What causes vicious hypertension

High blood pressure (hypertension)


High blood pressure, also known as hypertension, is a condition in which the Blood pressure permanently increased is. As a general guideline value for the diagnosis of "high blood pressure" is the internationally recognized limit value of 140/90 mmHg by the WHO.

High blood pressure remains often undetected for a long time. Most people live with high blood pressure for a long time without feeling any restrictions or signs. But that is precisely what makes hypertension so dangerous. Because even slightly elevated blood pressure values ​​over a longer period of time can damage the vascular system in the long term - especially if the patient has already been affected other risk factors such as high cholesterol, arteriosclerosis, condition after a stroke or heart attack and diabetes mellitus are affected. For this reason, the German High Pressure League e.V. speaks of an "individual cardiovascular risk", which must be taken into account when choosing the respective therapy for the treatment of high blood pressure.

Definition: what is blood pressure (hypertension)?

Blood pressure (hypertension) is the pressure at which the heart pumps blood through the vascular system. Its value is influenced by that Cardiac output and the Dilatation of blood vessels. The cardiac output can be measured as "cardiac output", i.e. the amount of blood that is moved by the heart per minute. The vessel width determines the resistance that the heart muscle has to overcome in its pumping work.

The regulation of both parameters is one complex interaction. It is mainly controlled by the autonomic nervous system and hormonally. The level of blood pressure fluctuates depending on physical activity and changes over the course of the day (decreased at night, increased in the morning). Also psychological factors have a great influence: The proverbial “thick neck” proves the blood pressure-increasing effects of anger, tension and hectic pace.

Blood pressure is measured in mmHg (millimeters of mercury). The first mentioned value describes the systolic pressure, the value that prevails in the arteries when the heart pumps blood into the arteries. The second value describes the diastolic pressure, the value that prevails in the arteries when the heart fills with blood again. The optimal blood pressure value is 120/80 mmHg.


Causes and risk factors of high blood pressure (hypertension)

In most cases, the cause of the hypertension remains unexplained. An organic cause for high blood pressure is often not found. The medic then speaks of one "Primary hypertension". However, prolonged stress, overweight (abdominal obesity), lack of exercise, family disposition and high consumption of salt or liquorice can all contribute to the development of hypertension.

From one "Secondary hypertension" one speaks when the high blood pressure is the result of another underlying disease. Such diseases are kidney disease, renal artery stenosis and diseases that cause hormonal disorders.

Hypertension is considered to be important risk factor for kidney, vascular and heart diseases. The risk of kidney damage, heart attack or stroke increases when other risk factors such as arteriosclerosis, diabetes mellitus, overweight (abdominal obesity) and smoking are added to high blood pressure.

Symptoms of high blood pressure (hypertension)

First of all, hypertension does not cause any noticeable problems. But even constant, slight high blood pressure (130/80 - 135/85 mmHg) can damage individual organs and the cardiovascular system in the long term.

The symptoms of high blood pressure are not easy to identify. Mostly they are called general malaise or sensitivity to the weather dismissed. As a result, the damaging effects of hypertension on organs, heart and vascular systems can develop unnoticed for a long time. It is therefore advisable to contact frequent symptoms how

  • a headache
  • dizziness
  • Nosebleeds
  • Palpitations
  • fatigue
  • nervousness

once the Blood pressure at the family doctor to be measured. If this is increased, the measurement should be repeated at another point in time.

However, only one can give a really meaningful result 24-hour long-term measurement provide. A 24-hour blood pressure profile is created using a mobile measuring device. White coat hypertension, high blood pressure that only occurs at the doctor's, and masked hypertension, existing high blood pressure that is normal at the doctor's visit, can be excluded in this way.

High blood pressure and its consequences

The effects of permanently high blood pressure are manifold, but they all have a direct origin Damage to the blood vessels. The constant high pressure in the arteries increases the likelihood that dangerous deposits (plaques) will form. In a slow but steady process, large areas of the vessel walls calcify (arteriosclerosis). They lose their elasticity and the ability to activate cerebral vasodilator regulatory mechanisms under high pressure.

Both have an intensifying effect on the blood pressure. The heart muscle must constantly against the increased resistance work. As the process progresses, the small vessels initially narrow more and more or even close. Serious tissue damage occurs in the undersupplied areas of the heart, kidneys or brain. If larger vessels close, coronary artery disease, heart attack and stroke are the consequences.

Therapy for high blood pressure (hypertension)

The choice of treatment depends on the overall cardiovascular risk of the individual high blood pressure patient. goal of non-drug and drug therapy against high blood pressure is a blood pressure value below 140/90 mmHg, in diabetics below 130/80 mmHg.

Whether, and if so, which therapy is indicated, depends not only on the level of blood pressure, but rather on the overall cardiovascular risk of the respective hypertensive patient. The doctor will therefore be appropriate Pre-existing or accompanying illnesses such as kidney failure or diabetes, as well as their occurrence in the family, take into account as well as Lifestyle and eating habits and tailor a therapy to it individually. The goal must be to achieve a blood pressure value below 140/90 mmHg, in diabetics below 130/80 mmHg, through non-drug and drug measures.

Non-drug treatment for high blood pressure (hypertension)

To lower high blood pressure is not only available at the beginning of the treatment Change of the Lifestyle in the foreground of the therapeutic approach, but is also the basis of any drug therapy. This includes:

Normalization of body weight

Even reducing body weight by a few kilos can have a positive effect on blood pressure. Abdominal fat in particular is problematic as it produces blood pressure-increasing hormones.

Regular exercise

At least three times a week for at least 30 minutes. Regular exercise is key to achieving normal blood pressure. It strengthens the heart and helps
breakdown and weight loss. An untrained high blood pressure patient shouldn't overdo it. The sporting activity should be adapted to the level of training. Regular walks, swimming and bike rides make more sense than strength and ball sports, which put additional stress on the cardiovascular system due to peak loads.

Low-salt and Mediterranean food

Salt is tasty and important. But salt binds water in the body and thus also increases blood pressure. A lot of salt is hidden, especially in ready meals. High blood pressure patients should not consume more than 3-5 grams of salt per day and reduce the consumption of animal fats. Vegetable fats and a balanced diet of fruits, vegetables, fish and lean meat are better. Excessive consumption of licorice can also lead to hypertension.

Smoking cessation

Even if it is difficult - the blue haze is doubly harmful for high blood pressure patients. On the one hand it promotes the formation of arterial plaque (arteriosclerosis), on the other hand it increases the heart rate. Talk to your doctor about supportive measures if you are afraid of gaining weight or if smoking cessation is an additional stress factor.

Reduction in alcohol consumption

A glass of wine or a bottle of beer a day is safe and probably healthy. Studies have shown that red wine has a positive effect on the flow and coagulation properties of the blood. But anything beyond that is harmful. Alcohol increases the heart rate and thereby causes an increase in blood pressure.

Reduce stress

Easier said than done - but necessary. Hypertension patients in particular are often under too much pressure. You have to learn to relax. Find your way to relieve pressure. This will also have a positive effect on your blood pressure.

Drug therapy for high blood pressure (hypertension)

If the non-drug measures fail and in patients with severe or malignant hypertension or at high or very high risk, the high blood pressure should be treated with the help of suitable drugs. Representatives of various classes of substances are available for this purpose, which are more or less suitable due to their respective properties in the individual situation of the patient.

First choice drugs for hypertension

Diuretics, beta-blockers, ACE inhibitors, angiotensin (AT) -2-receptor antagonists and calcium channel blockers are the therapeutic agents of first choice. Beta blockers lower the frequency (pulse) and pumping capacity of the heart and thus blood pressure by inhibiting the stress-induced adrenaline effect. Calcium channel blockers lower vascular muscle tone, causing blood vessels to widen and blood pressure to drop.

Newer drugs for high blood pressure (hypertension)

Starting points for ACE inhibitors and the newer, well-tolerated AT-2 receptor antagonists are those Hormones and enzymes of the renin-angiotensin-aldosterone system. In addition to blood pressure, this control circuit also controls the body's salt and water balance. As antagonists of these hormones, ACE inhibitors and AT-2 receptor antagonists on the one hand reduce the vascular resistance, on the other hand they suppress the adrenaline-mediated effects on cardiac output and reduce the amount of blood to be transported.

Diuretics for hypertension

The latter is also achieved by diuretics, the classic antihypertensive preparations, by using the Increase kidney function and more water and salts are excreted. Thiazide diuretics in particular are used today. Antihypertensive drugs should be used according to a grading scheme that is based on the severity of the hypertension, the patient's individual risk as well as the success of the therapy and the side effect profile of the substance in question.

A cure for high blood pressure cannot be achieved with medication at the moment

In principle, drug therapy cannot cure high blood pressure; it can only set the blood pressure to more favorable values. She is mostly permanently for yearsto continue, if not for life. And here is the problem. Many patients take the medication unauthorized fromwhen blood pressure has returned to normal. In doing so, they forget that it is the drugs that control the blood pressure regulation that has gone awry. The consequences are fatal. The blood pressure rises again and organs, vessels and heart are damaged further.

Always talk to your doctor before you stop taking your medication on your own. Tell him your reasons and he will try to find the optimal therapy for you.

New methods in high blood pressure therapy promise to lower blood pressure without medication

Two procedures, which are still in the test phase, promise to lower blood pressure without lifelong use of medication. A completely new procedure in high blood pressure therapy represents the Development of a vaccine It is supposed to stimulate the patient's immune system to produce an antibody reaction against angiotensin II. Angiotensin II is a small protein in the body that is part of an important blood pressure control system in the body. Angiotensin II causes blood vessels to narrow, which increases blood pressure. The vaccination and the antibodies it produces block this mechanism, which is supposed to lower blood pressure.

Another approach to therapy is that Implantation of a blood pressure pacemaker. The pacemaker is the size of a matchbox and is implanted behind the collarbone. A constant impulse is sent to the blood pressure regulation center through thin wires in the carotid arteries. The brain is, so to speak, simulated that blood pressure is permanently too high. This stimulates the body to activate its own antihypertensive measures. The blood pressure should thereby permanently reduced become.

Prevention of high blood pressure (hypertension)

The measures mentioned for non-drug treatment of hypertension in the direction of a healthy lifestyle can be used very effectively as a preventive measure. And not only to protect against high blood pressure, but also to prevent diabetes and high blood lipid levels as well as heart attacks and strokes as serious consequences of vascular diseases.