Contents
What is high blood pressure?
High blood pressure is too high blood pressure in the arteries.
Blood pressure is the physical result of blood being ejected from the heart through blood vessels. It is characterized by two values:
- the high value, measured during the contraction of the heart (systole), is called systolic pressure ;
- the low value, measured during the relaxation of the heart (diastole), is called diastolic pressure.
We speak of arterial hypertension when one or other of these values is greater than the values “normal”: 140 mmHg (millimeters of mercury) for systolic pressure, and 90 mmHg for diastolic pressure.
Blood pressure is thus judged too high if it is equal to or greater than 140/90, or 14/9 if expressed in centimeters of mercury (cmHG).
Hypertension: what are the symptoms and warning signs?
We often talk about high blood pressure as a “silent killer”. And for good reason: most of the time, it does not cause any specific symptoms. Difficult then to notice it. There is in spite of everything warning signs that should prompt you to consult and suspect hypertension: headaches, difficulty concentrating, dizziness, chest pain, shortness of breath, visual disturbances (in particular we speak of “butterflies in front of the eyes”), ringing in the ears, fatigue …
Hypertension: causes and risk factors
There is rarely a single cause that can explain the occurrence of high blood pressure. Some are avoidable risk factors, while others are inevitable.
Non-avoidable risk factors include age (the older we get, the more at risk we are), sex (women are less affected than men, but their risk increases during pregnancy or menopause), heredity, certain diseases and medications (contraception, anti-inflammatory drugs, antidepressants, corticosteroids, etc.), weight gain, etc.
There is also factors that increase hypertension, such as overweight, lack of physical activity, tobacco, salt, alcohol, stress, lack of sleep or isolation.
Hypertension and pregnancy: dangerous connections
Hypertension during pregnancy is far from a trivial condition, and must be taken seriously very quickly. This is why prenatal visits generally include blood pressure measurement, to screen for possible hypertension.
High blood pressure is the most common health problem during pregnancy (5-10% of pregnancies). Its management differs depending on the severity of the high blood pressure. We thus distinguish:
- high blood pressure during pregnancy (which means “during pregnancy”) mild to moderate, with a systolic pressure between 140 and 159 mmHg, or a diastolic pressure between 90 and 109 mmHg;
- severe high blood pressure, with systolic pressure greater than 160 mmHG, or diastolic pressure greater than 110 mmHg.
Depending on the severity, several health professionals may be called upon in the monitoring of pregnancy with hypertension : attending physician, gynecologist, midwife, obstetrician, cardiologist, nephrologist …
But if high blood pressure should be taken very seriously during pregnancy, it’s because it can lead to maternal complications which may be life-threatening, with in particular a risk of pre-eclampsia, which may progress to eclampsia, or cause the occurrence of a retroplacental hematoma (causing detachment of the placenta).
Neonatal complications can also affect the newborn, including a greater risk of intrauterine growth retardation or prematurity.
High blood pressure: what are the risks?
To resist the too great blood pressure, the arteries stiffen, their wall thickens. As a result, the free space for passing blood is getting smaller and smaller. At the same time, high blood pressure promotes the development of atheroma plaques, fatty deposits, which further narrow the arterial diameter. Sometimes an atherosclerotic plaque comes off, and then goes blocking an artery and causing a cardiovascular event.
High blood pressure is like this a major risk factor for cardiovascular disease (heart attack, angina pectoris, stroke, ruptured aneurysm…). It can also damage other key organs, including the kidneys (chronic kidney disease) or the retina (retinopathy), and promote the development of neurodegenerative diseases such as Alzheimer’s disease.
What are the treatments for high blood pressure?
Faced with major health risks, especially at the cardiovascular level, it is crucial to implement drug treatment in the event of arterial hypertension, if the adoption of hygienic and dietary measures is not sufficient.
Drug treatment for hypertension includes eight families of drugs, whose mechanisms of action are different and potentially complementary:
- angiotensin receptor antagonists (ARB II);
- ACE inhibitors;
- renin inhibitors (IDRs);
- beta blockers;
- thiazide and related diuretics;
- calcium channel blockers;
- central antihypertensive drugs;
- alpha blockers.
Treatment for hypertension should be individualized for each patient, and may change over time, as the disease progresses over time. Hence the need for appropriate follow-up with his or her attending physician or specialist.
Sources and additional information:
- https://www.fedecardio.org/Je-m-informe/Reduire-le-risque-cardio-vasculaire/lhypertension-arterielle
- https://www.fedecardio.org/sites/default/files/image_article/2019-BROCHURE-HTA-Web.pdf
- https://www.inserm.fr/information-en-sante/dossiers-information/hypertension-arterielle-hta