high blood pressure

Synonyms in a broader sense

Essential hypertension, hypertension, chronic arterial hypertension, hypertensive crisis

  • English: arterial hypertension
  • Medical: Arterial hypertension

    What is high blood pressure?

    The first value of blood pressure stands for the systolic, the second for the diastolic Blood pressure. The systolic value describes the pressure in the vascular system during contraction (contraction) of Heart and the diastolic value the same during subsequent relaxation (Dilation) of the heart.
    The high blood pressure (arterial hypertension) occurs when that heart has to do an increased pumping work and transports more blood into the body than normal per heartbeat (increased cardiac output = High volume pressure) or if the resistance offered by the vascular system to the heart is increased (increased peripheral resistance = high resistance pressure) or if these two factors are present at the same time.

    The increased resistance in the vascular system is the far more common cause of one chronic increase in arterial blood pressure.

    The blood pressure value is calculated according to the following equation: Blood pressure (RR) = cardiac output (CO) * vascular resistance (TPR = total peripheral resistance).
    Also read our topic artery

    Definition of high blood pressure

    The disease high blood pressure (arterial hypertension) exists if there are multiple, mutually independent Measurements at different times values ​​over 140/90 mmHg (spoken: 140 to 90 millimeters of mercury) occur. This definition comes from the current guidelines of the World Health Organization (WHO).

    Frequency (epidemiology)

    Occurrence in the population
    Around 25% of the population in the western industrialized nations have high blood pressure. For those over 50 years of age in this population group, this value rises to up to 50%.
    The frequency of occurrence of high blood pressure increases with age, i.e. older people are more likely to have increased blood pressure than younger people.

    Stages of hypertension according to values


    • Optimal:
      • systolic: <120 mmHg
      • diastolic: <80 mmHg
    • Normal:
      • systolic: <130 mmHg
      • diastolic: <85 mmHg
    • High normal:
      • systolic: 130-139 mmHg
      • diastolic: 85-89 mmHg

    High blood pressure:

    • Stage 1 (mild hypertension):
      • systolic: 140-159 mmHg
      • diastolic: 90-99 mmHg
    • Stage 2 (moderate hypertension):
      • systolic: 160-179 mmHg
      • diastolic: 100-109 mmHg
    • Stage 3 (severe hypertension):
      • systolic: 180-209 mmHg
      • diastolic: 110-119 mmHg
    • Stage 4 (very severe hypertension):
      • systolic: 210 mmHg
      • diastolic: 120 mmHg
    • Isolated systolic hypertension:
      • systolic: 140 mmHg
      • diastolic: <90 mmHg
    (JNC / NIH, USA 1997)

    Classification of high blood pressure

    The increase in blood pressure is divided into several forms:

    1. unstable and exertional high blood pressure that does not occur permanently or only during physical exertion

    2. persistent high blood pressure (stable hypertension)

    3. critical increase in blood pressure to values ​​above 230/130 mmHg without organ damage (hypertensive crisis)

    4. Emergency blood pressure increase, which is defined as an increase in blood pressure above 230/130 mmHg with organ damage that is life-threatening.

    Causes / development / risk factors

    While the causes of secondary high blood pressure are known, the development of primary high blood pressure is unclear.

    There are also two types of high blood pressure. The type of hypertension the patient has is determined by the cause of the increase in blood pressure.

    1. High blood pressure for which the cause is unknown (primary or essential hypertension).
      In 90-95% of hypertension, no organic cause for the increased blood pressure can be found.
      It is believed that factors such as diet, stress, smoking, physical constitution and hormones influence the development of high blood pressure.
      There is regular and very controversial discussion about whether or not an increased salt intake can lead to the development of high blood pressure. There seem to be connections, which is why a salt limit (5mg table salt / day) is often recommended. A scientifically proven statement cannot yet be made on this subject.
      Obesity and a high-fat diet increase high blood pressure. Smoking causes the blood vessels to constrict due to the nicotine, so that the blood pressure rises. Stress activates the sympathetic, i.e. the stress-related nervous system, which increases blood pressure. Alcohol causes the heart rate to increase, which can be accompanied by a significant increase in blood pressure.
    2. Secondary high blood pressure, the causes of which are known and can be named, i.e. the high blood pressure is partly due to recoverable underlying disease of an internal organ. 10-15% of patients with high blood pressure suffer from hypertension with an organic cause.
      A narrowing of the renal artery (renal artery stenosis), a kidney tumor or changes in the kidney tissue (renoparenchymal hypertension) are the causes. Since the kidney is diseased, it is called "renal hypertension".
      Other diseases that can be associated with an increase in blood pressure are aortic narrowing (aortic stenosis), heart valve disease and hormonal causes such as an overproduction of adrenaline and noradrenaline through an adrenal tumor (pheochromocytoma) or increased cortisone production (Cushing's disease), which is caused by hormones increase in blood pressure caused is called "endocrine hypertension".

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    Most often the increased one manifests itself Blood pressure not through symptoms, which can go undetected for a long time. Often the diagnosis is one Incidental finding during a routine check. Despite everything, there is one early therapy necessary to avoid later consequences of the increased blood pressure.

    The high blood pressure can be symptomatic by a Dizziness, a headache, sleep disorders, tinnitus, Nosebleeds (Epistaxis with headache), Visual disturbances or a flushed face express. Probably the most common symptom is the a headache which are usually in the back of the head and occur after waking up. The high blood pressure can also be increased by an nervousness and shortness of breath express. If the symptoms mentioned occur, it is advisable to do so to be checked by a doctoras an increased Blood pressure in the long run harmful consequences can bring with it.

    The severity of the symptoms does not necessarily indicate the level of the blood pressure; even with mild symptoms, there may be increased blood pressure. It happens more often a headache, Visual disturbances, dizziness or one Feeling of pressure in the chest, you should have this clarified by your family doctor. Especially in the pregnancy, you should consult a doctor immediately, as high blood pressure during pregnancy can be life-threatening Seizures can come.

    More about this topic can be found: Pregnancy high blood pressure - dangerous?

    Symptoms of high blood pressure

    Headache as a common cause of high blood pressure

    High blood pressure (arterial hypertension), both the essential and the secondary form, go unnoticed by many patients for a long time, as it is possible that no symptoms will occur for years or even decades. This is particularly tricky for the patient, since a constantly high blood pressure can cause serious damage to the vascular system, despite subjective well-being. If the increase in blood pressure becomes symptomatic, however, many patients complain of palpable palpitations, dizziness, ringing in the ears, shortness of breath during physical exertion and headaches in the morning after getting up and nosebleeds.
    It is important that the increased blood pressure (arterial hypertension) is medically treated in order to avoid damage to blood vessels and organs.
    If the blood vessels and organs are already involved, symptoms such as chest pain (angina pectoris) as part of a narrowing of the coronary arteries (coronary artery disease (CHD)) up to heart attack (myocardial infarction) and stroke (apoplexy) often occur.
    If the latter symptoms occur, it may be a hypertensive emergency in which blood pressure levels are increased above 230/130 mmHg. In this case, the patient must be treated immediately.

    Read more on the topic: What are the causes of a cerebral hemorrhage

    Headache from high blood pressure

    a headache are a common warning sign of too high Blood pressure. Especially when the headache is in the Morning hours occurs, this indicates a headache caused by high blood pressure. Usually the headache is in the area of ​​the Back of the head. The headache occurs through a lack of lowering of blood pressure up at night. If the blood pressure is normal, it will decrease during the night. Often the headache is simultaneously from Visual disturbances accompanied. Patients also frequently complain that they do not sleep through the night and often wake up, especially in the second half of the night.

    What to do with high blood pressure

    If the doctor determines that the blood pressure is elevated, the doctor usually recommends the personal one first lifestyle to change to make this a natural Lowering blood pressure and to reduce risk factors. These measures include increased Move, one Weight reduction if you are overweight, moderate consumption of alcohol, as well as a low-salt diet.

    Next step after the so-called Lifestyle modification, is then a drug-based lowering of blood pressure. First of all, the blood pressure is tried using a Drug to lower, but often two or three drugs with different types of action are required. But measures should also be taken parallel to drug therapy to reduce factors that increase blood pressure, so that the dose of the medication can be reduced or even discontinued entirely.

    One speaks of a borderline body weight from one BMI (Body mass index) of 25. The BMI is calculated from the body weight through the height to square. Values ​​between 18.5 and 24.9 correspond to a normal weight. Also more often stress increases blood pressure, so mechanisms should be developed to reduce it. For example, it helps some autogenic training or other relaxation methods. Some herbal active ingredients will also be a antihypertensive effect awarded. These include garlic (Allium sativum), Hawthorn (Crataegus), mistletoe (Viscum album) and Whitefoot (Rauwolfia serpentina). These are available from pharmacies without a prescription, but you should also consult your doctor if you are taking herbal antihypertensive agents.


    People with high blood pressure should eat low-salt food, plenty of fruit and vegetables, and vegetable fats in their diet.

    The first step in the therapy of a high blood pressure patient is the so-called Lifestyle modification represent that above all one healthy eating and regular Move includes. Especially the combination of increased Blood lipid levels, Obesity and high blood pressure can for that Cardiovascular system be dangerous in the context of heart attacks, for example.

    One is recommended Mediterranean food, with much fruit, vegetables and healthy Fats. It should be especially on vegetable fats can be used. Animal fats, such as those found in butter, cream, and meat, are best kept to a minimum. Also should be a high fiber food, for example through grain products.

    On a high-salt diet should definitely be avoided, as a high salt consumption leads to a increase of Blood pressure leads. Fast food dishes in particular have a high salt content. Therefore it is recommended to cook yourselfso that you can determine the amount of salt yourself. The increased salt concentration in the body ensures that the body excretes less fluid in the balance and more fluid flows into the vessels to compensate for the high salt content there, so that the blood pressure rises.

    In total, a daily salt intake of up to 6 grams per day at High blood pressure patients recommended, while normal salt intake is usually between 12 and 15 g per day. If the salt intake is reduced sufficiently, this can happen Lowering blood pressure between 10 and 15 mmHg.

    High blood pressure and exercise

    By regular exercise you can lower your blood pressure by values ​​between 5 and 10 mmHg. Furthermore, regular exercise contributes to the reduction of body weight, which also has a protective effect. Especially recommended are Endurance sports, how to jog, Cross-country skiing, To go biking, swim, hike or Nordic walking.

    Sports with extreme stress should be avoided, as this increases the blood pressure in an unhealthy way.

    Parallel to Endurance sports is also a moderate strength training helpful because the metabolism is optimized by building muscle. Strong strength training should be avoided, however, as this often leads to pressured breathing, which leads to harmful high blood pressure peaks.

    The sports units should three to five times a week for at least 30 minutes occur. If no sport has been practiced for several years, the units should only be increased slowly. Even with a lack of time, it is extremely important to carry out the training units, because exercise in general has a positive effect on the cardiovascular system. Special sports groups are also recommended for people with cardiovascular diseases.

    Read a lot more information on this topic at: High blood pressure and exerciseHigh blood pressure and exercise

    Medicines for high blood pressure

    Is the Blood pressure permanently increased and cannot be reduced by reducing risk factors, must be on a medical therapy can be used. This is especially important to protect the body from complications like one Heart attack or stroke to protect.

    Lowering the blood pressure to values ​​below 140 / 90mmHg means a significant increase in life. There are different ways of lowering blood pressure with medication. Among the most commonly prescribed drugs are the so-called ACE inhibitors, Beta blockers, Diuretics, Calcium antagonists and Angiotensin antagonists.

    ACE inhibitors cause the Inhibition of an enzyme (Angiotensin-Converting-Enzyme, ACE), which produces the hormone angiotensin. If the enzyme ceases to work, the formation and effect of angiotensin, which normally increases blood pressure, ceases. The ACE inhibitor is important in the pregnancy not used may be. A common side effect of this class of drugs is dryness cough.

    The drug group of the Beta blockers lower the heart rate and ensure that stress hormones like adrenaline and Norepinephrinewhich normally increase blood pressure have less effect on the heart. In the case of beta blockers, care should be taken not to stop these suddenly, but rather the Dose slowly tapering offotherwise it can lead to a high blood pressure crisis. Contraindicated are beta blockers for example Asthmatics, as they constrict the muscles within the bronchi and accordingly become one shortness of breath being able to lead.

    Diuretics serve to increase water excretion, so that less blood circulates in the bloodstream and the pressure is lower as a result. With diuretics, care should be taken that not too much water is excreted and that it becomes a Dehydration of the body comes. Especially on hot days and after sporting activity, one should adequate hydration be respected. Old people in particular are at risk. Signs of dehydration or impending dehydration are: Dry mouth, Muscle weakness and an increasing confusion.

    Opponents of calcium, the Calcium antagonists, cause the vessels to widen, while calcium normally narrows the vessels. To the Side effects of calcium antagonists count Facial flushing, Rashes and Palpitations.

    The so-called Sartans respectively Angiotensin antagonists inhibit the action of the hormone angiotensin, which is used to increase blood pressure. Accordingly, they have one similar effect as the ACE inhibitorsr.

    Overall, in drug therapy for high blood pressure it happens that in the initial phase of therapy there is a feeling of Slackness and Exhaustion comes because the body first has to get used to the lower blood pressure after it has been permanently increased for a long time. To reduce the side effects of medication, it is helpful to start with a low dose of Drug to kick offto slowly get the body used to it and then increase the dose later.

    For many patients it is enough sole drug to set the blood pressure not off, so on second and partly third must be resorted to. In some cases, it is then advisable to take one of the medications in the evening, since in some patients, as is usual in healthy people, the blood pressure does not fall in the evening, but is then increased at night.

    In ten percent of the cases the high blood pressure by secondary causes, as a Renal artery narrowing or one Overproduction of hormones by the kidney (Hyperaldosteronism). In these cases the underlying Disease treated be because the usual medication work against high blood pressure in this type of high blood pressure Not.

    Since this topic can only be touched on here, you can find out much more under the page: Medicines for high blood pressure

    High blood pressure from coffee

    The study situation too Coffee consumption in combination with increased blood pressure ambiguous. Some studies even claim that coffee has a beneficial effect on blood pressure, although it is certain that coffee is just like others caffeinated drinks, the Blood pressure shortly after consumption increase.

    The increase in blood pressure after drinking coffee is between 10 and 20 mmHg and lasts for about 20 to 30 minutes. After a cup of coffee, blood pressure should not be measured, as the values ​​are then increased by the caffeine and are of no informative value. It is recommended at three cups maximum Staying coffee a day so that blood pressure doesn't go up several times a day.

    High blood pressure from alcohol

    In the case of severe high blood pressure, alcohol should be avoided, as it can additionally increase blood pressure by releasing hormones.

    alcohol also provides one Risk factor for high blood pressure. On the one hand, alcohol is also one antihypertensive effect too, since alcohol leads to a dilatation of the skin vessels, which is characteristic reddish coloring of the face (Flush) when consuming alcohol. On the other hand, there is an activation of the sympathetic system, which leads to the release of blood pressure-increasing hormones. Especially in stressful situations or at the same time Nicotine consumption increases alcohol thereby the Blood pressure.

    Men shouldn't consume more than 20 g per day, which is about a half a liter of beer corresponds to or one quarter liter of wine. For Women is about the Half the amount. So corresponding to 10g per day, which corresponds to a quantity of 125ml of wine. Because in men the blood pressure rises with an amount of 30g of alcohol and in women of 20g.

    One speaks red wine also a cheap one protective effect for the Cardiovascular system to, but only if it is consumed in moderation. Scientific studies have shown that a daily alcohol consumption of more than 30g per day, too double risk leads to increased blood pressure. Patient with one special high blood pressure should be based on the Refrain from consuming alcohol. The blood pressure rises by about 7 mmHg when alcohol is consumed above the limit value of 30g alcohol. Especially in men, alcohol consumption increases blood pressure. In smokers also more strongly than in non-smokers.

    High blood pressure from smoking

    Smoke is a risk factor for high blood pressure, as is the case with many other diseases. Smoking causes the Blood vessels narrowed, so that the pressure inside the vessels, i.e. the blood pressure, increases. Smoking also increases this risk for one arteriosclerosisat which it too Deposits comes inside the vessels, which also increases blood pressure. Because of these mechanisms, the Waiver on the Smoke one of the most important activities to lower blood pressure.