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High Blood Pressure – Causes, Symptoms and Treatment

High blood pressure (hypertension) is a chronic condition where the force of blood against artery walls is persistently elevated. It is a leading risk factor for heart attack and stroke.

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Things worth knowing about "High Blood Pressure"

High blood pressure (hypertension) is a chronic condition where the force of blood against artery walls is persistently elevated. It is a leading risk factor for heart attack and stroke.

What Is High Blood Pressure?

High blood pressure, medically known as arterial hypertension, is a chronic condition in which the pressure of blood flowing through the arteries remains persistently elevated. According to the World Health Organization (WHO), a blood pressure reading of 140/90 mmHg or higher is considered hypertension. It is one of the most prevalent conditions worldwide and a major contributor to cardiovascular disease and premature death.

Causes

There are two main types of high blood pressure:

Primary (essential) hypertension: Accounts for approximately 90% of all cases. No single identifiable cause exists; rather, a combination of genetic predisposition, high-salt diet, physical inactivity, obesity, chronic stress, and smoking contribute to its development.
Secondary hypertension: Affects around 10% of patients and is caused by an underlying medical condition such as kidney disease, thyroid disorders, or obstructive sleep apnea. Certain medications, including oral contraceptives and nonsteroidal anti-inflammatory drugs, can also raise blood pressure.

Symptoms

High blood pressure is frequently called a silent killer because it often produces no noticeable symptoms for years. When symptoms do occur — typically at very high blood pressure levels — they may include:

Headaches, especially at the back of the head
Dizziness and visual disturbances
Nosebleeds
Heart palpitations or shortness of breath
General fatigue and discomfort

Because symptoms are often absent, hypertension is frequently detected incidentally during routine medical checkups.

Diagnosis

Diagnosis is established through repeated blood pressure measurements taken on different days and at different times. Additional diagnostic tools include:

Ambulatory blood pressure monitoring (ABPM): A portable device records blood pressure continuously over 24 hours.
Laboratory tests: Blood and urine tests to assess kidney function, blood glucose, and cholesterol levels.
ECG and echocardiography: To evaluate potential cardiac changes caused by prolonged elevated blood pressure.

Treatment

Lifestyle Modifications

For mildly elevated blood pressure or as a complement to medication, the following lifestyle changes are recommended:

Low-sodium diet (less than 5 g of salt per day)
Regular physical activity (at least 150 minutes of moderate exercise per week)
Weight loss in overweight individuals
Smoking cessation and reduced alcohol consumption
Stress management and relaxation techniques

Medication

When lifestyle changes are insufficient, antihypertensive medications are prescribed. Commonly used drug classes include:

ACE inhibitors (e.g., ramipril)
Angiotensin II receptor blockers (ARBs) (e.g., losartan)
Calcium channel blockers (e.g., amlodipine)
Thiazide diuretics (e.g., hydrochlorothiazide)
Beta-blockers (e.g., metoprolol)

The choice of medication depends on the individual risk profile, any coexisting conditions, and tolerability.

Potential Complications

If left untreated, high blood pressure can lead to serious complications, including:

Heart attack and coronary artery disease
Stroke
Heart failure
Chronic kidney disease
Hypertensive retinopathy (damage to the blood vessels in the retina)

References

World Health Organization (WHO): Hypertension – Key Facts. Geneva, 2023. Available at: https://www.who.int/news-room/fact-sheets/detail/hypertension
Williams B. et al.: 2018 ESC/ESH Guidelines for the management of arterial hypertension. European Heart Journal, 2018; 39(33): 3021–3104.
Whelton P.K. et al.: 2017 ACC/AHA High Blood Pressure Clinical Practice Guideline. Journal of the American College of Cardiology, 2018; 71(19): e127–e248.

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