High Blood Pressure. “silent killer”.

What is raised blood pressure (hypertension)?

Hypertension, also known as high or raised blood pressure, is a condition in which the blood vessels have persistently raised pressure, putting them under increased stress. Each time the heart beats; it pumps blood into the vessels, which carry the blood throughout the body. Blood pressure is created by the force of blood pushing against the walls of blood vessels (arteries) as it is pumped by the heart. The higher the pressure, the harder the heart has to pump.

Normal adult blood pressure is defined as a blood pressure of 120 mm Hg1 when the heart beats (systolic) and a blood pressure of 80 mm Hg when the heart relaxes (diastolic). When systolic blood pressure is equal to or above 140 mm Hg and/or a diastolic blood pressure equal to or above 90 mm Hg the blood pressure is considered to be raised or high.

Most people with hypertension have no symptoms at all; this is why it is known as the “silent killer”. Sometimes hypertension causes symptoms such as headache, shortness of breath, dizziness, chest pain, palpitations of the heart and nose bleeds, but not always.


There are two types of high blood pressure.

▪️ Primary (essential) hypertension. For most adults, there’s no identifiable cause of high blood pressure. This type of high blood pressure, called primary (essential) hypertension, tends to develop gradually over many years.

▪️ Secondary hypertension. Some people have high blood pressure caused by an underlying condition. This type of high blood pressure, called secondary hypertension, tends to appear suddenly and cause higher blood pressure than does primary hypertension. Various conditions and medications can lead to secondary hypertension, including:

▪️ Obstructive sleep apnea.

▪️ Kidney disease.

▪️ Adrenal gland tumors.

▪️ Thyroid problems.

▪️ Certain defects you’re born with (congenital) in blood vessels.

▪️ Certain medications, such as birth control pills, cold remedies, decongestants, over-the-counter pain relievers and some prescription drugs.

▪️ Illegal drugs, such as cocaine and amphetamines.

Risk factors.

High blood pressure has many risk factors, including:

▪️ Age. The risk of high blood pressure increases as you age. Until about age 64, high blood pressure is more common in men. Women are more likely to develop high blood pressure after age 65.

▪️ Race. High blood pressure is particularly common among people of African heritage, often developing at an earlier age than it does in whites. Serious complications, such as stroke, heart attack and kidney failure, also are more common in people of African heritage.Family history. High blood pressure tends to run in families.

▪️ Being overweight or obese. The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues. As the amount of blood blow through your blood vessels increases, so does the pressure on your artery walls.

▪️ Not being physically active. People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction and the stronger the force on your arteries. Lack of physical activity also increases the risk of being overweight.

▪️ Using tobacco. Not only does smoking or chewing tobacco immediately raise your blood pressure temporarily, but the chemicals in tobacco can damage the lining of your artery walls. This can cause your arteries to narrow and increase your risk of heart disease. Secondhand smoke also can increase your heart disease risk.

▪️ Too much salt (sodium) in your diet. Too much sodium in your diet can cause your body to retain fluid, which increases blood pressure.

▪️ Too little potassium in your diet. Potassium helps balance the amount of sodium in your cells. A proper balance of potassium is critical for good heart health. If you don’t get enough potassium in your diet, or you lose too much potassium due to dehydration or other health conditions, sodium can build up in your blood.

▪️ Stress. High levels of stress can lead to a temporary increase in blood pressure. Stress-related habits such as eating more, using tobacco or drinking alcohol can lead to further increases in blood pressure.

▪️ Certain chronic conditions. Certain chronic conditions also may increase your risk of high blood pressure, including kidney disease, diabetes and sleep apnea.

Complications of high blood pressure.

Excessive blood pressure on the artery walls can cause damage to blood vessels and other organs in the body. The more high the blood pressure and the longer it remains high without treatment, the greater the damage.Untreated high blood pressure may lead to:

1. Damage to blood vessels.

2. Aneurysm (local aneurysm).

3. Cardiac arrest.

4. A blockage or rupture of a blood vessel in the brain.

5. Weakness and narrowing of the blood vessels in the kidneys.

6. Thickening, narrowing or constriction of the blood vessels in the eyes.

7. Problems with memory or understanding.

Blood pressure measurements.

According to the latest blood pressure baselines published in 2003, the measurement values ​​are divided into four general groups:

▪️ Normal level: blood pressure is considered normal when it is less than 120/80 mm Hg. However, some doctors say that a blood pressure of 75/115 mm Hg is best.

▪️ Prehypertension level: when the systolic pressure is between 120-139 mm Hg, or when the diastolic pressure is between 80-89 mm Hg.

▪️ Stage 1 Hypertension: When the systolic pressure is between 140-159 mm Hg, or when the diastolic pressure is between 90-99 mm Hg.

▪️ Stage 2 Hypertension: When the systolic pressure is 160 mm Hg or more, or when the diastolic pressure is 100 mm Hg or more.

The two values ​​(the two numbers, the highest and the lowest) in measuring blood pressure are important. But after the age of 50 years, systolic pressure becomes more important.

Systolic hypertension (ISH) – a condition in which the diastolic pressure is normal, while the systolic pressure is high. This condition is the most common type of hypertension in people over the age of 50.


Changing your lifestyle can help control and manage high blood pressure. Your doctor may recommend that you make lifestyle changes including:

1.Eating a heart-healthy diet with less salt.

2. Getting regular physical activity.

3. Maintaining a healthy weight or losing weight if you’re overweight or obese.

4. Limiting the amount of alcohol you drink.

But sometimes lifestyle changes aren’t enough. If diet and exercise don’t help, your doctor may recommend medication to lower your blood pressure.


Medications used to treat high blood pressure include:

▪️ Diuretics. Diuretics, sometimes called water pills, are medications that help your kidneys eliminate sodium and water from the body. These drugs are often the first medications tried to treat high blood pressure.

There are different classes of diuretics, including thiazide, loop and potassium sparing. Which one your doctor recommends depends on your blood pressure measurements and other health conditions, such a kidney disease or heart failure. Diuretics commonly used to treat blood pressure include chlorthalidone, hydrochlorothiazide (Microzide) and others.

▪️ Angiotensin-converting enzyme (ACE) inhibitors. These medications — such as lisinopril (Prinivil, Zestril), benazepril (Lotensin), captopril and others — help relax blood vessels by blocking the formation of a natural chemical that narrows blood vessels.

▪️ Angiotensin II receptor blockers (ARBs). These medications relax blood vessels by blocking the action, not the formation, of a natural chemical that narrows blood vessels. ARBs include candesartan (Atacand), losartan (Cozaar) and others.

▪️ Calcium channel blockers. These medications — including amlodipine (Norvasc), diltiazem (Cardizem, Tiazac, others) and others — help relax the muscles of your blood vessels. Some slow your heart rate. Calcium channel blockers may work better for older people and people of African heritage than do ACE inhibitors alone.

Lifestyle and home remedies.

Lifestyle changes can help you control and prevent high blood pressure, even if you’re taking blood pressure medication. Here’s what you can do:

▪️ Eat healthy foods. Eat a heart-healthy diet. Try the Dietary Approaches to Stop Hypertension (DASH) diet, which emphasizes fruits, vegetables, whole grains, poultry, fish and low-fat dairy foods. Get plenty of potassium, which can help prevent and control high blood pressure. Eat less saturated fat and trans fat.

▪️ Decrease the salt in your diet. Aim to limit sodium to less than 2,300 milligrams (mg) a day or less. However, a lower sodium intake — 1,500 mg a day or less — is ideal for most adults.

▪️ Maintain a healthy weight. Keeping a healthy weight, or losing weight if you’re overweight or obese, can help you control your high blood pressure and lower your risk of related health problems. In general, you may reduce your blood pressure by about 1 mm Hg with each kilogram (about 2.2 pounds) of weight you lose.

▪️ Increase physical activity. Regular physical activity can help lower your blood pressure, manage stress, keep your weight under control and reduce your risk of many health conditions. If you have high blood pressure, consistent moderate- to high-intensity workouts can lower your top blood pressure reading by about 11 mm Hg and the bottom number by about 5 mm Hg.

▪️ Don’t smoke. Tobacco can injure blood vessel walls and speed up the process of buildup of plaque in the arteries. If you smoke, ask your doctor to help you quit.

▪️ Manage stress. Reduce stress as much as possible. Practice healthy coping techniques, such as muscle relaxation, deep breathing or mindfulness. Getting regular physical activity and plenty of sleep can help, too.

▪️ Monitor your blood pressure at home. Home blood pressure monitoring allows you to keep a daily log of blood pressure measurements. Your doctor can review the information to determine if your medication is working or if you’re having complications. Home blood pressure monitoring isn’t a substitute for visits to your doctor. Even if you get normal readings, don’t stop or change your medications or alter your diet without talking to your doctor first.

▪️ Practice relaxation or slow, deep breathing. Practice taking deep, slow breaths to help relax. Some research shows that slow, paced breathing (five to seven deep breaths per minute) combined with mindfulness techniques can reduce blood pressure. There also are some devices available that promote slow, deep breathing. According to the American Heart Association, device-guided breathing may be a reasonable nondrug option for lowering blood pressure, especially if you have anxiety with high blood pressure or can’t tolerate standard treatments well.

▪️ Control blood pressure during pregnancy. Women with high blood pressure should discuss with their doctors how to control their blood pressure during pregnancy.

Alternative medicine.

Although diet and exercise are the most appropriate tactics to lower your blood pressure, some supplements also may help lower it. However, more research is needed to determine the potential benefits. These supplements include:

▪️ Fiber, such as blond psyllium and wheat bran.

▪️ Minerals, such as magnesium, calcium and potassium.

▪️ Folic acid.

▪️ Supplements or products that increase nitric oxide or widen blood vessels (vasodilators), such as cocoa, coenzyme Q10, L-arginine and garlic.

▪️ Omega-3 fatty acids, found in fatty fish, high-dose fish oil supplements and flaxseed.

Reference :

ارتفاع ضغط الدم High Blood Pressure /

أسئلة وأجوبة عن فرط ضغط الدم/

ارتفاع ضغط الدم/

ارتفاع ضغط الدم (فرط ضغط الدم) /

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