High blood pressure - What you need to know

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Article by Dr. Tran Ngoc Thuy Hang - Emergency Resuscitation Doctor - Emergency Resuscitation Department - Vinmec Central Park International General Hospital.

Blood pressure is determined by the amount of blood the heart pumps out in beats and the resistance the blood exerts on the arteries. The more blood the heart pumps, the narrower the arteries become, and the higher the blood pressure.

1. Causes of high blood pressure

There are 2 types of hypertension:
Primary hypertension: often called essential hypertension because the cause of this condition is unknown. This form of hypertension usually occurs in older adults and can progress rapidly over several years.
Secondary hypertension: usually due to pre-existing medical conditions in the patient. This form of hypertension often comes on suddenly and causes blood pressure to rise more quickly than primary hypertension. Possible causes of secondary hypertension:
Sleep disorders Renal disease Adrenal tumors Thyroid abnormalities Inherited vascular defects Use of oral contraceptives, cold medicines, decongestants, drugs pain relief Alcohol addiction

2. Risk factors for hypertension

Modifiable risk factors: smoking, drinking alcohol, salty eating habits (high in salt), low-potassium diet (potassium is abundant in vegetables, fruits: bananas, coconut water... ), vitamin D deficiency, inactivity, stress...
Risk factors not/hard to change:
Age: the risk of hypertension increases with age (men usually develop the disease at the age of 45 and older, Women often appear sick from the age of 65) Race: High blood pressure is often seen in people of color, so the age of the disease is earlier than white people. People of color also see more dangerous complications such as stroke, heart attack, kidney failure Family history: High blood pressure tends to be inherited (parents have high blood pressure, children are often at risk. suffer from this condition more). Chronic disease: People with kidney disease, diabetes, and insomnia may be at increased risk. Overweight, obese. Pregnancy: can also cause pregnant women to have gestational hypertension.

3. Symptoms of high blood pressure

Most people have no symptoms, even when blood pressure reaches dangerous levels. High blood pressure is often detected early when the patient goes to the doctor regularly or accidentally discovered when going to see another medical condition.
In some cases, the patient may have headaches, shortness of breath, and nosebleeds, but these symptoms are atypical and often do not occur when the condition has reached a critical stage.
Complications of hypertension: uncontrolled hypertension can lead to many dangerous complications: Heart attack or stroke: High blood pressure can cause atherosclerosis. This can lead to a heart attack or stroke. Aneurysms: Constantly high blood pressure causes vessel walls to become less elastic, weak, and enlarged. If the aneurysm ruptures, it can be life-threatening. Heart failure: Pumping blood away from the heart with too high wall pressure interferes with pumping and exhausts the heart. Cardiac muscle fibers gradually thicken, increasing the duration of contraction, eventually leading to heart failure. Chronic kidney disease. Reduced vision: Due to thickening, narrowing, and tearing of blood vessels in the eyeball. Metabolic syndrome: This syndrome includes many abnormalities in the body's metabolism, such as increased hip circumference, increased blood fat, decreased blood HDL and increased insulin. This condition can lead to diabetes, heart disease and stroke. Memory and thinking abnormalities: Uncontrolled high blood pressure can affect your ability to think, remember, and learn. Patients often have difficulty remembering and understanding something.

4. Diagnosis of hypertension

When measuring blood pressure, there are 2 indicators you need to keep in mind: systolic blood pressure (the top number is above), diastolic blood pressure (the small number is below).
Normal blood pressure: systolic blood pressure 90 to 120 mmHg and systolic blood pressure 60 to 80 mmHg (90/60mmHg to 120/80mmHg) Consider a diagnosis of hypertension when: systolic blood pressure is higher than 140 mmHg (in people over 60 years old, systolic blood pressure is higher than 150 mmHg) or diastolic blood pressure is higher than 90 mmHg. Self-monitoring blood pressure at home: This is an easy and important method for you to check your own blood pressure at home. You can use electronic blood pressure monitors that are widely available in medical stores without a prescription from a doctor.

5. Treatment of high blood pressure

The goal of hypertension treatment is to get your blood pressure:
Lower than 150/90 mm Hg: If you are older than 60 years of age and otherwise healthy. Less than 140/90 mm Hg: If you are younger than 60 years old and in normal health. Lower than 130/90 mm Hg: If you have chronic kidney disease, diabetes, coronary heart disease, or are at high risk for coronary heart disease. The type of medicine your doctor prescribes for you depends on your blood pressure readings and other health problems. To reduce the number of times you take your medication per day, your doctor may prescribe a combination of low-dose drugs that work together more effectively. Sometimes, choosing the right drug for each patient is a difficult process.

Change the way of life: No matter what medication the patient takes, they need to have a scientific way of life:
Eat healthy, eat light exercise Regular exercise Quit smoking Limit alcohol intake Maintain a healthy weight Resistant Hypertension:
If your blood pressure is still not getting better after taking at least 3 different medicines, one of which is a diuretic, you may have resistant hypertension.
Having resistant hypertension doesn't mean your blood pressure will never drop. In fact, there is still a chance to effectively treat resistant hypertension.
Your doctor will evaluate the appropriateness of the drug and the dose you are taking. In some cases, certain medications, supplements, and foods can make the condition worse. Be open and honest with your doctor about the medications you are taking. If you do not take the medicine according to your doctor's instructions, the disease will get worse.

6. Measures to prevent high blood pressure

Eat science: Eat lots of vegetables, fruits, whole grains, meat, fish and low-fat dairy. Eat more foods that contain potassium, and limit your intake of saturated and trans fats. Reduce salt in meals: People over 51 years old, with diabetes, hypertension, chronic kidney disease should only eat up to 1.5g of salt per day. The average person can eat 2.3g of salt per day maximum. Pay attention to canned foods because they contain a lot of salt. Maintain a suitable weight: Losing weight if you are overweight or obese will help reduce the risk of dangerous diseases. Increase physical activity: Regular exercise helps lower blood pressure, regulate stress, reduce the risk of common diseases and help maintain a healthy weight. You should exercise for at least 150 minutes per week and set a goal of at least 2 days of muscle-strengthening workouts. Limit alcohol: If you are healthy, alcohol can raise blood pressure so you should drink in moderation. Men should drink 1-2 glasses per day, women should drink only 1 drink/day if absolutely necessary. Stop smoking: Smoking damages the walls of blood vessels and hardens the arteries, thereby increasing blood pressure. Manage stress: Learn how to reduce stress with a variety of methods such as trying stretching, deep breathing, or meditation. Playing sports and getting enough sleep are also effective methods. Monitor gestational blood pressure: If you're pregnant, you should ask your doctor about ways to stabilize your blood pressure during pregnancy. In case high blood pressure affects your life greatly and self-treatment is not effective, you should seek medical advice and help with treatment.

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