Diabetes Complications

High Blood Pressure (Hypertension)

High blood pressure, medically known as hypertension, is when blood pressure rises to unhealthy levels. 

As a result, the heart has to work harder to pump blood around the body, which can result in several serious complications, including an increased risk of a heart attack and stroke.

Hypertension is a fairly common condition, and according to statistics from The American Heart Association, 103 million U.S. adults suffer from it. 

It is especially common in people with diabetes, with reports from 2012 showing that high blood pressure affects 50% of people with diabetes.

Early detection is critical, and regular blood screening tests can help to mark any changes. This article will discuss the causes, symptoms, and treatment options for high blood pressure.

What is high blood pressure?

Blood pressure is the force your blood puts on the blood vessels carrying it. If your blood puts too much pressure on its vessels, then your heart is forced to work harder when pumping blood to your body. When you have your blood pressure checked, it is measured with two numbers.

When your Doctor tells you your blood pressure, they will say it is “x over x.” The first number is your systolic pressure, and the second is your diastolic pressure.

The systolic pressure tells you the pressure on your blood vessels when your heart beats. Diastolic pressure is when your heart rests between beats.

Hypertension is diagnosed when the systolic number is 140 or higher, and the diastolic number is 90 or higher. If your blood pressure is between 130-140 over 80-90, then you are considered to have pre-hypertension.

If you have one number in the “normal” range and one in the “hypertension” range, then you have hypertension. Ideally, your blood pressure should be 120/80 and below.

Symptoms of high blood pressure

High blood pressure can often be symptomless, which is why it is sometimes referred to as the ‘silent killer.’ It is a condition that develops over several years or even decades without symptoms going noticed. 

Severe symptoms can include:

  • Headaches.

  • Fatigue.

  • Confusion.

  • Changes in vision.

     
  • Chest pains.

  • Nose bleeds.

  • Blood in the urine.

  • Pounding in your chest, neck, or ears.

Risk factors for high blood pressure

Many factors can increase your risk of developing hypertension. While some factors can not be controlled, understanding your level of risk can encourage you to take preventive steps. 

  • Family history- If your  relatives have high blood pressure, there’s an increased chance that you’ll get it, too. 

  • Age- The risk of hypertension increases as you age. 

  • Gender- Until age 64, men are more likely to get high blood pressure than women are. At 65 and older, women are more likely to get high blood pressure. Learn more about women and high blood pressure.

  • Obesity- being overweight or obese can further increase your risk.

  • Race -African-Americans tend to develop high blood pressure more often than people of any other racial background in the United States.

     
  • Chronic kidney disease (CKD)- High blood pressure can occur as a result of kidney disease. 

  • Diabetes- people with type 1 diabetes and type 2 diabetes have an increased risk of developing high blood pressure.

Causes of high blood pressure 

High blood pressure is divided into two types; primary hypertension and secondary hypertension.

Primary hypertension

In as many as 95% of high blood pressure (essential hypertension) cases in the U.S., the underlying cause can’t be found. This is known as primary hypertension. However, some possible factors have been identified, including:

  • Genetic.

  • Smoking.

  • Excessive salt consumption.

  • Being obese or overweight.

  • Age.

  • Stress.

  • Excessive alcohol consumption.
  • Environmental factors, such as stress and lack of exercise.

Secondary hypertension

If a direct cause of high blood pressure can be determined, it is known as secondary hypertension. Causes can include:

  • Kidney disease

  • Thyroid problems

  • Adrenal gland problems

  • Sleep apnea

  • Pregnancy

Complications of high blood pressure

If left untreated, over a period of time, high blood pressure can result in serious health complications, including atherosclerosis. Atherosclerosis is where plaque develops on the walls of blood vessels, causing them to narrow.

This makes it increasingly challenging for the heart to circulate blood. This can result in the following: 

  • Cardiovascular disease

  • Heart attacks

  • Heart failure

  • Kidney failure

  • An aneurysm

  • Stroke

  • Amputation

  • Dementia

Diagnosing high blood pressure

Blood pressure is typically measured by a Doctor using a blood pressure cuff, which can detect the pressure inside your arteries. This provides a numerical reading using a sphygmomanometer

Hypertension is rarely diagnosed after one reading, and your Doctor will most likely request that you have more readings over the next few weeks.

This is as factors, such as stress, could be contributing to your elevated blood pressure. Therefore your blood pressure levels need to be monitored before a diagnosis is given.

If your blood pressure remains high, your Doctor may perform several more tests to rule out underlying conditions. These include:

Treatment for high blood pressure

Medication

If you are diagnosed with high blood pressure, your Doctor may prescribe medication.

There are a large number of blood pressure medications, and you may need to try several different ones to determine which works best for you.

Some of the most common medication for the treatment of hypertension include:

  • Diuretics- High levels of sodium can result in high blood pressure. Diuretics, also called water pills, help your kidneys remove excess sodium from your body.

  • Beta-blockers- work by blocking the effects of adrenaline. This causes your heart to beat more slowly, and with less force, lowering blood pressure. They also help to improve blood flow.

  • Alpha-blockers- Alpha-blockers are used both for the treatment of BPH and for hypertension. They can relax certain muscles and help small blood vessels remain open. However, it is worth noting that they can have severe side effects. 

  • Calcium channel blockers-  Calcium channel blockers work by relaxing blood vessels and increase the supply of blood and oxygen to the heart.

  • Central agonists- Central agonists block signals from your brain, sending messages that speed up your heart rate and narrow your blood vessels.

  • ACE inhibitors- ACE inhibitors block your body from producing a chemical called angiotensin II. This is a substance in your body that narrows your blood vessels and releases hormones that can raise your blood pressure.

Natural Treatments

Diet

Your diet is central to your health and food choices you make can either help or hinder healthy development. Of course, in practice, passing up on a bag of chips and opting for carrot sticks, is easier said than done. 

Changes in diet can lower blood pressure, prevent the development of hypertension, and reduce the risk of hypertension-related complications.

The DASH diet (dietary approaches to stop hypertension), in particular, has been hailed for its success at lowering blood pressure. 

The DASH diet focuses on fruits, vegetables, whole grains, and lean meats and is low in red meat, salt, added sugars, and fat.

A study published in the Journal of the American Dietetic Association reviewed 412 adults who followed either a typical American diet or the Dash diet.

The study provided all foods and beverages to participate for one month. Their daily sodium intake levels were monitored. The researchers found the following:

  • Reducing daily sodium lowered blood pressure for participants on either diet. However, at all three daily sodium levels, the DASH diet lowered blood pressure more than the typical American diet.

  • Blood pressure decreased with each reduction of sodium.

  • Reducing sodium intake and following the DASH diet is more beneficial for lowering blood pressure than following the DASH diet alone or reducing sodium alone.

A follow-up report found that combining the DASH diet with sodium reduction benefited people who had higher than normal blood pressure readings.

It was also found that people who began with the highest blood pressure readings experienced the greatest benefits.

Physical activity

Exercise can be an effective means of preventing and managing high blood pressure. This is as regular exercise makes your heart stronger, which in turn, makes it easier to pump blood.

The less work your heart has to put into pumping, the less force on your arteries and the lower your blood pressure. 

In fact, some research has suggested that exercise could be more effective at lowering blood pressure than medications.

A study published in the British Journal of Sports Medicine looked at the data from 194 clinical trials that reviewed the impact of antihypertensive medications on systolic blood pressure. They also looked at 197 clinical trials comparing the effect of exercise of blood pressure.  In total, these trials collected information from 39,742 participants.

Overall, the researchers found that antihypertensive medications were more effective in lowering blood pressure in the general population. However, in the case of people with high blood pressure, it was found that exercise was as effective as most medication for blood pressure.

The Department of Health and Human Services recommends getting at least 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity a week. Aim for at least 30 minutes of aerobic activity a day.

Weight loss

A healthy diet, combined with regular exercise, can help to encourage weight loss. This can further benefit blood pressure, with obesity being a risk factor for hypertension.

Research shows that even losing as little as 10 pounds can significantly lower your blood pressure. 

Stress

For many people, stress is considered a normal part of life. However, high-stress levels can have a severe impact on your health.

As noted above, stress can contribute to high blood pressure, so lowering stress levels is essential if you suffer from hypertension. 

Taking a step back from a busy schedule can do the world of good for both your physical and mental health. Try making time for yourself and enjoy stress-relieving activities. Some examples can include:

  • Yoga

  • Meditation

  • Deep breathing exercises

  • Massage

  • A relaxing lavender bath

Life style 

Factors such as smoking and alcohol consumption should also be considered when it comes to managing blood pressure.

Research indicates that smoking and excessive drinking may increase the risk of developing hypertension. 

Further research is needed to determine this, but it seems that smoking and even exposure to secondhand smoke increases the risk for the buildup of fatty substances (plaque) inside the arteries. This result in (atherosclerosis) — a process that high blood pressure is known to accelerate. 

Likewise, alcohol is also thought to increase the risk of developing hypertension.

Alcohol can temporarily elevate blood pressure; the effect will wear off once you stop drinking, and your liver processes the alcohol out of your body. However, if you drink excessively, this could result in a number of health problems.

For example, one study found that men with high blood pressure who occasionally drink more than six drinks, doubled their risk of heart attack or stroke, For those who drank 12 or more drinks, the risk of suffering a stroke was five times higher.

Conclusion

Hypertension can be a deadly condition. It is known as a “silent killer” because many people die from undiagnosed hypertension. Be sure to talk to your doctor about your blood pressure at every visit.

If you suspect you may have high blood pressure or if your family has a history of it, then consider monitoring your blood pressure at home. 

Uncontrolled hypertension can result in serious complications, so it is important to speak with you Doctor, practice good blood pressure control, and set blood pressure targets.

Above all, begin making healthy choices in your diet, exercise, and lifestyle habits to avoid developing hypertension.

Sources

  1. https://www.nhlbi.nih.gov/health-topics/dash-eating-plan
  2. Friedman, GD, Klatsky, AL, Siegelaub AB. (1982). Alcohol, tobacco, and hypertension.. Hypertension. 5 (2), p143-150.
  3. Harsha, D, Bray, G. (2008). Weight Loss and Blood Pressure Control. Hypertension. 51 (6), p1420–1425.
  4. Feldstein, CA. (2002). Salt intake, hypertension and diabetes mellitus.. Journal of Human Hypertension. 16 (1), p48-51.
  5. Eryd, S, Gudbjörnsdottir, S, Manhem, K, Rosengren, A, Svensson, A, Miftaraj, M, Franzén, S, Björck, S . (2016). Blood pressure and complications in individuals with type 2 diabetes and no previous cardiovascular disease: national population based cohort study. BMJ. 354 (1), p1-2.
  6. Svetkey LP, Sacks FM, Obarzanek E, Vollmer WM, Appel LJ, Pao-Hwa L, Karanja NM, Harsha DW, Bray GA, Aickin M, Proschan MA, Windhauser MM, Swain JF, McCarron PB, Rhodes DG, Laws RL, for the DASH-Sodium Collaborative Research Group The DASH Diet, Sodium Intake and Blood Pressure Trial (DASH-sodium): rationale and design. J Am Diet Assoc. 1999;99 (suppl):S96–S104. 
  7. Sull JW1, Yi SW, Nam CM, Choi K, Ohrr H.. (2010). Binge drinking and hypertension on cardiovascular disease mortality in Korean men and women: a Kangwha cohort study.. Stroke. 41 (10), p2157-62.
  8. Bazzano LA, Green T, Harrison TN, Reynolds K. Dietary approaches to prevent hypertension. Curr Hypertens Rep. 2013;15(6):694–702. doi:10.1007/s11906-013-0390-z
  9. https://www.alzheimers.org.uk/about-dementia/risk-factors-and-prevention/high-blood-pressure
  10. https://www.mayoclinic.org/diseases-conditions/high-blood-pressure/in-depth/ace-inhibitors/art-20047480

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