High Blood Pressure Hypertension Symptoms & Causes

High blood pressure also known as Hypertension may not have any noticeable symptoms. The best indicator is to regularly check your blood pressure. If blood pressure is consistently above 140/90 mmHg on separate visits, it is classified as hypertension and should be evaluated by a health care provider.

What Is High Blood Pressure?

High blood pressure is when the blood has a high pressure that consistently exceeds the blood vessel walls.

Blood pressure consists of two numbers:

• Systolic pressure: The top number, which refers to a contraction of the heart.
• Diastolic pressure: The bottom number, which is the pressure as the heart relaxes between each beat.

A blood pressure reading of 130/80 mmHg, for instance, indicates that the blood pressure (BP) is 130 mmHg when the heart is pumping blood (systolic pressure) and 80 mmHg when the heart rests (diastolic pressure).

A single high blood pressure reading does not necessarily indicate hypertension or in common language high blood pressure. Stress, pain, exercise, caffeine, smoking or an incorrectly sized cuff can all cause blood pressure to temporarily rise. Repeated readings taken properly over a period of time are typically given great weight by the doctor and home or ambulatory monitoring may be recommended.

WHO defines hypertension as a blood pressure of 140 mmHg or more on two separate days, and/or a diastolic blood pressure of 90 mmHg or more on two separate days. Other international recommendations might be slightly lower, so it is best to discuss this with a health care provider.

High Blood Pressure Symptoms

The most significant thing to know about the blood pressure symptoms is that most of the people do not experience any. Hypertension may be considered a “silent” condition as the person may feel fine and slowly, the blood pressure can start to damage the heart, brain, kidneys, eyes and blood vessels.

This is why it is not recommended to wait for signs and symptoms of blood pressure before checking.

Common Hypertension Symptoms

The following is common hypertension symptoms  :

• Headache.
• Dizziness or light-headedness.
• Nosebleeds.
• Fuzzy, or fluctuating vision.
• Shortness of breath.
• Chest discomfort.
• Fatigue or weakness.
• Palpitations.
• Confusion or anxiety.

These symptoms are not always indicative of normal high blood pressure, however. They can happen for numerous other reasons and some individuals with very high levels may feel perfectly fine.

The best way to determine if you have high blood pressure is to use a validated blood pressure device or with a health care provider's help.

Severe High Blood Pressure Symptoms

When blood pressure becomes very high (typically 180/120 mmHg or higher), it can lead to serious high BP symptoms, especially if it is linked to acute organ damage.

• Possible symptoms include:
• Severe headache.
• Pain or pressure in the chest.
• Difficulty breathing.
• Sudden weakness or numbness.
• Difficulty speaking.
• Disorientation or decreased level of consciousness.
• Sudden vision changes.
• Severe dizziness.
• Nausea or vomiting.
• Convulsions or fainting.

These are not at home symptoms to be watched. They can be signs of a hypertensive emergency, stroke, heart attack, heart failure or some other serious illness. Seek urgent medical attention or head to the nearest emergency department as soon as possible.

High Blood Pressure Causes

The high blood pressure causes vary from person to person. Most adults have a combination of causes. Rather, blood pressure slowly rises due to the influence of a genetic disposition, age, lifestyle, body weight, medical conditions and environment.

Primary hypertension

Primary (or essential) hypertension is a slowly developing hypertension, in which there is no single causative disease.

• Factors to consider are:
• Family history of high blood pressure.
• Increasing age.
• Obesity or overweight.
• High salt intake.
• Low physical activity.
• Smoking or using tobacco.
• Excessive alcohol consumption.
• Bad sleep or OSA.
• Long-term psychological stress.
• Diabetes or insulin resistance.
• High cholesterol.
• Low vegetable, fruit, pulse and whole grains diet.

For many in India, sodium intake can be from salt added during cooking, pickles, papad, namkeen, instant foods, sauces, packaged foods and restaurant food. Minimizing these sources can help maintain a normal blood pressure.

Secondary hypertension

Secondary hypertension is caused by a known condition, drug or substance.

The following are potential hypertension causes:

• Chronic kidney disease.
• Constriction of the vessels that bring blood to the kidneys.
• Thyroid disorders.
• Abnormally high levels of hormones made by the adrenal glands.
• Obstructive sleep apnoea.
• Some congenital defects of blood vessels.
• Pregnancy-related disorders.
• Some pain relievers, steroids, birth control medications, decongestants and other medications.
• Excessive alcohol consumption, illicit drugs or stimulants.

If a person has unusually high blood pressure that begins suddenly, hard to control, or if it develops at a young age, without the usual risk factors, a doctor may explore possible secondary causes. Treating the underlying condition may improve blood pressure.

Risk Factors for Hypertension

Understanding the causes of high BP helps to identify what can be modified and what cannot.

Things that you cannot control.

• Age.
• Family history.
• Genetic predisposition.
• Ethnic or population related risk.
• Previous pregnancy-related hypertension.
• Certain genetic or birth defects.

Factors you can control

• High-salt diet.
• Being overweight.
• Physical inactivity.
• Tobacco use.
• Excess alcohol.
• Poor sleep.
• Untreated sleep apnoea.
• Uncontrolled diabetes.
• High cholesterol.
• Ongoing stress.
• Inconsistent use of prescribed medicines.

While having one risk factor is no guarantee of hypertension, it does indicate that you have a higher risk of developing it. On the other hand, individuals who do not have any apparent risk factors can get it as well. It's still important to measure regularly.

How is Hypertension Diagnosed?

Hypertension diagnosis must be accurate and follow-up must be undertaken. A clinician may take readings more than once during your visit, or he or she might instruct you to check your blood pressure at home.

A brief explanation of correct blood pressure measurement

To get a better reading:

• Try to refrain from smoking, drinking caffeine or heavy exercise within about 30 minutes prior.
• Empty your bladder.
• Relax for 5 minutes or more.
• Do not round your back and do not allow either foot to come off of the floor.
• Keep your arm on your chest.
• Make sure to take the right size upper arm cuff.
• Don't talk while the measurement is taken.
• Read two times 1 minute apart, and record both.
• If taking readings at home, do this at the same time everyday.

If not used properly, a wrist monitor may not be as effective. Select a validated device and bring to appointments for comparison with the health care team's machine.

Tests a doctor may recommend

Depending on your age, symptoms, risk factors, and readings, evaluation may include:

• Blood glucose, blood cholesterol, kidney function and blood electrolyte tests.
• Protein and blood tests of urine.
• Electrocardiogram (ECG): To check the heart's rhythm and strain.
• Echocardiogram - when assessment of structure/function of the heart is indicated.
• Eye examination for changes in retinal blood vessels.
• Evaluation of sleep for suspected sleep apnoea.
• Imaging of the hormones or kidneys when the causes are not known.

It is not only to confirm high blood pressure, but also to detect cardiovascular risks and early organ effects.

Why High Blood Pressure Should Not Be Ignored

Without treatment, high blood pressure can slowly cause damage to the blood vessels and organs.

It increases the risk of:

• Heart attack.
• Heart failure.
• Stroke.
• Kidney disease/kidney failure.
• Vision loss.
• Peripheral artery disease.
• Aortic disease.
• Mental changes and vascular dementia.

High pressure makes the heart work harder which in turn can make heart muscle thicken. This can lead to the heart's decreased pumping efficiency over time. In addition, it can damage the small vessels in the eyes and brain and the fine vessels in the kidneys.

Not having high BP symptoms doesn't indicate it's harmless. Treatment is aimed not at relieving unsavory symptoms, but at preventing further complications.

Prevention and Control

Lifestyle changes can help reduce the risk of high blood pressure and help treat it. Your plan should be realistic and be based on your health.

Practical steps

• Limit added salt and packaged/processed and restaurant foods.
• Eat more vegetables, fruits, pulses, beans, whole grains, and unsalted nuts.
• Opt for healthier fats and minimise saturated and trans fats.
• Work up to regular exercise like brisk walking, cycling, swimming, strength training medically appropriate.
• If you are overweight, try to lose weight slowly.
• Never smoke or use tobacco products.
• Limit alcohol.
• Get regular sleep and consult a doctor about snoring or daytime sleepiness.
• Control diabetes, cholesterol and kidney disease.
• Follow treatment regimen for medication.
• Take home readings and share with subsequent visits.

The WHO has recommended that people get regular exercise, eat a healthier low salt diet, quit smoking, manage their weight and take medicines as prescribed.

Don't discontinue blood pressure medications due to normal readings. If the result is normal, it's a good sign that the medicine and lifestyle changes are working. Treatment should not be stopped without medical advice as this can lead to a return of high blood pressure.

When to Seek Medical Help for High BP

Make an appointment with a doctor if:

• Readings are consistently outside of the recommended range.
• You have new or worsening blood pressure symptoms.
• You're under 40 years old and you have very high readings.
• You have high blood pressure that doesn't respond to treatment.
• You are pregnant or have recently given birth and your readings are high, you have headache, are having problems with your vision or your hands are swollen.
• You have had diabetes, kidney disease, heart disease or a stroke in the past.

If the reading is 180/120 mmHg or above, sit quietly and take another reading after a few minutes. If it continues at this level, seek medical attention immediately. If the symptoms include chest pain, difficulty breathing, weakness, numbness, confusion, vision changes or trouble speaking, get emergency medical help right away.

Use the JVH E-Consult App for consultation

In case of a concern with high blood pressure symptoms, repeated readings or probable hypertension causes, the JVH e-consult app serves to reach out to the healthcare team at Jaipur Vatika Hospital.

Discuss home readings, current medications, risks, headaches, dizziness, diabetes, cholesterol, kidney issues or if you need an in-person evaluation. Patients seeking hypertension management, preventive health assessment, chronic disease management and comprehensive care in case of a need for cardiology or other specialists, can turn to the General Medicine department at Jaipur Vatika Hospital.

Offering 24/7 general medicine and emergency services, Jaipur Vatika Hospital can be found at Thikariya on the Jaipur-Ajmer Expressway. Seek emergency medication/ assistance whenever having serious cases of high blood pressure rather than an online consultation.

Conclusion

High blood pressure and hypertension are often silent, meaning it's not safe to wait for symptoms. With regular check-ups, proper diagnosis, lifestyle modifications, and treatment, the risk of heart disease, stroke, kidney damage and vision problems can be significantly decreased.

Knowing what causes high blood pressure and what warning signs to look for can help you seek help when it's needed. Even if you are feeling very well, if your readings are regularly high, make a medical appointment for them to review.