High Blood Pressure
Overview
Symptoms of hypertension
When to see a cardiologist
Causes of hypertension
Complications of hypertension
Overview of Hypertension
High blood pressure is a very common condition but until a complication is experienced, it causes very few symptoms. Common complications of high blood pressure include heart attack and stroke; the risk of these be reduced by blood pressure treatment. There are agreed criteria for starting treatment and another set of “target” figures to aim for in reducing the blood pressure to minimise risk of heart attack and stroke.
Blood pressure measurements are recorded as two numbers: the “systolic” (written on top) over the “diastolic” (written on the bottom). The systolic pressure is the peak pressure in the arteries while the heart is contracting. The diastolic is the lowest pressure recorded while the heart is relaxing in between beats. Either the systolic, diastolic or both may be high to trigger a diagnosis of hight blood pressure.
The cut off for diagnosing high blood pressure depends on age and other factors, such as whether the patient has diabetes. Also different ways of measuring blood pressure (home versus at a doctor’s surgery; one-off readings versus ambulatory monitoring) carry different cut-offs for what is considered normal vs high.
When to See a Cardiologist
If you are concerned that you may have high blood pressure then a cardiologist can help you confirm this. If you feel that blood pressure readings you have made might be inaccurate in some way then a cardiologist can also suggest ways to get a more accurate picture of your true blood pressure, for example with a 24hr blood pressure recording called an “ambulatory blood pressure monitor”. For some people this approach can overcome artificially high readings due to anxiety around having your blood pressure taken (so-called “white coat hypertension”).
If you have a diagnosis of high blood pressure and are concerned that no cause has been found, or that the treatment you have been prescribed is not working or does not suit you, then a cardiologist can also help you address these questions. Rarely, a cardiologist may uncover that you have one of the rare, “secondary” causes of high blood pressure, treatment of which may reverse your high blood pressure completely.
Lastly, if you are concerned that you may have inherited a tendency to high blood pressure, then a cardiologist can help you understand what you can do to reduce your chance of developing the condition by focusing on lifestyle and dietary changes.
Causes of Hypertension
Most people develop high blood pressure due to a combination of lifestyle factors, diet and their genetic inheritance. The leading dietary cause of high blood pressure is salt intake: in general terms, the less salt you eat the lower your blood pressure will be. Likewise, alcohol intake and intake of other stimulants have an important effect on blood pressure over the longer term.
Some common health conditions such as diabetes, kidney disease and being overweight can increase blood pressure, sometimes to the point where the blood pressure requires treatment. Obstructive sleep apnoea is a very potent cause of high blood pressure.
There are also some rarer medical conditions – mainly hormone abnormalities and rare narrowings in important blood vessels – that can cause very high blood pressure. These are called “secondary” causes of hypertension. If none of the common causes for high blood pressure is found then a cardiologist may suggest testing for these rarer conditions with special blood tests or scans.
Complications of Hypertension
High blood pressure can cause damage to the lining of the blood vessels, leading to narrowing and clot formation. If this happens in the brain, this leads to stroke. In the heart, it can lead to angina and heart attacks. If the process affects the kidneys, then kidney function can decline over the long term. High blood pressure also affects the retina of the eye, and is a leading cause of blindness.
Prompt diagnosis and treatment of high blood pressure can reduce the risk of all these complications.