Symptoms
Hypertension presents without symptoms unless your blood pressure is extremely high. When your blood pressure exceeds 180/120 mm Hg it is considered a hypertensive crisis – a medical emergency. If your blood pressure is very high and you have a headache, feel unwell, or a nosebleed occurs, call 911. Emergency-level symptoms that require immediate medical attention with a high blood pressure reading are:
- Chest pain or pressure
- Nosebleed
- Headache
- Dizziness and/or nausea
- Visual disturbances
- Feeling unwell
Types
Primary hypertension. Also known as essential hypertension, primary hypertension has no known cause and can be a result of age, heredity, lifestyle, and/or diet. Most cases of hypertension are attributed to this type.
Secondary hypertension. Occurring in 5-10% of cases, this type has a known cause usually related to a medical condition (i.e., narrowing of the arteries, adrenal gland disease, thyroid abnormalities, etc.) or a side effect of certain medications.
Malignant hypertension. A most severe type of hypertension. Malignant hypertension results in damage to your organs and requires immediate medical attention.
Isolated systolic hypertension (ISH). Occurs when your systolic reading is high (140 mm Hg and above) and your diastolic reading is normal. ISH can be an indicator of an underlying condition, like anemia, or is a result of stiffened arteries that come with age.
Resistant hypertension. Named for a high blood pressure that does not respond to medications and remains high until a secondary hypertensive cause is identified. May require multiple medications.
Risk Factors
Elevated blood pressure. Blood pressure readings that are marginally higher than what is considered normal (120/80mmHg) increase your risk for developing hypertension. Usually, blood pressure increases over time and a reading between 120/80 mmHg and 129/80mmHg may indicate that you are on the path to developing hypertension.
Diabetes. People with diabetes are at a very high risk of developing hypertension. The high blood sugar that accompanies diabetes causes the build-up of plaque in the arteries, narrowing the passageways, and the heart pumps with increased pressure to allow for proper blood flow. Hypertension in diabetics leads to serious complications, such as kidney disease, heart disease, and diabetic eye disease.
Obesity. Being overweight causes an increase in the volume of blood that flows through your arteries. This blood volume increase requires a higher blood pressure to supply nutrients and oxygen throughout the body.
Diet. High-fat foods (i.e., butter, margarine, fried foods, whole milk) can lead to the build-up of plaque in the arteries which increases blood pressure. Processed foods, especially those high in salt, and fast foods are particularly unhealthy. Salt is known to increase blood pressure as the body will retain water to dilute the salt in your body. The retention of water increases blood volume and causes the blood pressure to rise.
Low physical activity. When you exercise, the blood flow increases in the arteries, and natural hormones are released that relax the blood vessels of the body. This relaxation lowers the blood pressure while lack of physical activity increases it.
Alcohol. Having more than two drinks of alcohol a day activates the nervous system which in turn constricts the body’s blood vessels, increases blow flow, and heart rate. All of these factors combined cause an increase in blood pressure.
Stress. High levels of stress will release stress hormones in the body, initiating a rapid increase in blood pressure. Some people may smoke tobacco, drink alcohol, or eat food to relieve this stress – all of which may lead to an increase in blood pressure. stress – all of which may lead to an increase in blood pressure. Healthier coping mechanisms like relaxation and meditation will help lower blood pressure.
Chronic conditions. As mentioned earlier, some chronic conditions like diabetes may lead to an elevated risk for developing hypertension. Kidney disease and sleep apnea may also increase
your risk.
Medications. Some medications will increase your blood pressure. For example, medicines that contain pseudoephedrine or phenylephrine constrict the arteries, increasing blood pressure and heart rate.
Genetics and family health history. If you have a family history of heart disease and/or hypertension, you may be at an increased risk. Often, people within families share common behavioral habits, such as diet and exercise, that further exacerbate predisposition to high blood pressure.
Age. Blood pressure tends to get higher as you age, with 9 out of 10 people at risk for developing high blood pressure in their lifetime.
Diagnosis
According to ACC/AHA guidelines, blood pressure is categorized as follows:
Normal. Systolic less than 120 mm Hg, diastolic less than 80 mm Hg.
Elevated. Systolic between 120-129 mm Hg and diastolic less than 80 mm Hg.
Stage 1. Systolic between 130-139 mm Hg, diastolic between 80-89 mm Hg.
Stage 2. Systolic of 140 mm Hg or higher and diastolic of 90 mm Hg or higher.
Hypertensive crisis. Systolic over 180 and/or diastolic over 120 mm Hg. Requires immediate medical interventions.
Hypertension is typically diagnosed during a routine physical exam when a person’s blood pressure reading seems elevated. However, hypertension should be diagnosed after 2-3 visits at 1–4-week intervals unless the blood pressure reading is above 180/110 mm Hg.
Treatments
The best course of treatment for hypertension is to change unhealthy lifestyle habits and choose healthier living behaviors. Treatment may initially involve eating a low salt diet supplemented with fruits and vegetables, and exercise. Later, medication can be added to help further lower blood pressure. These medications are known as anti-hypertensive drugs. The three main types are:
- Diuretics – removes excess fluid and sodium from circulation
- Beta-blockers – decreases strength and rate of heart contraction
- Vasodilators – opens up blood vessels
As with many medications, you may experience unwanted side effects and if you feel ill after taking them, contact your healthcare provider.
Alternative Treatments and Home Remedies
Your healthcare provider will most likely prescribe an anti-hypertensive drug to help manage your high blood pressure. You must be open with your doctor about any herbal or dietary supplement you are planning to take to make sure this supplement does not interact with your prescribed medications.
Hawthorn berry.
Garlic. This flavorful bulb is known to reduce stiffness in the arteries and lower elevated cholesterol levels. Numerous studies have shown that supplementation with garlic has effectively lowered blood pressure readings in hypertensive patients.
Hibiscus tea. Herbalists recommend the use of hawthorn tea to treat circulatory disorders, like angina and arrhythmia. This tea may help lower blood pressure readings while acting to reduce anxiety.
Coenzyme Q10 (CoQ10). Also known as ubiquinone, this fat-soluble protein is found in high concentrations in the mitochondria of all living organisms. Studies have shown that if taken as a supplement, CoQ10 may have cardioprotective and anti-hypertensive properties.
Fish oil. Fatty acids found in freshwater fish have several beneficial attributes for the cardiovascular system. Like Vitamin E and garlic, fish oil high in EFAs are known to decrease LDL (low-density lipoprotein) cholesterol and decrease blood pressure readings.
Vitamin E. This fat-soluble vitamin is found in nuts, whole grains, egg yolks, seeds, and vegetable oils. It is an antioxidant that stops the oxidation of LDL cholesterol that causes atherosclerosis, or the build-up of plaque in the arteries. Atherosclerosis is a common cause of hypertension, especially in obese, diabetic, and aging populations.
B- vitamins. A recent study in rats prone to hypertensive strokes showed that supplementation with the B vitamins riboflavin (B2), pyridoxine (B6), and folic acid (B9) showed a significant decrease in systolic blood pressure and oxidative stress related to being prone to strokes.
Vitamin C. This antioxidant has been shown to lower blood pressure in a research study when taken as a supplement of 500 mg daily.
Lifestyle Changes
Stop smoking.
Lose excess weight. Set a healthy goal to lose excess pounds in small increments over time. Rapid weight loss plans usually result in the pounds coming right back and put excess strain on the heart.
Reduce sodium intake. Pay close attention to labels on processed foods (these are usually incredibly high in sodium additives, including MSG). Avoid any foods that have more than 300mg per serving.
Limit alcohol. Drink a healthy amount of alcohol. One drink per day for women and two for men.
Increase physical activity. Exercise releases hormones that dilate the blood vessels and calm the anxious mind.
Manage stress. Talk with your friends and family when are experiencing anxiety. Simply talking to a friend can release good-feeling hormones into your body and naturally lowers your level of stress hormones. Give yourself time to finish tasks through the practice of time management. Evaluate your priorities and set a manageable time limit that you can complete without undue pressure or stress. Set a time aside each day for quiet relaxation and take 20 minutes to sit in a quiet place, breathe deeply, and contemplate a beautiful place.
References
American Heart Association. (2016, October 31). What is high blood pressure? Retrieved from American Heart Association: https://www.heart.org/en/health-topics/high-blood-pressure/the-facts-about-high-blood-pressure/what-is-high-blood-pressure
Centers for Disease Control and Prevention. (2020, February 24). High blood pressure: Know your risk for high blood pressure. Retrieved from Centers for Disease Control and Prevention: https://www.cdc.gov/bloodpressure/risk_factors.htm#:~:text=Genes%20likely%20play%20some%20role,factors%20that%20increase%20their%20risk.
Chrysant, S. G. (2016). The clinical significance and costs of herbs and food supplements used by complementary and alternative medicine for the treatment of cardiovascular diseases and hypertension. Journal of Human Hypertension, 30(1), 1-6. Retrieved from: https://pubmed.ncbi.nlm.nih.gov/25994996/
Gurushankar, G., Sowers, J. R., and Stump, C. S. (2006). Hypertension and diabetes mellitus. European Cardiovascular Disease, 2(1). Retrieved from: https://www.ecrjournal.com/articles/hypertension-and-diabetes-mellitus
Siyad, A. R. (2011, August 12). Hypertension. Hygeia: Journal for Drugs and Medicine, 3(1), 1-16. Retrieved from: http://www.hygeiajournal.com/downloads/editorial/1909191763hypertension.pdf
UCSF Health. (2021). Risk factors for high blood pressure (hypertension. Retrieved from: https://www.ucsfhealth.org/education/risk-factors-for-high-blood-pressure-hypertension
