Increased blood pressure

Blood pressure is a measure of the force that pushes blood against the walls of blood vessels. High blood pressure, also called hypertension, is dangerous because it forces the heart to work harder to pump blood into the body and can contribute to atherosclerosis, stroke, myocardial infarction, and heart failure.

What is an increase in blood pressure?

The appearance of hypertension is the result of a complex interaction of genetic, psycho-emotional and physiological factors. Numerous common genetic variants with little effect on blood pressure and some rare factors with significant effect on blood pressure have been identified. In addition, studies of the genome as a whole have identified 35 genetic factors associated with blood pressure (12 of these affect blood pressure and have been recently identified). DNA methylation may somehow associate common genetic variation with multiple phenotypes, although the mechanisms underlying these associations are not understood. One variation of the test performed in this study showed that genetic variants singly or in combination contribute to the risk of clinical phenotypes associated with high blood pressure.

Blood pressure increases with aging, and the risk of becoming hypertensive later in life increases. Several environmental factors influence this. High salt intake raises blood pressure levels in salt-sensitive individuals. Lack of exercise, obesity and depression may play a role in some cases. The role of other factors, such as excessive caffeine intake and vitamin D deficiency, is less clear. Insulin resistance, which is common in obesity and is a component of syndrome X (metabolic syndrome), is also believed to contribute to hypertension. Research shows that sugar may play an important role in the development of hypertension.

Early life events such as low birth weight, maternal smoking, and lack of breastfeeding may be risk factors for adult hypertension, although the mechanisms linking them to adult hypertension remain unclear.

Elevated urea levels have been found in people with the condition compared to people with normal blood pressure, although it is unclear whether this symptom is causative or an indicator of poor kidney function. Mean blood pressure may be higher in winter than in summer.

Normal blood pressure readings

Blood pressure readings are labeled as follows: 120/80. It reads like “120 by 80”. The top number is called systolic and the bottom number is called diastolic. Blood pressure ranges:

• optimal: less than 120 and less than 80;
• normal: 120-129 and/or 80-84;
• high normal: 130-139 and/or 85-89;
• arterial hypertension of the 1st degree: 140-159 and / or 90-99;
• arterial hypertension of the 2st degree: 160-179 and / or 100-109;
• arterial hypertension of the 3rd degree: more than 180 and / or more than 110;
• isolated systolic hypertension: greater than or equal to 140 and less than 90.

If your results are higher than normal, talk to your doctor about how to lower it properly.

Causes of increased pressure

There is evidence that some young people with prehypertension (borderline hypertension) have an elevated heart rate and normal peripheral resistance (hyperkinetic borderline hypertension). They develop the typical features of hypertension later in life.

Is this picture traditional for all people who eventually develop hypertension? So far this has been disputed. The increased peripheral resistance in established hypertension is mainly due to structural narrowing of small arteries and arterioles, although a decrease in the number or density of capillaries may also contribute to this.

It is not clear whether vasoconstriction of arterial blood vessels plays a role in hypertension. Hypertension is associated with decreased peripheral venous compatibility, which can increase venous return, cardiac preload, and ultimately cause diastolic dysfunction.

Pulse pressure often increases in older people with hypertension. This confirms that systolic readings are high and diastolic readings show normal or low readings, indicated by isolated systolic hypertension.

High pulse pressure occurs in older people with hypertension and is due to the increased arterial stiffness that usually accompanies aging and can be exacerbated by high blood pressure.

Many mechanisms have been proposed to investigate the increase in blood pressure in hypertension. Most of the evidence suggests either abnormalities in the behavior of the kidneys and water (especially abnormalities of the intrarenal renin-angiotensin system) or abnormalities of the sympathetic nervous system. These methods are not mutually exclusive, and it is likely that they contribute to some extent to hypertension. It has also been suggested that endothelial dysfunction and vascular inflammation can lead to increased peripheral resistance and vascular damage in hypertension. Consumption of excess sodium or potassium deficiency provokes an excessive intake of intracellular sodium, which tones the smooth muscles of the vessels and limits blood flow.

The exact reasons for the increase in performance are unknown, but several things may play a role, including:

• overweight or obesity;
• lack of physical activity;
• excessive salt intake in food;
• excessive alcohol consumption (more than 1-2 drinks per day);
• stress and age;
• family history of the disease, genetics;
• chronic kidney disease, adrenal and thyroid disorders;
• sleep apnea.

Secondary hypertension is due to an identifiable cause (kidney disease is the most common cause of secondary hypertension). This phenomenon can also be caused by endocrine conditions such as:

• syndrome or Cushing’s disease;
• hyperthyroidism, hypothyroidism, hyperparathyroidism;
• acromegaly;
• Conn’s syndrome or primary hyperaldosteronism;
• renal artery stenosis (from atherosclerosis or fibromuscular dysplasia);
• pheochromocytoma and other chromaffin tumors;
• obesity;
• sleep apnea;
• pregnancy;
• coarctation of the aorta;
• excessive introduction to the diet of licorice and drinking alcohol.

In 95% of cases of high blood pressure, the underlying cause may not be found. This type is called hypertension. Although it remains mysterious, it is directly related to some risk factors. High blood pressure tends to run in families and is more likely to affect men than women. Age and race play a role (blacks are twice as likely as whites to have higher scores). And while the gap begins to narrow around age 44, black women experience the highest incidence of high blood pressure after age 65.

Diagnosis of hypertension

Hypertension is defined as persistently elevated blood pressure. Traditionally, three separate observations are recommended monthly. For an accurate diagnosis of arterial hypertension, it is necessary to use the method of measuring blood pressure. Misreading of readings is common and can alter data by up to 10 mmHg, leading to misdiagnosis and misclassification of hypertension.

The correct technique includes several steps. Careful measurement of blood pressure requires the patient to sit quietly for at least five minutes, during which time the blood pressure cuff should be carefully put on. The person needs to lean against the back of the chair (legs on the floor should not cross) and talking or moving should be avoided during this process. The hand should lie on a flat surface at the level of the heart. The measurement should be carried out in a quiet room. To ensure accuracy, you need to take several blood pressure readings (at least two), located at a distance of 1-2 minutes from each other. Outpatient monitoring of indicators within 12-24 hours is the most accurate method of confirming the diagnosis.

The exception is patients who have excessive high blood pressure, especially when a particular organ is not functioning well. The initial evaluation of people with hypertension should include a medical history and physical examination. With the availability of 24-hour ambulatory and home devices, it is important to accurately diagnose patients with high blood pressure.

Pseudohypertension in incompressible artery syndrome requires a specific diagnosis. This condition is thought to be due to calcification of the arteries, resulting in abnormally high cuffed readings while intra-arterial measurements are normal. Orthostatic hypertension is an increase in blood pressure when a person is standing.

Once a diagnosis of hypertension is made, doctors should try to determine the underlying cause based on risk factors and other symptoms, if present.

Secondary hypertension is more common in adolescent children, in most cases caused by kidney disease, and has many risk factors, including obesity and a family history of hypertension.

Laboratory tests may be done to look for possible causes of secondary hypertension and to determine whether the condition has caused damage to the heart, eyes, and kidneys. Additional tests for diabetes and high cholesterol are usually done because the condition itself is a concomitant risk factor for heart disease and may require further treatment.

Serum creatinine is measured to assess the presence of kidney disease (may be the underlying cause or result of hypertension). The EGFR test provides a baseline assessment of kidney function that can be used to monitor the side effects of certain antihypertensive drugs. In addition, protein testing of urine samples is used as a secondary indicator of kidney disease. Analysis of the electrocardiogram is done to check for evidence that the heart is under stress from high blood pressure (this shows the presence of hypertrophy – thickening of the heart muscle). A chest x-ray or echocardiogram may be done to look for signs of an enlarged or damaged heart.

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