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Dossier: Healthy heart

What you need to know about high blood pressure

High blood pressure is a common ailment – and hard to detect. In most cases, the symptoms of hypertension are only felt when it has already caused some damage.

Text: Helwi Braunmiller; photo: Unsplash

Your blood pressure reading is based on a high and low value. These two values are taken at different times during the heart beat. With every heartbeat, the heart forces blood through the blood vessels. The pressure created here is the upper, systolic blood pressure. When the heart muscle relaxes again between beats, the pressure in the blood vessels also decreases. This pressure forms the lower value, the diastolic blood pressure. Ideally this value should be approximately 120/80. A permanent reading of 140/90 and above is considered to be high blood pressure and requires treatment. “The threshold values have been defined on the basis of major international studies”, explains Isabella Sudano, cardiologist at Zurich University Hospital “These studies have shown that using medication to reduce blood pressure for patients who have a value of 130/80 does not deliver benefits in the long term. However, patients with a value of 140/90 clearly benefit from taking medication. They suffer fewer heart attacks and strokes and are less likely to develop an occlusive cardiovascular disease.”

Symptoms are felt very late – if at all

Hypertension, the medical name for high blood pressure, is widespread. “The most recent statistics suggest that around one in three people suffer from hypertension. This figure rises to one in two among 65 or 70 year olds. The problem is that we don’t notice high blood pressure”, explains Isabella Sudano. But it leaves traces in the body. Hypertension only becomes noticeable when it is clearly above the threshold values, with symptoms including headaches, buzzing in the ears, dizziness or nose bleeds. At this point, however, the body is often already damaged and patients may also suffer from breathlessness and shortness of breath, chest pains as well as problems with vision and sensitivity. Taking your blood pressure regularly is important to make sure things don’t escalate in this way and to reduce blood pressure before it’s too late.

Blood pressure varies

Your blood pressure is not always exactly the same. It fluctuates during the day – controlled by your brain, autonomic nervous system and organs such as the kidneys and adrenal glands. Blood pressure is highest in the morning just before you get up, provided that you’ve slept. That’s why most heart attacks or strokes occur at this time. Blood pressure then decreases during the day, with short peaks depending on your level of activity, for example if you do sport or are stressed.

Your blood pressure should be much lower at night when you’re asleep. This can be demonstrated, for example, by taking a 24-hour measurement with an automatic measuring device that can be obtained from the doctor. “At night, your blood pressure should be 10 to 20% below your daily value”, explains Sudano. “If this is not the case, your doctor should take a closer look. Do you perhaps suffer from a sleeping disorder such as sleep apnoea? In these cases, the heart is unable to recover at night, and this can be very dangerous in the long term.”

If the blood vessels lose their elasticity due to illness or old age, blood pressure will increase. The blood vessels find it harder to withstand the pressure, thus increasing the pressure on the vessel walls. At the same time, the vessels are unable to relax properly between heart beats, which is why the lower blood pressure value also increases. This permanent strain takes its toll on the vessels, with the result that the heart, brain, kidneys and eyes suffer.

High blood pressure? Permanent reduction is a must

The best thing, of course, is to prevent high blood pressure by eating a healthy balanced diet, not smoking, maintaining a healthy weight, getting plenty of exercise, and achieving a good balance between stress and relaxation.“Once you’ve got chronic high blood pressure, changing your lifestyle alone is not usually enough to reduce it,” explains Dr Sudano.“However, a healthy lifestyle does significantly reduce the risk of suffering a heart attack or stroke, so it is certainly worthwhile.” That’s why the most efficient way of treating high blood pressure is to take antihypertensive drugs. Finding the most effective medication is often a case of trial and error under medical supervision and you’ll need a little patience. Sometimes, treatment using a combination of active ingredients is the most effective.

In order to be able to counteract high blood pressure at an early stage, the Swiss Heart Foundation recommends that everyone over the age of 18 measures their blood pressure at least once a year. Isabella Sudano recommends that her patients take the measurement themselves at home. “It’s very important to measure your blood pressure independent of the doctor, because a single measurement isn’t a diagnosis. Hypertension can only be confirmed through several elevated values.”

How do you take your blood pressure correctly? You can find out here.