What Causes High Blood Pressure, And How Can It Be Managed

High blood pressure, also known as hypertension, is a prevalent health condition where the force of the blood against the artery or vein wall is consistently too high. This condition is often dubbed the “silent killer” because it can quietly damage the body for years before symptoms become noticeable. If left unmanaged, high blood pressure can lead to a myriad of serious health issues, including heart disease, stroke, and kidney failure. 

Lowering blood pressure is crucial for maintaining heart health and reducing the risk of these life-threatening conditions. Adopting lifestyle changes, such as a balanced diet, regular physical activity, and stress management, along with medication when necessary, can significantly contribute to controlling blood pressure. Recognising and managing high blood pressure is essential for long-term health and wellbeing.

The Dangers Of High Blood Pressure

The known complications of high blood pressure

Hypertension poses significant health risks and can lead to severe complications if left unchecked. This condition forces the heart to work harder than normal to circulate blood through the blood vessels, which over time can cause substantial damage to the cardiovascular system and other organs. Here are the primary dangers associated with high blood pressure:

Heart Disease and Stroke

According to the World Health Organization (WHO), high blood pressure contributes to around 13% of all deaths globally. The correlation between hypertension and cardiovascular diseases is well-established, with numerous studies providing evidence of their association.

Heart Disease
High blood pressure places increased strain on the heart and blood vessels, leading to various cardiovascular complications. The British Heart Foundation reports that individuals with untreated high blood pressure are three times more likely to develop heart disease than those with normal blood pressure. Over time, hypertension can cause the arteries to narrow and harden (atherosclerosis), leading to conditions such as coronary artery disease, heart attack, heart failure, and arrhythmias.

Hypertension is a primary risk factor for stroke, a medical emergency that occurs when the blood supply to the brain is interrupted or reduced. According to the Stroke Association UK, high blood pressure is the single most important modifiable risk factor for stroke, contributing to approximately 50% of all strokes. Elevated blood pressure damages the delicate blood vessels in the brain, increasing the risk of blood clots, haemorrhages, and impaired cerebral circulation, all of which can lead to stroke.

Heart Failure

High blood pressure, or hypertension, is strongly correlated with an increased risk of heart failure, a serious condition where the heart becomes progressively unable to pump blood efficiently. 

According to a study, individuals with high blood pressure are at significantly higher risk of developing heart failure compared to those with normal blood pressure. The study found that for every 20mmHg increase in systolic blood pressure (the top number), the risk of heart failure doubles. 

Additionally, a landmark investigation into cardiovascular risk factors, reported that hypertension is the most important modifiable risk factor for heart failure, accounting for approximately 39% of heart failure cases in men and 59% in women.

Kidney Damage

Hypertension is a leading cause of chronic kidney disease (CKD), with approximately 30% of cases attributed to high blood pressure. The study found that individuals with hypertension are at increased risk of developing CKD, characterised by a gradual loss of kidney function over time. Additionally, the National Kidney Foundation reports that hypertension is the second leading cause of kidney failure, accounting for around 25% of all cases. 

High blood pressure, or hypertension, can lead to kidney damage through several mechanisms, exacerbating existing renal conditions or initiating new ones. The correlation between high blood pressure and kidney damage is bidirectional, meaning each condition can worsen the other, creating a vicious cycle. 

Vision Loss

Hypertension is closely correlated with vision loss, particularly through the development of various eye conditions. The correlation between hypertension and vision loss stems from the damaging effects of elevated blood pressure on the delicate blood vessels in the eyes. Here’s how hypertension correlates with vision loss:

Hypertensive Retinopathy
Chronic hypertension can damage the small blood vessels (capillaries) in the retina, the light-sensitive tissue at the back of the eye. This condition, known as hypertensive retinopathy, is characterised by narrowing of the blood vessels, leakage of blood or fluid into the retina, and the formation of abnormal new blood vessels. These changes can impair vision and lead to complications such as retinal detachment or macular edema, resulting in vision loss.

Optic Neuropathy
Hypertension can also affect the optic nerve, which transmits visual information from the retina to the brain. Elevated blood pressure can cause compression or damage to the optic nerve, leading to a condition called hypertensive optic neuropathy. This can result in symptoms such as decreased peripheral vision, blurred vision, or even permanent vision loss if left untreated.

Increased Risk of Eye Diseases
Hypertension is associated with an increased risk of other eye diseases that can cause vision loss, including diabetic retinopathy, age-related macular degeneration (AMD), and glaucoma. Individuals with hypertension are more likely to develop these eye conditions, further increasing their risk of vision impairment.

What causes High Blood Pressure?

High blood pressure, or hypertension, can result from a combination of factors, including genetic predisposition, lifestyle choices, and underlying health conditions. Here are some common causes of high blood pressure:

  • Genetics
    Family history plays a significant role in the development of hypertension. Individuals with a family history of high blood pressure are at higher risk of developing the condition themselves.
  • Unhealthy Diet
    Consuming a diet high in sodium (salt), saturated fats, and cholesterol can contribute to high blood pressure. Excessive sodium intake can lead to fluid retention and increased blood volume, putting strain on the heart and blood vessels.
  • Lack of Physical Activity
    Sedentary lifestyles and lack of regular exercise are associated with an increased risk of hypertension. Regular physical activity helps maintain healthy blood pressure levels by improving blood vessel function and reducing stress on the heart.
  • Obesity or Overweight
    Being overweight or obese increases the risk of hypertension. Excess body weight puts additional strain on the heart and circulatory system, leading to elevated blood pressure.
  • Smoking
    Tobacco use and smoking can raise blood pressure temporarily and damage the lining of blood vessels over time, increasing the risk of hypertension and cardiovascular disease.
  • Excessive Alcohol Consumption
    Heavy alcohol consumption can raise blood pressure and contribute to hypertension. Limiting alcohol intake is important for maintaining healthy blood pressure levels.
  • Stress
    Chronic stress and anxiety can temporarily elevate blood pressure levels. Prolonged stress can also lead to unhealthy coping mechanisms such as overeating, smoking, or excessive alcohol consumption, further exacerbating hypertension.
  • Underlying Health Conditions
    Certain medical conditions, such as kidney disease, diabetes, thyroid disorders, and sleep apnea, can contribute to high blood pressure. Treating and managing these underlying conditions is essential for controlling blood pressure.
  • Age
    Blood pressure tends to increase with age as blood vessels become less flexible and arteries stiffen. However, hypertension is not an inevitable part of ageing and can be prevented or managed through healthy lifestyle choices.

How To Reduce High Blood Pressure?

Reducing high blood pressure, or hypertension, typically involves a combination of lifestyle modifications and, in some cases, medication. 

These are the most common treatment options to reduce high blood pressure.

Lifestyle Modifications

Healthy Diet
Adopting a diet rich in fruits, vegetables, whole grains, lean proteins, and low-fat dairy products while limiting sodium, saturated fats, highly processed foods, and added sugars can help lower blood pressure. This eating plan, known as the Dietary Approaches to Stop Hypertension (DASH) diet, has been shown to be effective in reducing blood pressure.

Regular Exercise
Engaging in regular physical activity, such as brisk walking, swimming, cycling, or aerobics, for at least 150 minutes per week can help lower blood pressure. Exercise helps strengthen the heart, improve blood vessel function, and promote weight loss or weight management.

Weight Management
Losing excess weight or maintaining a healthy weight through a combination of diet and exercise can significantly reduce blood pressure. Even a modest weight loss of 5-10% of body weight can lead to meaningful reductions in blood pressure.

Limiting Alcohol
Limiting alcohol consumption to moderate levels—up to one drink per day for women and up to two drinks per day for men—can help lower blood pressure. Excessive alcohol consumption can raise blood pressure and negate the benefits of other lifestyle changes.

Quitting Smoking
Smoking and tobacco use can raise blood pressure and damage blood vessels. Quitting smoking is essential for lowering blood pressure and reducing the risk of heart disease and other health complications.

Stress Management
Practising relaxation techniques such as deep breathing, meditation, yoga, or tai chi can help reduce stress levels and lower blood pressure. Finding healthy ways to cope with stress, such as spending time with loved ones, engaging in hobbies, or seeking support from a therapist, can also be beneficial.

Hypertension Medication

Antihypertensive medications are drugs specifically designed to treat hypertension. These medications work through various mechanisms to help relax blood vessels, reduce blood volume, or decrease the force of the heart’s contractions, thereby lowering blood pressure. 

There are several classes of antihypertensive medications, each with its own mechanism of action:

Diuretics, also known as water pills, help the body get rid of excess sodium and water through the urine, reducing the volume of fluid in the bloodstream and lowering blood pressure. Common diuretics include thiazide diuretics (e.g., hydrochlorothiazide) and loop diuretics (e.g., furosemide).

Work by blocking the effects of adrenaline (epinephrine) on the heart, reducing heart rate and cardiac output, which in turn lowers blood pressure. They also help relax blood vessels, further reducing blood pressure. Examples of beta-blockers include atenolol, metoprolol, and propranolol.

Angiotensin-Converting Enzyme (ACE) Inhibitors
ACE inhibitors block the conversion of angiotensin I to angiotensin II, a hormone that causes blood vessels to constrict. By inhibiting this conversion, ACE inhibitors help relax blood vessels and lower blood pressure. Examples include enalapril, lisinopril, and ramipril.

Angiotensin II Receptor Blockers (ARBs)
ARBs work by blocking the action of angiotensin II at the receptor sites on blood vessels, preventing them from constricting. This helps to lower blood pressure by promoting vasodilation (relaxation of blood vessels). Common ARBs include losartan, valsartan, and irbesartan.

Calcium Channel Blockers (CCBs)
Calcium channel blockers prevent calcium from entering the muscle cells of blood vessels and the heart, causing them to relax and widen. This relaxation leads to lower blood pressure. Examples of CCBs include amlodipine, diltiazem, and verapamil.

Alpha-blockers block the effects of the hormone norepinephrine on blood vessels, causing them to relax and widen. This helps to lower blood pressure by reducing peripheral vascular resistance. Examples include doxazosin and prazosin.

Alpha-Beta Blockers
Similar to alpha-blockers, Alpha-beta blockers work by blocking both alpha and beta receptors, leading to a decrease in heart rate, cardiac output, and peripheral vascular resistance. This results in lower blood pressure. Carvedilol and labetalol are examples of alpha-beta blockers.

The use of various medications, such as diuretics, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors, angiotensin II receptor blockers (ARBs), calcium channel blockers (CCBs), alpha-blockers, and alpha-beta blockers, carries inherent risks that individuals should be aware of. Diuretics, for instance, can lead to electrolyte imbalances, dehydration, and potassium deficiencies. Beta-blockers may cause fatigue, dizziness, and heart rate irregularities. ACE inhibitors and ARBs might result in kidney dysfunction, elevated potassium levels, and dry cough. Calcium channel blockers pose risks of ankle swelling, dizziness, and heart rhythm disturbances. Alpha-blockers can induce dizziness, headaches, and low blood pressure. Lastly, alpha-beta blockers may cause fatigue, dizziness, and difficulty breathing.

It’s important for individuals with hypertension to work closely with their healthcare provider to determine the most appropriate antihypertensive medication or combination of medications based on factors such as blood pressure level, overall health, and any underlying medical conditions. Regular monitoring and adjustments to the treatment plan may be necessary to effectively manage hypertension and reduce the risk of cardiovascular complications.

Complementary Medicines

Medical Marijuana

There isn’t substantial scientific evidence to support the use of medical marijuana as a treatment for hypertension or as a means to lower high blood pressure. However, some health professionals believe that cannabis has an effect on heart rate and blood pressure. 

Whilst short-term cannabis use may temporarily elevate blood pressure, prolonged medication usage can have the opposite effect. A clinical study revealed that cannabis treatment led to a reduction in blood pressure among older adults.

During the study, researchers administered THC to 38 participants over a three-month period. The findings indicated that individuals who continued with the treatment experienced significant decreases in their blood pressure readings. 

Despite that promising study, it is essential for individuals, particularly older adults who are sensitive to changes in blood pressure, to consult with a medical professional before using cannabis in any form, and it should not be substituted for hypertensive medications unless there is far stronger evidence to support its use as a hypertensive medication produced in the future.

Combating High Blood Pressure: A Unified Approach

In the endeavour to manage and mitigate the risks associated with high blood pressure, it is imperative to adopt a holistic approach that includes lifestyle modifications, medical interventions, and a vigilant awareness of one’s health. The consequences of untreated hypertension are far-reaching, affecting vital organs and significantly impacting one’s quality of life. 

By prioritising heart-healthy choices, staying informed about personal health metrics, and collaborating closely with healthcare professionals, individuals can forge a path towards improved wellbeing and longevity. The fight against the “silent killer” is a collective endeavour, underscoring the importance of education, prevention, and timely management.

Written by

Priyom holds a Ph.D. in Plant Biology and Biotechnology from the University of Madras, India. She is an active researcher and an experienced science writer. Priyom has also co-authored several original research articles that have been published in reputed peer-reviewed journals. She is also an avid reader and an amateur photographer.

Written by

Priyom holds a Ph.D. in Plant Biology and Biotechnology from the University of Madras, India. She is an active researcher and an experienced science writer. Priyom has also co-authored several original research articles that have been published in reputed peer-reviewed journals. She is also an avid reader and an amateur photographer.

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