High blood pressure when to worry? Causes and what to do right away

High blood pressure: when to worry?

Having high blood pressure seriously endangers the health of the heart and blood vessels. Fortunately, many of the factors that can promote it are controllable. Let's find out when to be concerned and what to do right away to bring values back within acceptable levels.

 It is the most common cardiovascular problem in the world. Between the ages of 30 and 79 it affects 34 percent of men and 32 percent of women, but it does not spare younger people either. We are talking abouthypertension, a condition that according to the World Health Organization affects 1.28 billion people and looks set to affect more and more, with estimates predicting 1.5 billion hypertensives by 2025.

 The problem all these people are (and will be) dealing with is the increased force exerted by blood on the wall of their arteries. If excessive, this pressure can damage various tissues and organs, triggering problems not only for the heart and vessels but, for example, also for the kidneys and eyes.

 Not that every red eye should set off the alarm bell for high blood pressure, but alterations in vision could indeed be associated with severe forms of hypertension, as well as severe headaches, confusional states, nosebleeds, nausea and vomiting. There are also those who count fatigue and a general feeling of weakness among the symptoms of high blood pressure, but the truth is that in the vast majority of cases this condition does not trigger any symptoms, so much so that it is considered a "silentkiller."

 That is why it is very important to measure blood pressure regularly. We should all have started doing it 1 time a year as early as age 18. Neglecting this checkup could cost us dearly, causing us to be faced with health problems that are difficult to manage.

High blood pressure: the causes

Sometimes blood pressure increases due to factors that are beyond our control. For example, hypertension is a more common problem at older ages because as we age, blood vessels lose the elasticity that, in young people, allows them to adequately handle the pressure exerted by blood on their walls. It is different, however, to be a young man or a young woman; in fact, sex hormones also influence the risk of high blood pressure, protecting women. This is precisely why before the age of 50, hypertension is more common in the male population; however, the rapid rise in blood pressure that follows menopause causes the prevalence of hypertension to become higher in women over the age of 65.

 Familiarity is not under our control either, while we can act on other factors including:

-excess weight;

- diabetes;

- tobacco smoke;

- stress and anxiety;

- The excessive consumption of alcohol;

- Excess salt in the diet.

Finally, hypertension may be due to the presence of other conditions (chronic kidney disease, adrenal disease, hyperparathyroidism, renal artery stenosis, obstructive sleep apnea) or due to taking medications (e.g., migraine or cold medicines). High blood pressure can also appear suddenly during pregnancy; when to worry? In this case, it is always important to contact your gynecologist as soon as possible.

When to worry about high blood pressure

However, it is necessary to point out that there are two values to consider:

- the maximum (or systolic) pressure, which corresponds to the force exerted by the blood on the wall of the arteries when the heart contracts, pushing it into the circulation;

- the minimum (or diastolic) pressure, which corresponds, on the other hand, to the force exerted by the blood on the wall of the arteries when the heart relaxes, between beats.

According to theEuropean Society of Cardiology (ESC), blood pressure is optimal when the maximum is less than 120 mmHg and the minimum is less than 80 mmHg, otherwise it is:

- Normal blood pressure, with maximum between 120 and 129 mmHg and/or minimum between 80 and 84 mmHg;

- Normal-high blood pressure, with maximum between 130 and 139 mmHg and/or minimum between 85 and 89 mmHg;

- Grade 1 hypertension, with maximum between 140 and 159 mmHg and/or minimum between 90 and 99 mmHg;

- Grade 2 hypertension, with maximum between 160 and 179 mmHg and/or minimum between 100 and 109 mmHg;

- Grade 3 hypertension, with maximum > 180 mmHg and/or minimum > 110 mmHg.

The above "and/or" tell us that pressure can be high even if only the maximum or only the minimum are above the reference limits. In particular, the cases of:

- ipertensione sistolica isolata, con massima > 140 mmHg e minima <90;

- ipertensione diastolica isolata, con massima < 140 e minima ≥ 90.

In turn, cases of isolated hypertension, systolic or diastolic, can present with different grades (1, 2 or 3), depending on the most accurate values of altered blood pressure.

You may have heard that high minimum blood pressure is more dangerous, but this is not quite correct. On the one hand, it is true that the risk of fatal stroke or coronary artery disease doubles whenever the maximum increases by 20 mmHg, whereas an increase in the minimum of 10 mmHg is enough to have the same effect. On the other hand, once you turn 50, the association with cardiovascular events is stronger for the maximum than for the minimum. What's more, while some studies in the past had suggested that high minimum blood pressure was associated with increased cardiovascular risk in young people, more recent research indicates that risks increase even when it is high maximum. In addition, differential pressure (or pressure pulse, i.e., the difference between maximum and minimum) is also associated with adverse prognosis because it is an index of increased arterial stiffness.

In general, it is now known that the maximum gradually increases with age, while the minimum tends to increase only until the age of 50-60 years, after which there is a brief stabilization followed by a slight decrease, resulting in an increase in the pressure pulse.

However, in order to understand when (or rather how much) to worry because of high blood pressure (minimum or maximum), one must also look at other aspects in addition to the values such as the stage of the disease, which is determined by damage and associated pathologies.

- Stage 1 hypertension is not complicated, that is, it is not associated with organ damage or cardiovascular disease, but it may be associated with stage 1 or 2 kidney problems.

- Stage 2 hypertension is associated with organ damage, diabetes, or stage 3 kidney problems.

- Stage 3 hypertension is associated with cardiovascular disease or stage 4 or 5 kidney problems.

That said, there is never a good reason to underestimate high blood pressure. In fact, the relationship between blood pressure and cardiovascular and renal health is continuous, and problems can appear as early as when the maximum exceeds 115 mmHg or the minimum exceeds 75 mmHg.

High (minimum or maximum) blood pressure, how to lower it? What to do right away

In some cases, medication is necessary to bring blood pressure back to normal. It is the doctor who determines whether or not medication should be used; however, it is always necessary to get a grip on one's lifestyle right away, acting on the risk factors that may have contributed to the rise in blood pressure.

Those who smoke should quit; at the same time, excess alcohol should be avoided. On the other hand, as far as daily diet is concerned, cracking down on excesses, preferably by combining diet with adequate physical activity, will help lose any extra pounds that may promote higher blood pressure. In addition, it is essential to limit the use of table salt and reduce the consumption of foods that could excessively increase daily sodium intake.

The list of foods to avoid for high blood pressure (or at least limit) includes many canned, industrial foods and baked goods, which are often high in salt; the best way to recognize those that contain too much is to read the labels: an indication of how much is present is mandatory. For the same reason, it is necessary to limit consumption of processed meats, such as hams; of all of them, raw is particularly high in salt.

Foods that lower high blood pressure (or, rather, that are ideal ingredients for a diet aimed at keeping blood pressure under control), on the other hand, are fresh fruits and vegetables, rich in potassium and fiber, whole grains, legumes and nuts. Better to prefer fish, a source of Omega 3 fats, to meats (rich in saturated fats); in fact, marine-derived Omega 3s(EPA and DHA) are recognized as having the ability to help keep blood pressure in the normal range. And for seasoning foods?Olive oil is also preferable against high blood pressure.

The supplements for high blood pressure

Finally, extra help when you are not yet on medication can come from dietary supplements. Which is the best product to buy? Natural active ingredients for an anti-high blood pressure supplement with proven efficacy include the aforementioned EPA and DHA; taken at a dosage of 3 grams per day they help bring values back to normal.

A magnesium supplement is also often suggested, but at present the European Food Safety Authority (Efsa) does not authorize claims that this mineral helps control high blood pressure.

Sources:

European Commission. EU Register of Helath Claims. Last viewed 31/05/24

Mancia G et al. 2023 ESH Guidelines for the management of arterial hypertension The Task Force for the management of arterial hypertension of the European Society of Hypertension: Endorsed by the International Society of Hypertension (ISH) and the European Renal Association (ERA). Journal of Hypertension 41(12):p 1874-2071, December 2023. doi: 10.1097/HJH.0000000000003480

MedlinePlus. High blood pressure in adults - hypertension. Last viewed 5/30/24