Hypertension is also known as the 'silent killer enemy' because of the damage it can cause to the kidney, brain, heart, and vascular system without causing symptoms for a long time. Due to high blood pressure, occlusion, enlargement, or rupture of the vessels feeding the organs may occur. High blood pressure can cause organ failure by disrupting blood flow to the organs. 'High blood pressure' must be followed under the control of a specialist.
What are the Symptoms of Hypertension?
Let's list the main symptoms that can be seen in hypertension:
The most common symptom of hypertension is a headache. It usually starts at the nape and spreads to the top. One of the points that should not be forgotten is that there are many diseases that can cause headaches. For this reason, there is no rule that every person with a headache will have hypertension. Headaches may be observed in people who have no disease, only due to daily tension and fatigue.
How does a headache occur in hypertension? If the headache is not due to a complication of hypertension, it does not come from the brain. This headache is due to excessive stretching of the neck and the muscle layer under the scalp. The mechanism by which this tension is created is not fully understood. As the patient panics, the tension increases and the headache intensifies. With the reduction of blood pressure and correction of panic, the headache goes away, and the patient feels better. A headache in hypertension is usually felt during the daytime, not so much at night.
Sudden and severe headaches should be feared in patients with hypertension. In this case, the nearest health institution should be applied to.
Shortness of breath
Mild dyspnea on exertion may be observed in hypertensive patients without any complications. As is known, shortness of breath is among the symptoms of many diseases. The most important cause of dyspnea in hypertension is overweight. Shortness of breath improves when weight is lost. It is necessary to distinguish shortness of breath, which is seen only in heart failure due to hypertension, from this picture. The treatment of heart failure due to hypertension is different.
Palpitation is the feeling of the heart beating fast. It is a common symptom in hypertension patients. The biggest reason is the patient's anxiety, fear, and stress due to high blood pressure. Palpitations can be improved with suggestions and treatment for these issues.
One of the causes of palpitations is the occasional misfire of the heart. This condition, called extrasystole, can be seen in healthy people, in cases of excessive caffeinated beverages, fatigue, and stress. It should not be forgotten that extrasystoles, that is, the misfires felt in the heart, may be a symptom of another serious disease and should be examined. In patients with hypertension, if there is thickening of the heart walls, misfiring, that is, extrasystoles, is more common.
Nose bleeding is one of the most frightening symptoms for patients. When there is a nosebleed, physicians immediately say the following and make the patient even more alarmed. "It's good that you had a nosebleed, so you got rid of the brain hemorrhage." This saying is not true. It makes the patient panic and causes the blood pressure to rise even more. The veins in the nose are very thin and weak, and the supporting tissue around them is less dense. It can bleed even at the slightest increase in pressure. Nosebleeds are also common in people with normal blood pressure. In other words, if a person coughs, strains, or sneezes, the nose may bleed. Nose bleeding can also be observed in influenza infections. Even a slight rise in blood pressure may cause some people's noses to bleed. People with frequent nosebleeds may have structural defects in their nasal vessels, and an ear, nose, and throat specialist should be seen. However, I would like to emphasize the following issue here: Nosebleeds in patients with severe hypertension or untreated hypertension can be very severe. These patients may need hospitalization to be treated. If patients with nosebleeds are taking blood thinners such as aspirin, the severity of the bleeding increases even more.
Hypertension patients with nosebleeds should have their blood pressure adjusted and kept at normal levels. Nosebleeds can sometimes be a symptom of severe hypertension, and they should be treated by performing the necessary investigations.
Bleeding in the white part of the eye
Eye bleeding is similar to nose bleeding. Hypertension is not necessarily required for these bleeds to occur. With the slightest increase in pressure in the veins, the capillaries in the white part of the eye can bleed. Bleeding may occur due to straining, coughing, sneezing, or for no other reason. Eye bleeding also makes the patient very anxious. When he looks in the mirror, he is afraid of his image and immediately seeks a doctor. However, these are innocent bleedings, they pass in 2–3 weeks. Important eye hemorrhages due to blood pressure are hemorrhages in the retinal layer between the brain and the eye, which we call the bottom of the eye. They must be treated.
Very frequent bleeding in the white part of the eye may be a sign of latent hypertension. These people should be examined for hypertension.
Hypertension is not a direct cause of dizziness. If the blood pressure fluctuates a lot and falls below normal, dizziness can be observed. Like the symptoms described above, dizziness has many causes. The most common cause is related to the balance organ in the ears. Patients with hypertension often attribute their dizziness to their blood pressure. However, for most people, dizziness is not related to hypertension. With careful questioning, it can be understood whether it is related to the ear. If there is ringing, buzzing, and especially hearing loss, an ear, nose, and throat physician should be sought for help.
Balance organ disorders in the ear alone are common in people with long-term hypertension and diabetes. Sometimes, the cause of this balance disorder may be a sudden increase in blood pressure. Dizziness may continue even if blood pressure returns to normal.
If vertigo related to the ear starts suddenly, a slight increase in blood pressure may be seen with it. The blood pressure elevation in these patients is transient and short-lived.
Some brain diseases can also cause dizziness in people. Hypertension can be the trigger for these diseases. For this reason, it would be good for patients with vertigo to be evaluated by a neurologist when necessary.
If there is dizziness and a feeling of faintness in elderly patients with hypertension, it should be investigated by suspecting that the blood pressure decreases with position, which we call postural hypotension.
Tinnitus is one of the symptoms that most preoccupy hypertension physicians and otolaryngologists. There are many causes of tinnitus, which is generally called tinnitus. People with long-term hypertension are more likely to have tinnitus. Also, spikes in blood pressure can cause or initiate tinnitus. One of the most important causes of tinnitus is exposure to high-level and long-term sound, which we call acoustic trauma. Apart from this, there are many more reasons. Tinnitus can be seen for no apparent reason.
Tinnitus is a symptom that bothers the patient very much. They think that it will be fixed by controlling the blood pressure. If tinnitus is chronic, it will not improve with blood pressure control, but its severity may decrease. Therefore, it is of great importance to control blood pressure in patients with tinnitus.
Patients with ENT and nitus should undergo detailed control in terms of ENT and control aspects. If a cause can be identified, it should be treated.
Frequent Urination at Night
The symptom of frequent urination at night is frequently observed in patients with hypertension. This may be partly due to the enlarged prostate seen in male patients.
The main symptoms seen in hypertension are those listed above.
Hypertension Risk Factors
There are many risk factors for hypertension:
Age: The risk of hypertension increases with age. Hypertension is common in men up to 64 years of age. Hypertension in women usually occurs after the age of 65.
Family history: Hypertension is passed on from generation to generation through genes.
Being overweight or obese: The more you weigh, the more blood is needed to supply your tissues with oxygen and nutrients. The greater the amount of blood flowing through the blood vessels, the greater the pressure on the arteries.
Inactivity: Inactive people have a higher heart rate. People who are inactive tend to have higher heart rates. The higher your heart rate, the harder your heart works with each contraction, and the more pressure it puts on your arteries. Inactivity also increases the risk of being overweight.
Tobacco use: Smoking and using tobacco temporarily increase your blood pressure, and the chemicals in tobacco damage artery walls. This can lead to narrowing of the arteries and the risk of a heart attack. Passive smoking can also increase the risk of heart disease.
Salty diet: Consuming too much salt in food can increase blood pressure.
Potassium deficiency: potassium helps balance the sodium rate in the cells. The balance of potassium is important for heart health. If you don't get enough potassium, or if you lose potassium due to thirst or other illnesses, sodium can build up in the blood, leading to increased blood pressure.
Excessive alcohol consumption: Prolonged use of alcohol can damage your heart. Drinking more than once a day for women and more than twice a day for men can affect blood pressure. If you drink alcohol, be careful to use it at normal levels. In healthy people, this amount is once a day for women and twice a day for men.
Stress: Too much stress can cause a temporary increase in blood pressure. Stress-related habits, such as overeating, tobacco or alcohol use, can cause blood pressure to rise even more.
Some chronic diseases: Some chronic conditions such as kidney disease, diabetes, and sleep apnea can also increase the risk of hypertension.
In some cases, pregnancy can also lead to hypertension.
Although hypertension is most common in adults, children may also be at risk from time to time. In some children, hypertension can arise from problems with the kidneys or heart. However, some bad habits, such as an unhealthy diet and inactivity, are increasing the number of children with hypertension.
What Organs Damaged by Hypertension?
High blood pressure affects vital organs such as the heart, brain, kidneys, aorta, and eyes. It can enlarge the heart and cause heart failure, triggering a heart attack. It can lead to dialysis by wearing down the kidneys. It can cause a blockage in the brain vessels and cause paralysis, or it can cause a life-threatening risk by causing cerebral hemorrhage in attacks of sudden high blood pressure. It can cause vision problems by causing deterioration of the eye vessels. It can cause a fatal situation by causing enlargement of the aortic vessels and then aortic rupture.
The higher the blood pressure, the higher the risk of developing heart attack, heart failure, stroke, eye disease, and kidney disease. Many disabilities and deaths caused by high blood pressure can be prevented with early diagnosis and treatment. The important thing is to accept the seriousness of the disease and do what needs to be done.
Diagnosis of Hypertension
Certain tests are recommended to confirm the diagnosis of hypertension and check for underlying causes.
Ambulatory Measurement (Holter): This measurement, which lasts 24 hours, confirms whether there is hypertension. With this device, blood pressure is measured at certain points in a 24-hour period, and the change in pressure is observed throughout the day. However, these devices may not be available in all healthcare institutions.
Laboratory tests: Your doctor may order blood tests, such as a cholesterol test, in addition to a urinalysis.
Electrocardiogram (ECG): This quick and painless test monitors the electrical movements of your heart.
Echocardiogram: Based on your symptoms and test results, your doctor may recommend an echocardiogram to assess your heart disease risk. This procedure uses sound waves to get images of your heart.
How is hypertension treated?
In the basic treatment of hypertension;
- There are two important elements, lifestyle changes.
- Lifestyle changes
Lifestyle changes are very important to control hypertension.
Important lifestyle changes for hypertension include:
- Reducing salt and eating a healthy diet (increasing fruit and vegetable consumption, reducing saturated and total fat consumption; consuming less salty foods such as offal, dried fruits, canned foods, pickles, and olives).
- Doing regular physical activity and exercise.
- Keeping the weight at a healthy level and losing weight in cases of overweight.
- Quit smoking.
- Limiting alcohol use.
- Providing stress management.
In some cases, lifestyle changes may not be enough to reduce blood pressure. Especially if the blood pressure values are systolic 160 mmHg, diastolic 100 mmHg, or above, lifestyle changes and concomitant medication are required to lower blood pressure.
Hypertension drugs control blood pressure using different mechanisms. One or more of the most appropriate drugs are prescribed by the physician to the patient,
- The cause of high blood pressure
- blood pressure values,
- It is prescribed taking into account other diseases.
Hypertension drugs should be used regularly and every day; they should never be left without the advice of a physician.
Medicines that lower blood pressure have side effects like other medicines. However, these side effects are not seen in everyone who uses the drug. When a side effect is seen in a drug group, it can be changed with another group of drugs. If the side effect is dose-related, the dose of the drug can be adjusted by the physician. In the event of any side effects related to the drug, the physician should be consulted before taking the next dose or deciding to stop the drug completely.