Arterial Hypertension: Understanding the Silent Killer

Introduction

Arterial hypertension, commonly known as high blood pressure, is a chronic condition in which the force of the blood against the arterial walls is consistently too high. If left untreated, it significantly increases the risk of heart disease, stroke, kidney failure, and other serious complications.

Causes and Risk Factors

1. Primary (Essential) Hypertension

• No identifiable cause.
• Develops gradually over time.
• Affected by genetic and lifestyle factors.

2. Secondary Hypertension

• Results from underlying medical conditions such as:
  • Kidney disease
  • Hormonal disorders (e.g., Cushing's syndrome, thyroid dysfunction)
  • Side effects of medications (e.g., oral contraceptives, corticosteroids)

3. Risk Factors

• Age (>60 years)
• Family history of hypertension
• Obesity and sedentary lifestyle
• High salt and alcohol intake
• Smoking
• Stress

Symptoms and Early Signs

Hypertension is often called the “silent killer” because it typically shows no symptoms until severe complications arise. However, in some cases, patients experience: - Headaches - Dizziness - Shortness of breath - Blurred vision - Chest pain (in severe cases)

Diagnosis and Monitoring

Hypertension is diagnosed via blood pressure measurements. Normal blood pressure is considered below 120/80 mmHg. It is classified as follows: - Elevated: 120–129/<80 mmHg - Stage 1 Hypertension: 130–139/80–89 mmHg - Stage 2 Hypertension: ≥140/90 mmHg

Home monitoring and regular check-ups are essential to confirm persistent high blood pressure.

Treatment and Lifestyle Modifications

1. Lifestyle Changes (First-line approach)

• Reduce salt intake to <5 g/day
• Increase physical activity (at least 30 min, 5 times per week)
• Maintain a healthy weight (BMI <25 kg/m²)
• Eat a heart-healthy diet (DASH diet, Mediterranean diet)
• Limit alcohol and quit smoking
• Manage stress through relaxation techniques

2. Medication Treatment

When lifestyle changes are not sufficient, antihypertensive medications are prescribed: - Diuretics (Thiazides, Loop diuretics) - ACE Inhibitors (e.g., Enalapril, Ramipril) - ARBs (e.g., Losartan, Valsartan) - Calcium Channel Blockers (e.g., Amlodipine) - Beta-Blockers (e.g., Metoprolol)

The choice of medication depends on the patient's overall health, comorbidities, and individual response.

Conclusion

Hypertension is a highly manageable condition if diagnosed and treated early. Regular blood pressure monitoring, lifestyle changes, and medication (if necessary) are the key pillars to maintaining a healthy blood pressure and preventing complications.

Recommended Reading

For further guidance, refer to: - European Society of Cardiology (ESC) Guidelines on Hypertension - American Heart Association (AHA) Guidelines on High Blood Pressure

Source recommendations

1. European Society of Cardiology (ESC) Guidelines on Hypertension

1. https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Elevated-Blood-Pressure-and-Hypertension
2. https://academic.oup.com/eurheartj/article/45/38/3912/7741010
3. https://pubmed.ncbi.nlm.nih.gov/37345492/
4. https://academic.oup.com/eurheartj/article/39/33/3021/5079119
5. https://pubmed.ncbi.nlm.nih.gov/23771844/

2. American Heart Association (AHA) Guidelines on High Blood Pressure

1. https://www.heart.org/en/health-topics/high-blood-pressure
2. https://www.ahajournals.org/doi/10.1161/hyp.0000000000000065
3. https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings
4. https://www.acc.org/latest-in-cardiology/articles/2017/11/08/11/47/mon-5pm-bp-guideline-aha-2017
5. https://www.heart.org/en/health-topics/high-blood-pressure/understanding-blood-pressure-readings/monitoring-your-blood-pressure-at-home