What is it?
Arterial hypertension is characterised by high blood pressure in the arterial vessels, which is determined by the amount of blood pumped by the heart and the resistance of the arteries to blood flow. Blood pressure increases with age and decreases during pregnancy. Factors that cause high blood pressure include stress, smoking, excessive weight, oral contraceptives, liquorice and high salt diet.
In 5% of patients with hypertension, the increase in blood pressure is due to specific diseases of certain organs, such as the thyroid gland, adrenal glands, kidneys or heart.
In the remaining 95% of patients, however, the cause of the high blood pressure cannot be found despite complex investigations. It is called essential or primary hypertension. It is a very common condition that is becoming more prevalent as people live longer. Today about 30% of the adult population is estimated to have this problem.
In recent years, many genes involved in controlling blood pressure have been identified, making the it a family disease.
Thus, essential hypertension is a multifactorial disease caused by predisposing genetic and environmental factors.
Which are the symptoms?
Arterial hypertension is often symptom-free, especially if the increase in blood pressure occurs gradually: in this case the body gradually gets used to higher blood pressure values without giving any signal to the patient. That is why many people with arterial hypertension do not complain about the symptoms, even if their blood pressure is very high. However, in some cases the patient may have non-specific symptoms that are usually underestimated or ignored by the patient, such as: headache, dizziness, tinnitus (ringing in the ears), visual changes (bright spots in front of the eyes, blurred vision). Scarce and non-specific symptoms are the main reasons why patients often do not suspect arterial hypertension. For these reasons, blood pressure should be checked regularly, as early diagnosis is very important in preventing related damage. On the other hand, complications of arterial hypertension, which develop years later and include heart failure, cerebral stroke, myocardial infarction, coronary heart disease and chronic renal failure, which represent hypertensive vascular damage, have a different impact.
- ischemic heart disease
How is it diagnosed?
The easiest and most effective method of high blood pressure diagnosis is to take regular blood pressure measurements. During diagnosis, it is important to characterise the hypertension patient as best as possible in order to personalise therapy and thus achieve the best possible outcomes in terms of reducing complications. This can be done by a second-level examination including a dietary sodium sensitivity test and 24-hour blood pressure monitoring. Currently, it is also possible to test groups of genes linked to hypertension.
How is it treated?
The first step in high blood pressure treatment is changing the patient's lifestyle, which requires moderate and regular physical activity, weight control, a low-salt diet, abstaining from smoking cigarettes and limiting alcohol consumption. These simple lifestyle changes may be sufficient to control slightly raised blood pressure. Otherwise medication therapy must be initiated. Possible prescriptions have different mechanisms of action, and the choice of antihypertensive medication is based on factors such as the patient's medical history, age, other comorbidities and individual tolerance of specific drugs. Personalisation of antihypertensive therapy, which is based on genetic and phenotypic information from individual patients, is currently being studied.
Where do we treat it?
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