypertension the children are also prone to elevated blood pressure. So far, we cannot influence our genes, but if preventive measures are put in place on time, we can prevent the early occurrence of hypertension. Therefore, we focus prevention of elevated blood pressure and suggest the following:

  • Healthy diet – avoid high salt intake (daily allowance is 5g of salt, but one has to bear in mind that processed food has high salt content, i.e. 78% of excessive salt intake comes from industrially processed food, which is the main cause of excessive dietary intake of salt).
  • Make sure not to eat too much carbohydrates because this may lead to obesity.
  • Regular exercise (daily walks of 35-60 min).
  • Quit smoking.
  • Moderate alcohol consumption (1-2 strong spirits, 150-300ml of wine or 350-700ml of beer) (one of these and the lower figures apply to women since they are more susceptible to alcohol).
  • Refrain from any intake of energy drinks.
  • Avoid high stress situations (more laughter can be beneficial).

What are the symptoms of hypertension and can one recognize to have blood pressure “spiked” by some signs?

A person with elevated arterial blood pressure most commonly manifests no symptoms whatsoever, and that is the reason why arterial hypertension is also called “the silent killer”. 

Some persons manifest non-specific symptoms of hypertension such as:

  • headache (back of the head, occipital or frontal),
  • flashes of light in the eyes
  • ringing in ears (tinnitus),
  • vertigo,
  • gait instability,
  • pressure in the chest, i.e. weight on the chest.

 

Due to these non-specific symptoms the disease remains undiagnosed for a long time, i.e. usually is discovered by accidental measuring that shows elevated values. In the worst-case scenario it is discovered only when hypertension complications are developed, i.e. heart attack, stroke, rhythm disorders, changes on the blood vessels, kidney disease, changes on the optic fundus.

It is also important to make note of the following:

Normal blood pressure includes the values between 120-129/80 mmHg. The pressures 130-139/85-89mm, are considered high normal and require introduction of medication in cases when:

  • target organs are damaged (if the patient has a history of heart attack or stroke),
  • patient is diagnosed with diabetes or kidney disease.

 

Conversely, in absence of damage, the so called non-pharmacological measures are recommended: quitting smoking, dietary changes to reduce fatty foods, losing weight, regular exercise, adequate intake of water…

How and why women that had problems with low blood pressure, suddenly with menopause get high blood pressure and can this be somehow prevented?

Before menopause women tend to suffer less from cardiovascular diseases, but with menopause they become a risk group for cardiovascular diseases (lower estrogen being the main culprit).

Statistical data show that:

  • 27% of women with cardiovascular diseases suffer from hypertension, women with high normal pressure (130-139/85-89 mmHg) have the risk for development of cardiovascular diseases doubled.
  • 8% of women in menopause suffer from hypertension.

Women who had lower blood pressure before menopause with onset of menopause:

  • Become hypertensive (changes in hormone secretion),
  • Commonly lipid blood values also rise (2/3 of women aged 40-64yrs in the West have high blood cholesterol),
  • May have obesity problem (abdominal type) – one of the risk factors.

 

Lowering the diastolic pressure (the bottom one) by 10mmHg, reduces the risk of stroke by 30%, and the risk of heart attack by 23%.

At an older age (after 50 yrs) systolic hypertension (elevated top pressure values) usually develops, due to atherosclerotic processes on the blood vessels – their elasticity is reduced.

Elevated blood pressure in women in this age group is associated with 6-fold increase of coronary diseases, as compared to 3-fold rise in men. Therefore, elderly women must pay attention to non-pharmacological therapy (regular exercise – walks, quitting smoking, losing body weight, reduced intake of salt, fatty food, alcohol and sugar) and attend scheduled follow-up visits and take prescribed medicines regularly.

For appropriate treatment of hypertension in menopause, individual approach is recommended for both antihypertensive medicines and mandatory non-pharmacological measures.

Hormonal therapy does not treat hypertension. This treatment is not recommended for patients with breast cancer, estrogen-dependent-tumors, liver and kidney failures.

Serbian Society of hypertension

Hypertension centers

Multidisciplinary center for Polyclinic Diagnostics, Assessment and Treatment of Blood Pressure Disorders, Clinic for Cardiology, Clinical Centre of Serbia Contact: Prof. Dr. Vesna Stojanov
Clinic for internal disease InterMedica Nis, Serbia Polyclinic InterMedica

Hypertension Societies

European Society of Hypertension www.eshonline.org
American Society of Hypertension www.ash-us.org
American Society of Hypertension www.dableducational.com

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