Hypertension: Symptoms, Causes, Diagnosis & Treatment

Hypertension, commonly known as high blood pressure, is a prevalent health condition that affects around 30% of adults worldwide, and an estimated 46% of adults with hypertension are unaware that they have the condition. 

It refers to the increased pressure of blood circulating within the body’s arteries. When left uncontrolled, hypertension can result in severe complications, including heart disease, stroke, and kidney problems. Early detection and proper management are crucial in preventing these life-altering consequences.

The symptoms of hypertension are often subtle or non-specific, with some individuals experiencing headaches, nosebleeds, or shortness of breath. In many cases, high blood pressure has no identifiable cause. 

To accurately diagnose and effectively treat hypertension, it is essential to understand its various types, stages, and risk factors.

Symptoms of Hypertension

Hypertension is often called a “silent killer” because it does not usually show any noticeable symptoms. A person may not know they have high blood pressure until it reaches a dangerous level and they experience symptoms of its complications, such as chest pain or difficulty breathing.

The following symptoms are worth being aware of and monitoring. 

Headaches

Headaches can occasionally be a symptom of hypertension, especially when blood pressure reaches a life-threatening stage.

These headaches might occur due to the increased pressure in blood vessels within the brain. 

Nosebleeds

Similarly, nosebleeds may occur in some individuals under the same circumstances.

Shortness of Breath

Shortness of breath is another symptom that can be connected to high blood pressure. This indication might appear as the heart is required to exert more effort to circulate blood through the body due to increased blood pressure. Consequently, the body may demand more oxygen, leading to shortness of breath.

Dizziness, Nausea, and Vision Changes

Other potential symptoms of hypertension include dizziness, nausea, and blurred vision. These symptoms could be the result of blood vessel damage caused by increased pressure in the arterial walls. 

However, it is crucial to note that these symptoms are not exclusive to hypertension and could be caused by other health conditions as well. Early detection through regular check-ups can help prevent serious complications and facilitate timely treatment measures to manage the condition.

Causes and Risk Factors

Hypertension consists of two categories: primary hypertension and secondary hypertension. Both categories involve various causes and risk factors.

Primary Hypertension

Primary hypertension, also known as essential hypertension, has no identifiable cause but is likely due to a combination of factors. Some of the primary causes and risk factors for developing primary hypertension include:

Age: 

Age is a significant risk factor in developing primary hypertension or high blood pressure due to non-specific causes. 

The risk of developing hypertension increases as you get older.

Family history: 

A family history of high blood pressure may make you more susceptible to the condition. Certain inherited genetic mutations and having a family history of high blood pressure can increase a person’s likelihood of developing this condition.

While you can’t change your genetics, you can manage lifestyle factors like diet, physical activity, stress, and smoking. 

Race: 

Certain racial groups, such as African Americans, are at an increased risk of developing hypertension.

Factors such as genetics, socioeconomic conditions, and access to healthcare can influence this predisposition. 

Obesity and being overweight: 

Obesity and being overweight are significant risk factors for primary hypertension. 

Excess weight often increases the demand on the heart and alters the way your body uses insulin, contributing to high blood pressure.

Tobacco use and smoking: 

Tobacco use and smoking are potent risk factors for primary hypertension. 

These habits can raise blood pressure temporarily, and the chemicals in tobacco can damage your arteries, leading to elevated blood pressure levels over time.

Alcohol and drug use: 

Regular, heavy consumption of alcohol can cause hypertension, while certain recreational drugs can cause dangerous spikes in blood pressure. Moderation in alcohol and avoidance of illicit drugs are essential for maintaining healthy blood pressure levels. 

If you’re struggling with substance abuse, it’s vital to seek professional help, as overcoming these issues can significantly reduce your risk of hypertension and lead to overall improved health.

Stress: 

Chronic stress might contribute to the development of hypertension through unhealthy coping mechanisms, such as overeating, smoking, or excessive alcohol consumption. Though short-term stress-related spikes in blood pressure aren’t the same as ongoing hypertension, they still warrant consideration.

Identifying stressors in your life and developing effective strategies, such as relaxation techniques or physical exercise, can help manage stress levels and, by extension, blood pressure levels. 

Dietary factors: 

Dietary habits significantly influence blood pressure levels. Consuming a diet high in sodium, processed foods, and unhealthy fats, while lacking fruits, vegetables, and fiber can lead to hypertension over time.

Secondary Hypertension

An underlying disease or condition can cause elevated blood pressure, which is known as secondary hypertension. Some common causes and risk factors for secondary hypertension are:

Kidney disease: 

Kidney disease is a common cause of secondary hypertension. 

When kidneys don’t function optimally, they can’t regulate body fluid and ion concentrations correctly, leading to an increase in blood pressure.

Sleep apnea: 

Sleep apnea, a condition characterized by frequent, brief interruptions of breathing during sleep, can lead to secondary hypertension. 

These constant disturbances in sleep put stress on the body, increasing the risk of high blood pressure. If you’re diagnosed with sleep apnea, treating this condition can have a positive effect on controlling blood pressure levels. 

Pregnancy: 

Pregnancy can lead to secondary hypertension, known as gestational hypertension. This condition can pose risks to both mother and baby, and in severe cases, it can escalate to preeclampsia, a serious complication requiring immediate medical attention.

Regular prenatal care is crucial to monitor blood pressure during pregnancy. If you’re pregnant and notice a significant increase in your blood pressure readings, or if you have other symptoms like severe headaches, vision changes, or swelling, contact your healthcare provider immediately.

Diabetes: 

Diabetes often goes hand in hand with hypertension. The high blood sugar levels associated with diabetes can damage blood vessels over time, leading to high blood pressure. 

Equally, hypertension can exacerbate diabetic complications. Managing diabetes is highly interlinked with managing blood pressure. 

Certain medications: 

Certain medications, including some over-the-counter drugs and prescription medications, can lead to secondary hypertension. These might include non-steroidal anti-inflammatory drugs, certain birth control pills, decongestants, and medications for mental health conditions.

By understanding the causes and risk factors of hypertension, individuals can seek help from medical professionals to take preventive measures and reduce the risk of developing this common medical condition.

Types and Stages of Hypertension

The following section will discuss the different types and stages of hypertension, thereby offering insights into the seriousness and associated risks of this widespread yet often under-recognized health issue. 

This knowledge can inform timely health actions and lifestyle modifications.

Stage 1 Hypertension

Stage 1 hypertension is defined as having a systolic blood pressure between 130-139 mm Hg, or a diastolic blood pressure between 80-89 mm Hg. 

This stage of hypertension is usually managed with lifestyle changes and sometimes medication. It is essential to monitor and manage blood pressure in this stage to prevent progression to more severe hypertension stages.

Stage 2 Hypertension

Stage 2 hypertension occurs when the systolic blood pressure is at least 140 mm Hg, or the diastolic blood pressure is at least 90 mm Hg. 

This stage typically requires a combination of lifestyle changes and medications to manage blood pressure levels effectively. Proper treatment is crucial in stage 2 to avoid complications and severe health problems.

White Coat Hypertension

White coat hypertension is a condition where blood pressure readings are higher when taken by a healthcare professional compared to measurements taken at home. This form of hypertension is believed to be caused by anxiety or stress associated with a clinical setting. 

White coat hypertension does not necessarily require treatment but should be monitored to ensure it does not progress to more severe hypertension stages.

Hypertensive Crisis

A hypertensive crisis occurs when blood pressure suddenly and dramatically increases to dangerously high levels (systolic blood pressure over 180 mm Hg or diastolic pressure over 120 mm Hg). 

This can cause severe damage to blood vessels and organs, increasing the risk of stroke, heart attack, and kidney damage. Immediate medical attention is required during a hypertensive crisis, and it typically requires acute hospitalization for proper management and treatment.

Hypertensive Emergency

A hypertensive emergency is a severe form of hypertensive crisis where organ damage is already present due to extremely high blood pressure. 

This condition requires immediate hospitalization and treatment to reduce blood pressure and minimize further damage to vital organs. Symptoms of a hypertensive emergency may include severe headache, chest pain, difficulty breathing, or vision problems.

Diagnosing Hypertension

To diagnose hypertension, a healthcare professional will use a blood pressure monitor to measure your blood pressure. This is typically done in a medical setting, but at-home monitors are available. 

If your blood pressure is consistently high after multiple readings, your doctor may prescribe medication or suggest lifestyle changes to help manage your condition.

The measurement unit for blood pressure is millimeters of mercury (mm Hg), and it consists of two values. The pressure exerted on the walls of the arteries with each cardiac pump is known as systolic blood pressure. In contrast, the pressure experienced by the arteries during the relaxation phase after a heartbeat is known as diastolic blood pressure.

A standard blood pressure measurement deemed within the normal parameters is generally less than 120/80 mm Hg. A diagnosis of hypertension is made when measurements form a trend that reads a systolic blood pressure of 130 mm Hg or more and/or a diastolic blood pressure of 80 mm Hg or above. 

It is important to measure blood pressure in both arms, with continuous measurements being taken from the arm with the higher reading. This approach helps rule out “white coat hypertension.”

Doctors may recommend additional blood tests to assess factors that could contribute to or signal the presence of hypertension. These tests include assessments of kidney function, electrolytes, and blood sugar levels.

Complications and Diseases

Hypertension, if not effectively managed, can lead to a host of complications and diseases. It can escalate to serious cardiovascular health problems, including heart disease, stroke, and kidney failure.

Heart Diseases

Hypertension increases the risk of developing heart disease.

High blood pressure puts strain on the heart, causing it to work harder to pump blood throughout the body. Over time, this increased workload can damage the heart muscle and result in the development of coronary artery disease or other heart-related issues.

Stroke

Elevated blood pressure can cause strokes by deteriorating and weakening the blood vessels within the brain. 

This damage can cause blood vessels to rupture or become blocked by a blood clot, both of which prevent blood flow to the brain and can lead to a stroke.

Kidney Damage

Uncontrolled hypertension is a major contributor to kidney damage. Elevated blood pressure harms the blood vessels within the kidneys, hindering their capacity to expel waste and oversupplied fluids from the body. 

Over time, kidney damage can progress to kidney failure, requiring dialysis or a kidney transplant.

Vision Loss

Heightened blood pressure could potentially damage the blood vessels in the eyes, possibly leading to impaired vision.

Blood vessel damage in the retina can result in retinopathy, which can cause blurred vision or complete vision loss. Additionally, hypertension increases the risk of other eye complications, such as glaucoma and macular degeneration.

Heart Failure

Hypertension is a significant risk factor for heart failure, which occurs when the heart cannot pump enough blood to meet the body’s needs. 

The increased workload on the heart, combined with damage to the blood vessels and heart muscle, can lead to the heart’s inability to function efficiently. Left untreated, heart failure can become life-threatening.

Frequently Asked Questions

What are the common symptoms of hypertension?

Hypertension, commonly known as high blood pressure, often presents without any noticeable symptoms. However, when symptoms do occur, they may include dizziness, shortness of breath, headaches, and nosebleeds. 

It is crucial to have regular blood pressure checks, as hypertension can go undetected for a long time, leading to serious health complications.

How is hypertension diagnosed?

A healthcare professional can diagnose hypertension by taking multiple blood pressure readings over a few appointments. The measurement unit for blood pressure is millimeters of mercury (mm Hg), consisting of two values.

Systolic blood pressure is the pressure experienced by the artery walls during a heartbeat, while diastolic blood pressure is the force exerted during the resting phase after and between heartbeats. 

If consistently high readings are observed, your doctor may diagnose you with hypertension.

What factors contribute to high blood pressure?

There is no single cause for high blood pressure, but several factors can contribute to its development.

Inactivity, poor diet, obesity, older age, and genetics all play a role in the development of hypertension.

How can hypertension be prevented?

Preventing hypertension involves lifestyle modifications, including maintaining a healthy weight, engaging in regular physical activity, consuming a balanced diet rich in fruits and vegetables, reducing salt intake, limiting alcohol consumption, and managing stress levels. 

Quitting smoking can also help in preventing hypertension.

What are the different types of hypertension?

There are two main types of hypertension: primary (essential) hypertension and secondary hypertension. 

Primary hypertension has no identifiable cause and develops gradually over time, while secondary hypertension results from an underlying condition, such as kidney disease or hormone disorders, and can occur suddenly and cause higher blood pressure than primary hypertension.

What are the common treatment options for high blood pressure?

Treatment for high blood pressure typically begins with lifestyle changes, such as adjusting diet, increasing physical activity, and managing stress. If these measures do not successfully control blood pressure, medication may be prescribed. 

Common medications include diuretics, beta-blockers, ACE inhibitors, and calcium channel blockers. Regular monitoring and communication with your healthcare provider will help ensure the most effective treatment plan is implemented.