Preview
Hypertension (high blood pressure) occurs when the pressure in your blood vessels is too high (140/90 mmHg or more). It is common but can be serious if left untreated.
People with high blood pressure may not experience any symptoms. The only way to know is to have your blood pressure checked.
Factors that increase the risk of high blood pressure include:
- advanced age
- genetic
- be overweight or obese
- not being physically active
- high salt diet
- drink too much alcohol
Lifestyle changes, such as eating a healthier diet, quitting smoking and increasing physical activity, can help lower blood pressure. However, some people may need to take medication.
Blood pressure is written as two numbers. The first number (systolic) represents the pressure in the blood vessels when the heart contracts or beats. The second number (diastolic) represents the pressure in the vessels when the heart rests between beats.
Hypertension is diagnosed if, when measured on two different days, the systolic blood pressure on both days is ≥ 140 mmHg and/or the diastolic blood pressure on both days is ≥ 90 mmHg.
Risk factors
Modifiable risk factors include unhealthy diet (excessive salt consumption, diet high in saturated and trans fats, low fruit and vegetable consumption), physical inactivity, tobacco and alcohol use, and being overweight or obesity.
Non-modifiable risk factors include a family history of hypertension, age greater than 65 years, and coexisting diseases such as diabetes or kidney disease.
Symptoms
Most people with hypertension do not experience any symptoms. Very high blood pressure can cause headaches, blurred vision, chest pain and other symptoms.
Checking your blood pressure is the best way to know if you have high blood pressure. If hypertension is left untreated, it can lead to other health problems like kidney disease, heart disease and stroke.
People with high blood pressure (usually 180/120 or higher) may experience the following symptoms:
- severe headaches
- chest pain
- dizziness
- difficulty breathing
- nausea
- vomiting
- blurred vision or other vision changes
- anxiety
- confusion
- ringing in the ears
- nosebleeds
- abnormal heart rhythm
If you have any of these symptoms and high blood pressure, seek medical attention immediately.
The only way to detect hypertension is to have a healthcare professional measure your blood pressure. Measuring blood pressure is quick and painless. Although individuals can measure their own blood pressure using automated devices, evaluation by a healthcare professional is important to assess risk and associated conditions.
Treatment
Lifestyle changes can help reduce high blood pressure. These include:
- eat a healthy, low-salt diet
- losing weight
- be physically active
- stop smoking.
If you have high blood pressure, your doctor may recommend one or more medications. Your recommended blood pressure goal may depend on your other health conditions.
The blood pressure goal is less than 130/80 if you have:
- cardiovascular disease (heart disease or stroke)
- diabetes (high blood sugar)
- chronic kidney disease
- high risk of cardiovascular diseases.
For most people, the goal is to have blood pressure below 140/90.
There are several common medications for hypertension:
- ACE inhibitors, including enalapril and lisinopril, relax blood vessels and prevent kidney damage.
- Angiotensin-2 receptor blockers (ARBs), including losartan and telmisartan, relax blood vessels and prevent kidney damage.
- Calcium channel blockers, including amlodipine and felodipine, relax blood vessels.
- Diuretics, including hydrochlorothiazide and chlorthalidone, remove excess water from the body, thereby lowering blood pressure.
Prevention
Lifestyle changes can help reduce high blood pressure and can help anyone with hypertension. Many who make these changes will still need to take medication.
These lifestyle changes can help prevent and reduce high blood pressure.
Do:
- Eat more vegetables and fruits.
- Sit less.
- Be more physically active, which may include walking, running, swimming, dancing, or activities that build strength, like lifting weights.
- Do at least 150 minutes per week of moderate-intensity aerobic activity or 75 minutes per week of vigorous aerobic activity.
- Do muscle-strengthening exercises 2 or more days per week.
- Lose weight if you are overweight or obese.
- Take medications prescribed by your healthcare professional.
- Keep your appointments with your healthcare professional.
Don’t do it:
- eating too many salty foods (try to stay below 2 grams per day)
- eat foods high in saturated or trans fats
- smoking or using tobacco
- drinking too much alcohol (1 drink per day maximum for women, 2 for men)
- missing or sharing medications.
Reducing hypertension prevents heart attacks, strokes and kidney damage, as well as other health problems.
Reduce the risk of hypertension by:
- reduce and manage stress
- check blood pressure regularly
- treat high blood pressure
- manage other medical conditions.
Complications of uncontrolled hypertension
Among other complications, hypertension can cause serious damage to the heart. Excessive pressure can harden the arteries, decreasing the flow of blood and oxygen to the heart. This elevated pressure and reduced blood flow can cause:
- chest pain, also called angina;
- heart attack, which occurs when the blood supply to the heart is blocked and heart muscle cells die from lack of oxygen. The longer blood flow is blocked, the greater the damage to the heart;
- heart failure, which occurs when the heart cannot pump enough blood and oxygen to other vital organs in the body; And
- irregular heartbeat which can lead to sudden death.
High blood pressure can also burst or block the arteries that supply blood and oxygen to the brain, causing a stroke.
Additionally, hypertension can cause kidney damage, leading to kidney failure.
Hypertension in low- and middle-income countries
The prevalence of hypertension varies among regions and income groups of countries. The WHO African Region has the highest prevalence of hypertension (27%), while the Region of the Americas has the lowest prevalence of hypertension (18%).
The number of adults with hypertension increased from 594 million in 1975 to 1.13 billion in 2015, with this increase largely seen in low- and middle-income countries. This increase is mainly due to an increase in risk factors for hypertension in these populations.
WHO response
The World Health Organization (WHO) helps countries reduce hypertension as a public health problem.
In 2021, WHO published a new guideline on the pharmacological treatment of hypertension in adults. The publication provides evidence-based recommendations for initiating treatment of hypertension, as well as recommended intervals for follow-up. The document also includes the target blood pressure to be achieved for control, as well as information on who in the health system can initiate treatment.
To help governments strengthen prevention and control of cardiovascular disease, WHO and the US Centers for Disease Control and Prevention (US CDC) launched the Global Hearts Initiative in September 2016, which includes the HEARTS technical package . The six modules of the HEARTS technical package (Healthy Lifestyle Counseling, Evidence-Based Treatment Protocols, Access to Essential Medicines and Technologies, Risk-Based Management, Team-Based Care, and Monitoring Systems) provide an approach strategic to improve cardiovascular health. in countries around the world.
In September 2017, WHO began a partnership with Resolve to Save Lives, an initiative of Vital Strategies, to support national governments in implementing the Global Hearts Initiative. Other partners contributing to the Global Hearts Initiative include the CDC Foundation, the Global Health Advocacy Incubator, the Johns Hopkins Bloomberg School of Public Health, the Pan American Health Organization (PAHO), and the US CDC. Since the program’s implementation in 2017 in 31 low- and middle-income countries, 7.5 million people have received protocol-based hypertension treatment through person-centered care models. These programs demonstrate the feasibility and effectiveness of standardized hypertension control programs.
