Hypertension: Everything you need to know

What is hypertension?

It is a chronic condition in which blood pressure is high. It is marked as two numbers, and the optimal value is 120/80 mm Hg. The first number is the systolic pressure, which occurs when blood is ejected from the left ventricle of the heart into the aorta at the time of systole (contraction of the ventricles of the heart). 

The second number means diastolic pressure when the heart muscle is relaxed. Blood pressure rises during physical exertion, emotional arousal, but its value should be close to normal at rest. 

If, with several measurements taken at different times, the systolic pressure exceeds 139 mm Hg. and / or diastolic pressure is greater than 90 mm Hg. diagnose hypertension.

A persistent rise in blood pressure has been linked to several factors, including excess weight and lack of physical activity, unhealthy diet, bad habits, and high levels of stress.


Causes and risk factors of hypertension

Hypertension can be primary or secondary:

  • Primary (essential) hypertension occurs more often – according to various estimates, in 85-95% of cases. Its appearance is not associated with concomitant diseases, the pressure rises under the influence of a complex of factors;
  • Secondary (symptomatic) hypertension occurs in 5-15%. In this case, high blood pressure is one of the symptoms that can be associated with endocrine disorders, kidney disease, and abnormalities of large vessels.

When the regulation and maintenance of optimal blood pressure is impaired, primary hypertension occurs. The cause of its occurrence is usually a constant nervous tension. 

When diagnosing, it is important to establish as accurately as possible what caused the hypertension, whether it has secondary causes (the presence of diseases that increase blood pressure). Turn off the sound

Some factors that increase the chances of developing primary hypertension:

  • overweight (Obesity)
  • insufficient activity, physical inactivity, lack of physical activity
  • drinking and smoking
  • stress, constant emotional stress
  • lack of sleep, its poor quality insomnia
  • excess amount of salt consumed
  • improperly organized sleep and rest routine (including due to irregular or too long working hours)
  • changes in hormonal levels (in women, they can be associated with taking oral contraceptives, with the onset of menopause)
  • hereditary factors (in total, more than 20 genes have been identified that determine the predisposition to hypertension)
  • age over 65 years (the disease can also occur in young people, periodically monitoring blood pressure is already after 35 years)
  • unhealthy diet (lack of vegetables and fruits in the diet, excess foods high in trans fats and saturated fats)
  • kidney disease, diabetes mellitus and some other concomitant conditions, diseases.

Many of these factors are related and reinforce each other. Some of them can be controlled (for example, diet and diet, sleep, physical activity, weight, alcohol consumption, smoking). This is an easy way to reduce your risk of hypertension or to make you feel better if your blood pressure is already high.


To classify a disease, two approaches are used: by degrees and stages. 

The degrees of hypertension differ in how much blood pressure rises, the difference between the stages is in the course of the disease, in the number, and the severity of concomitant organic lesions.

First degree

Systolic blood pressure is more than 139 and less than 159 mm Hg, and the diastolic is at the level of 90-99 mm Hg. At higher values, you can normalize blood pressure by adjusting your lifestyle. To do this, you need to increase physical activity, adjust nutrition, give up bad habits, and reduce stress levels.

Second degree

In the second degree, blood pressure values become high and amount to 160-179 mm Hg. for systolic and 100-109 mm Hg. for diastolic. At such values, the load on the heart is greatly increased. The blood supply to the brain is impaired, and this can cause headaches and dizziness, and decreased performance. 

Changes occur in the fundus.  Sclerosis of the tissues and blood vessels of the kidneys begins, the excretory function is impaired, the development of renal failure is possible.  The state of the blood vessels is deteriorating. For treatment, you need to change your lifestyle, as well as start taking medications.

Third degree

The systolic pressure is above 180 mm Hg. Art., diastolic – above 110 mm Hg. With hypertension, the load on the heart becomes too high and provokes irreversible changes. The pressure must be constantly reduced with medication. Without this, there is a threat of acute heart failure, arrhythmias, angina pectoris, myocardial infarction, and other serious conditions. Patients with hypertension of the third degree need to be constantly monitored by a doctor.  Continuous medication to lower blood pressure is required.

Stages of hypertension

The disease develops gradually. There are three stages in total.

1. The first stage: moderate hypertension. Blood pressure is unstable and can change throughout the day. At this stage, the state of the internal organs and the central nervous system remains normal, there are no signs of organic damage.  Hypertensive crises are rare and relatively easy.

2. Second stage: severe hypertension. At the second stage, there is a significant increase in blood pressure, health often worsens, hypertensive crises become severe. At this stage, due to the constantly high blood pressure, changes in the internal organs begin.  Vascular disorders appear, blood supply to the brain deteriorates. Retinal arteries are narrowed. Left ventricular hypertrophy of the heart develops, and this increases the risk of severe cardiac pathologies. Signs of kidney dysfunction appear (increased urinary albumin, increased serum creatinine)

3. Stage three: very severe hypertension. Blood pressure becomes critically high – above 200 mm Hg. for systolic and 125 mm Hg. for diastolic.  Organic lesions intensify, heart failure, cerebral vascular thrombosis, aneurysms, renal failure and other serious conditions develop. Severe hypertensive crises often occur.

Symptoms of hypertension

Even with a significant increase in blood pressure, hypertension may not have symptoms for a long time. For this reason, you need to periodically measure your blood pressure (monitoring is especially important for those over 35). You can measure pressure with an automatic electronic tonometer – such devices are sold in pharmacies.

Among the main symptoms of hypertension are headache, dizziness, heaviness in the head. 

These manifestations are associated with vasospasm and impaired blood supply to the brain. Possible nosebleeds, ringing in the ears, decreased vision, cardiac arrhythmias. In severe hypertension, weakness, chest pains, nausea, vomiting, tremors (“tremors” of the muscles) may appear. Other symptoms include the appearance of veils or blackheads in front of the eyes, trouble sleeping, palpitations, and tinnitus.

If the disease progresses, visual acuity gradually decreases, the sensitivity of the arms or legs may decrease, in severe cases, their paralysis is possible. During periods of stress, against the background of nervous tension or physical activity, symptoms may increase. They are more common in middle-aged and elderly people. 

The disease is more severe in the presence of excess weight, bad habits, with a tendency to overeat, with a high level of stress. It is necessary to seek advice from a therapist or cardiologist for regular headaches, dizziness, vision problems, if its values are often increased during self-measurement of blood pressure.

Diagnostics Diagnostics is

usually carried out in three directions:

  • blood pressure measurement. It is performed at intervals of several hours or for 2-3 days in order to determine the degree of hypertension and its stage
  • identification of the causes of the disease. It is important to determine whether arterial hypertension is primary or secondary (caused by other diseases). In the second case, specific treatment may be required
  • control of the general state of health. During the examination, the condition of the heart, blood vessels of the brain, fundus, kidneys is monitored. High blood pressure disrupts these organs. When diagnosing, it is important to assess their condition.
  • At the first appointment, the doctor will conduct a survey, collect the details of the anamnesis that relate to the disease. You will need information about how long the patient has been suffering from hypertension, what is the level of blood pressure, whether there are symptoms of heart disease, apnea, severe snoring, whether a person or his close relatives have had strokes, peripheral arterial disease, gout, diabetes, kidney disease … The doctor will definitely ask questions about the lifestyle: physical activity, bad habits, diet, medication.
  • For patients with arterial hypertension, the following examinations are performed:
  • measurement of blood pressure. It is measured several times at rest (half an hour before the measurement, physical activity, caffeine consumption, smoking are excluded), measurements are taken at different times of the day;
  • general examination: measurement of height and weight, waist circumference, palpation of the abdomen, assessment of the pulsation of the peripheral arteries;
  • Analysis of urine. The levels of albumin and creatinine are important – a deviation from the norm indicates a violation of the kidneys and requires an ultrasound;
  • a blood test to control the levels of potassium, creatinine, lipids, an ultrasound of the kidneys is prescribed. Assessment of lipid levels is needed to control lipid metabolism in order to exclude the risk of complications from the cardiovascular system;
  • An ECG is performed when left ventricular hypertrophy is detected to monitor the condition of the heart.
  • Additionally, the doctor may refer the patient for a cardiological or neurological examination, for examination of the respiratory system.

Hypertension treatment

Arterial hypertension is a disease that cannot be completely cured, but can be controlled. Therapy and lifestyle changes can stop the development of hypertension, reduce the frequency and severity of crises and relieve symptoms. But the most important thing is to reduce the risks for the cardiovascular system, brain, and kidneys.

Treatment begins with lifestyle correction:

  • smoking cessation
  • refusal to drink alcohol or significantly limit the amount of alcohol
  • diet: adjust the diet, reduce salt intake (less than 3.75 g per day), increase the amount of vegetables and fruits (ideally, 5 servings per day), whole grains, dairy products, low-fat foods, limit calorie intake.  If there are no contraindications and kidney disease, increase the consumption of foods containing potassium (spinach, beans, pumpkin, fish, milk, kefir, yogurt and others)
  • increased physical activity.  Moderate exercise is recommended to help reduce weight and strengthen the cardiovascular system
  • Blood pressure during treatment is reduced to target values (below 130/80 mm Hg) to reduce the risk of complications. With such a decrease, constant monitoring by a doctor is needed. The tonometer used for home measurements should be regularly calibrated. For patients with diabetes, pregnant women, the elderly and debilitated people, the use of antihypertensive drugs requires special care.

Important! Prescribing medications and their dosages should be made by a therapist or cardiologist after the examination.  Taking medication without a doctor’s prescription can be dangerous.

If the doctor prescribes medication, periodically you need to undergo follow-up examinations in order to evaluate the effectiveness of treatment and adjust it. It is important to adjust the lifestyle, restore normal health so that the minimum amount of medication is required to control the course of hypertension.

Possible complications

Due to high blood pressure, the walls of the arteries lose their elasticity, and the heart muscle works too hard. This increases the risk of angina pectoris, acute heart failure, heart attack. Due to disturbances in the blood supply to the brain, transient ischemic attacks and strokes are possible. 

The severity of hypertension will increase without treatment and lifestyle correction: the pressure will continue to rise, and this will lead to damage to internal organs, worsen overall health and well-being. 

Smoking, alcohol consumption, overeating, lack of physical activity and high levels of stress accelerate the development of hypertension and make its course more difficult.


Without treatment, arterial hypertension provokes serious consequences.  Constant spasm of cerebral vessels leads to ischemia, stroke. They are dangerous with severe disability and even death. When the load on the heart muscle becomes too high, tachycardia, arrhythmia, and heart failure occur. Without treatment, myocardial infarction is possible.

The severity of hypertensive crises increases, they become complicated, life-threatening and may be accompanied by stroke, acute coronary syndrome and other serious conditions. The quality of life against the background of hypertension without adequate therapy and restoration of a normal state of health is sharply reduced, up to severe disability.


The prognosis is good if the patient seeks a doctor on time, takes measures to control blood pressure and factors influencing hypertension. In this case, it is possible to avoid the long-term consequences of hypertension and its severe course. Even with a severe degree of arterial hypertension, it is necessary to undergo treatment and adjust the lifestyle.


For the prevention of hypertension, self-monitoring of blood pressure is recommended at the age of over 35 years or when symptoms of hypertension appear. It is important to exclude the influence of factors provoking an increase in blood pressure: control nutrition, exclude smoking and alcohol consumption, reduce stress levels, devote more time to physical activity: in short, to lead a healthy lifestyle.


Arterial hypertension is a dangerous disease, but it can be controlled by maintaining a normal state of health and reducing the risk of complications. To do this, it is important to monitor the level of blood pressure, control weight, lead a healthy lifestyle, undergo preventive examinations from a therapist or cardiologist.

Dr. Ashwani Kumar is highly skilled and experienced in treating major and minor general medicine diseases.