“I don’t even have any symptoms, so why does my doctor say my blood pressure is too high?” I believe that many patients have the same doubts when they first find out that they have high blood pressure, because most high blood pressure has no symptoms, and by the time they have symptoms, they have usually had high blood pressure for several years.

If there are no symptoms, is there no need for treatment?

According to research, untreated hypertensive patients have an average life expectancy 20 years shorter due to the risks associated with atherosclerosis. Untreated hypertensive patients are 21 times more likely to have a stroke, twice as likely to develop kidney disease, six times more likely to develop congestive heart failure, and more likely to suffer from myocardial infarction, arrhythmia, eye lesions, and brain lesions than the general population. Therefore, the goal of hypertension treatment is to prevent and minimize the occurrence of complications by maintaining normal and stable blood pressure.

What is the definition of hypertension?

Hypertension is defined as high blood pressure when measured at rest, with a systolic blood pressure greater than 140 mmHg and a diastolic blood pressure greater than 90 mmHg.
In November 2017, the American Heart Association revised the criteria for hypertension from 140/19 to greater than 130/80 in its hypertension treatment guidelines. Paul Whelton, the lead author of the guidelines, noted that people with blood pressure over 130/80 are twice as likely to have heart complications as the general population.
Fun fact: There are two types of hypertension

1.Essential hypertension
More than 90% of cases are classified as essential hypertension. The cause of essential hypertension is unknown and may be related to genetics and lifestyle.
2.Secondary hypertension
Secondary hypertension accounts for about 5% of all cases and is caused by pregnancy, kidney disease, aortic stenosis, endocrine abnormalities, and sleep apnea.
Secondary hypertension can also be caused by the use of oral contraceptives, steroids, immunosuppressants, amphetamines, and other medications.

Groups at high risk for hypertension

1.Heredity, Family History
Heredity is considered a risk factor for hypertension, but many studies have confirmed that environmental factors may be more important than heredity. Therefore, even if there is a family history of hypertension, as long as you maintain good lifestyle habits and avoid risk factors in your life, you will not necessarily develop high blood pressure.
2.Excessive salt intake
Eating too much salt is indeed an important risk factor, but as long as you reduce the amount of salt in your diet, you can lower your blood pressure within 4 weeks.
However, low-sodium salt should not be used as a substitute for table salt because it replaces sodium chloride with potassium chloride, which is not suitable for people with kidney disease or high blood potassium levels due to its high potassium content. It is best to consult a doctor if you want to switch to low-sodium salt.
3.Being overweight
According to statistics, there is a positive correlation between body weight and blood pressure; the heavier the body weight, the higher the blood pressure.
4.Lack of exercise
Research confirms that exercise can lower blood pressure, and people who exercise often have lower blood pressure.
5.Excessive stress
Stress can raise blood pressure, and some lifestyles that can lead to stress also increase the risk of high blood pressure, such as working overtime, working long hours in noisy environments, and living in complex social environments.

6.Smoking and excessive alcohol use
Nicotine in cigarettes causes constriction of peripheral blood vessels, raising blood pressure and increasing the risk of cardiovascular disease. Studies have shown that smokers have a 15% higher risk of developing high blood pressure than nonsmokers, which is reduced to 8% after smoking cessation.
Prolonged alcohol consumption can cause vasoconstriction of the blood vessels and increase blood pressure, and patients with high blood pressure who drink too much alcohol may also have difficulty controlling their blood pressure.

Symptoms of hypertension

Studies have shown that, on average, 1 in 4 people develop high blood pressure. Because most cases of high blood pressure are asymptomatic, it is not easy to tell if you have high blood pressure by its symptoms. When symptoms of high blood pressure do occur, it is usually because certain organs have been affected.
1.Brain and nerve symptoms
Dizziness, headache, ringing in the ears, shoulder or neck pain, vision problems
2.Heart symptoms
Often long lasting, such as palpitations, shortness of breath, chest tightness
3.Kidney symptoms
High blood pressure and kidney disease often occur together. Kidney disease can cause high blood pressure, and high blood pressure can affect kidney function. Symptoms include nausea, vomiting, edema, and wheezing.

Complications of hypertension

Like many chronic diseases, high blood pressure is not a scary condition in and of itself, but the complications that can result from poorly controlled blood pressure can be quite problematic.
Stroke: Hypertensive patients who do not take medication to control their blood pressure are 21 times more likely to have a stroke.
Vascular disease: carotid atherosclerosis, intermittent claudication.
Ocular lesions: retinopathy, fundus hemorrhages
Heart lesions: heart failure, myocardial infarction, aortic aneurysm, aortic dissection
Kidney Lesions: Long-term hypertension may cause renal vascular sclerosis, leading to renal dysfunction and failure.

Prevention of hypertension

1.Regular Blood Pressure Measurement
Regular blood pressure measurement can detect the blood pressure condition in time. If it is in the pre-hypertension stage, it can be improved by adjusting lifestyle and diet to prevent the development of high blood pressure.
2.Low salt diet
Limiting salt intake is an important guideline for controlling high blood pressure. Reducing salt in the diet to minimize sodium intake can effectively lower blood pressure. However, over-restriction with little or no salt intake can also cause damage to the body because the sodium in salt maintains the body’s osmotic pressure, and insufficient blood sodium can cause symptoms such as lethargy, loss of energy, nausea, and headaches.
The Department of Health and Human Services recommends that salt intake should not exceed 6 grams per day. If you already have high blood pressure, you should discuss your salt intake with your doctor.
3.Regular lifestyle
Maintain a regular routine, get enough sleep, and avoid working overtime.
4.Weight control
According to statistics, the heavier the weight, the higher the blood pressure, so weight control is one of the ways to prevent and improve hypertension.
5.Exercise regularly
Exercise can lower blood pressure, control body weight, lower LDL (bad) cholesterol, and reduce the risk of cardiovascular disease. Exercise has the function of reducing stress and preventing hypertension caused by long-term stress.
It is better to exercise 3-5 times a week for about 30 minutes each time. If you already have high blood pressure, high-intensity exercise is not suitable for you. Low- to moderate-intensity exercise such as swimming, Tai Chi, walking, and health exercises are more appropriate.
6.Stop smoking and drinking
Cigarettes and alcohol have a negative effect on high blood pressure. Cigarettes not only raise blood pressure, but long-term smoking can cause hardening of the small arteries, making hypertension worse.

Dietary Tips to Prevent High Blood Pressure

1.Eat whole grains (brown rice, germ rice, whole wheat bread, etc.)
2.Eat tomatoes or dark green vegetables
3.Eat fresh fruit instead of canned fruit
4.Replace whole milk with low-fat or skim milk
5.Eat white meat, less red meat
6.Choose vegetable oils

How to measure blood pressure?

1.Morning and bedtime measurements are more appropriate
2.Avoid smoking and caffeinated beverages 30 minutes before measuring your blood pressure.
3.Sit in a chair with a backrest and rest quietly for 5 minutes before the measurement.
4.Keep your upper body straight, do not clench your fists, and place a cuff on the upper arm of your dominant hand at the level of your heart.
5.Press the button of the blood pressure monitor and record the result.
6.After two minutes of rest, take another reading and average the results of two or more readings for a more accurate result.

High blood pressure medications
There are several common blood pressure medications:
1.Diuretics, such as spironolactone, furosemide, metolazone, etc.
2.Beta-sympathetic blockers, such as propranolol, atenolol, carvedilol, etc.
3.Calcium channel blockers, e.g., diltiazem, isoptin, lercanidipine, etc.
4.ACEI (angiotensin converting enzyme inhibitors), e.g., captopril, ramipril, etc.
5.Vasoconstrictor enzyme acceptor antagonists, e.g., valsartan, irbesartan, etc.
6.Vasodilators, e.g. minoxidil, hydralazine, etc.

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