Hypertension: causes and treatment

Hypertension: causes and treatment

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High blood pressure

Has been valid for more than 30 years high blood pressure, medical hypertension mentioned, as one of the most common ailments found in the western industrialized countries and can therefore also be regarded as a common disease in this country. While a temporarily increased blood pressure can be a symptom of various diseases or a side effect of certain medicines, a chronic increase in blood pressure in the arterial blood vessels can be seen as a clinical picture, which in turn can result in numerous complications. For example, high blood pressure is considered a significant risk factor for potentially fatal cardiovascular diseases, such as a heart attack

or stroke.

Hypertension: the most important at a glance

Even if high blood pressure usually does not cause any direct complaints, massive damage to the blood vessels can occur. Hypertension is one of the main causes of heart attacks and heart diseases - the most common causes of death in Germany. For this reason, all those affected should inform themselves well about their illness. Here is a brief overview of the symptoms:

  • Hypertension values: If values ​​of 140 to 90 mmHg or higher are present in different measurements on different days, one speaks of hypertension. There is also a disease if one of the two values ​​is already exceeded.
  • Measure blood pressure: Measurement should be done while sitting and after a five-minute rest period. Do not drink coffee or alcohol beforehand. Take the measurement two to three times in succession at short intervals. The last two measurements are crucial.
  • Lower blood pressure: During therapy, care should be taken to keep blood pressure levels below 140 to 90 mmHg. This can be done through lifestyle interventions such as healthier nutrition, regular exercise, less alcohol and less stress can be achieved. If this is not enough or if there is severe hypertension, antihypertensive medication must be taken.
  • Hypertension consequences: The high blood pressure slowly and steadily damages important organs such as the heart, coronary arteries, brain, kidneys and the blood vessels. This results in life-threatening diseases such as heart attacks and strokes.
  • Hypertension causes: Hypertension is a complex disease involving the interaction of messenger substances, organs, blood vessels and the nervous system. The exact causes are still unknown and are still being researched.
  • Risk factors: Contrary to the exact causes, favorable factors are well known. In addition to a hereditary predisposition, lack of exercise, unhealthy diet, overweight and stress are responsible for the development.

From what blood pressure values ​​is there hypertension?

The World Health Organization (WHO) defines "normal" blood pressure with a systolic value of 120 mmHg and a diastolic value of 80 mmHg. If the systolic blood pressure reaches 140 mmHg and the diastolic blood pressure 90 mmHg or higher, the WHO defines this as arterial hypertension. Temporary deviations in blood pressure, for example as a result of taking medication, do not fall under this definition. In addition, a distinction is made between primary (with no apparent physical cause) and secondary hypertension (immediate consequence of underlying diseases). Furthermore, special forms of high blood pressure, such as pulmonary hypertension (increased blood pressure in the pulmonary circulation, for example as a result of smoking cough or heart disease) and portal hypertension (high blood pressure in the portal vein of the liver, often as a result of cirrhosis of the liver), are considered as separate symptoms.

Measuring blood pressure: this is how it works!

Many sufferers do not know that a single blood pressure measurement is of little significance. Blood pressure is often higher at the first measurement, especially if the value is measured in a doctor's office. However, this does not necessarily have to be associated with pathological processes, but can be due to the excitement and unrest. According to the Federal Association of German Pharmacists' Associations, the second value should always be taken seriously. For a correct measurement, the patient should first come to rest physically, mentally and mentally. Then the blood pressure is measured for the first time. If there is an increased value, a second, possibly even a third measurement should be carried out at intervals of one to two minutes.

Blood pressure and high blood pressure

The heart pumps the blood, which comes out of the lungs with oxygen, through the arteries, which branch out ever more finely towards the extremities and finally pass into the venous system in order to make the "way back" by going through the liver. The force that the blood exerts on the walls of the arteries and veins is known as blood pressure. The upper, so-called systolic value indicates the pressure at which the blood is pumped through a larger artery (usually the upper arm) when the heart muscle contracts. The lower, so-called diastolic value, indicates the pressure in the same artery at rest. The measuring unit mmHg comes from the earlier measuring devices, in which the pressure values ​​were read from the height of the mercury column. Values ​​around 120/80 mmHg (systolic / diastolic) are considered optimal. Since there is a connection between the occurrence of high blood pressure and age, the rule of thumb "age plus 100" for systolic blood pressure was previously used to determine the individually optimal blood pressure, but this has long been considered outdated. Today, in international consultation, there is hypertension from a value of over 140/90 mmHg. The most severe stage of hypertension is reached at levels exceeding 180/110 mmHg.

Dissemination of the symptoms

According to the WHO, more than a third of adults worldwide have high blood pressure. The high blood pressure caused “around half of all deaths from strokes and heart diseases.” In 2004, 7.5 million deaths were directly attributable to hypertension, the WHO continued. The World Health Organization estimates that approximately 54 percent of strokes and 47 percent of ischemic heart disease are a direct result of high blood pressure.

In Germany, almost half of the population suffers from high blood pressure, reports the German Hypertension League (DHL), citing figures from the Robert Koch Institute (RKI). However, only every second person knows about the disease and “only about 40 percent of those affected who know about it are treated,” DHL continues. According to the WHO, however, the significantly improved diagnosis and treatment with inexpensive medications has resulted in a significant decrease in deaths from hypertension in recent years.

Although the likelihood of developing high blood pressure increases with age, in principle young people can also suffer from hypertension. All age groups and both genders are affected and there is a high risk of dangerous secondary diseases. Since in most cases there are no complaints for a long time, the necessary countermeasures are often only taken late.
[GList slug = ”10-signs-for-hypertension”]

Hypertension symptoms

Most of the high blood pressure patients initially show no noticeable symptoms. Diagnosis is usually delayed accordingly. However, various complaints can indicate hypertension at an early stage. The German high pressure league calls here

  • Sleep problems,
  • Inner unrest,
  • Nosebleeds,
  • Tinnitus,
  • A headache,
  • Feeling hot,
  • Dizziness,
  • Nausea,
  • general poor performance,
  • Shortness of breath during physical exertion,
  • Visual disturbances,
  • Racing heart (may indicate a medical emergency!).

Secondary hypertension symptoms

In secondary hypertension, depending on the causes of high blood pressure, there can be a wide variety of accompanying symptoms, which are explained in more detail below in connection with the underlying diseases. Both primary and secondary arterial hypertension can, in turn, favor or trigger secondary diseases that cause additional complaints. "The higher the blood pressure, the higher the risk of damage to the heart and blood vessels in important organs such as the brain and kidneys," explains the World Health Organization. According to the WHO, uncontrolled blood pressure can lead to pathological enlargement of the heart, heart failure, an aneurysm (bulges of the blood vessels) or a heart attack. Blood vessels are also more likely to burst due to the increased pressure. In addition, the “pressure in the blood vessels can cause blood to leak into the brain and cause a stroke,” warns the WHO. In addition, kidney failure and cognitive impairment or impaired consciousness are mentioned as possible consequences of hypertension.

The increased blood pressure also increases the risk of arterial calcification, coronary heart disease (CAD) and permanent damage to the heart muscle. The latter in turn causes an impairment of the cardiac function, which can be associated with cardiac arrhythmias or atrial fibrillation, for example. Last but not least, the so-called hypertensive crisis (hypertensive crisis), in which a sudden rise in blood pressure to values ​​of 230/130 mmHg or higher, is often associated with acute damage to the heart, brain and lungs. Action must be taken immediately to avoid potentially fatal consequential damage.

Hypertension causes

An increase in blood pressure results from an increased cardiac output, increased vascular resistance or a combination of both mechanisms. In most patients, arterial hypertension is not due to direct physical causes, so the medical diagnosis is "primary" or "essential" hypertension. According to the German Hypertension League, more than 90 percent of those affected suffer from primary hypertension, while secondary hypertension has a relatively small share of the total diseases.

"In the human body, blood pressure is regulated by a very complex mechanism", whereby "biochemical messengers, organs, blood vessels and the nervous system interact with each other", explains the high pressure league. To date, however, the underlying mechanism has only been partially researched.

Unclear causes of primary hypertension

Especially in the case of primary high blood pressure, the causal relationships in the organism remain largely unclear. However, there is obviously a connection with the genetic makeup or genes. In addition, several significant risk factors for primary hypertension have been identified in various studies. Here, the German Hypertension League mentions, for example, lack of exercise, unhealthy nutrition, overweight and stress as essential influencing factors.

In addition, tobacco use is a critical risk factor for primary hypertension. In addition, diabetes mellitus and lipid metabolism disorders as well as a salt and fat-rich diet, various medications (e.g. the "pill") and alcohol are rated as favorable factors. Naturopathy also considers possible interference fields that irritate and impair the natural regulatory mechanisms of the cardiovascular system as triggers of high blood pressure.

Possible causes of secondary hypertension

With secondary hypertension, certain physical causes of high blood pressure can be determined by definition. These can be diseases of the kidneys, certain diseases of the cardiovascular system, hormonal disorders or the so-called sleep apnea syndrome.

Renal diseases that can cause secondary hypertension include chronic inflammation of the kidneys, kidney damage due to diabetes and the cystic kidneys. A narrowing of the renal artery can also cause secondary hypertension. In addition to the increased blood pressure, those affected show symptoms such as kidney pain or flank pain, blood in the urine and the development of edema (fluid accumulation in the tissue).

Cardiovascular impairments such as narrowing of the main artery (stenosis of the aorta; mostly due to a congenital heart defect) or vasculitis (inflammation of the blood vessels) are also known as possible causes of secondary hypertension. In addition, there are so-called endocrine diseases (diseases of the hormonal glands), which lead to disturbances in the hormone balance and in this way bring the blood pressure out of balance.

For example, so-called primary hyperaldosteronism (Conn syndrome; characterized by an increased aldosterone level in the blood), Cushing syndrome (increased cortisol concentration in the blood) and hyperfunction of the parathyroid glands (hyperparathyroidism) are possible endocrine diseases that lead to a can cause secondary hypertension. With sleep apnea syndrome, breathing interruptions during sleep are evident, which are accompanied by a drastic decrease in the oxygen content in the blood, subsequent wake-up reactions and, as a result, an increase in blood pressure.

Other possible causes include taking medicines with active ingredients such as adrenaline, corticosteroids or methylphenidate. Drugs such as cocaine can also raise blood pressure. In addition, blood pressure often rises significantly during pregnancy. However, these temporary derailments of blood pressure are to be distinguished from the pathological forms of hypertension mentioned above.

All in all, one thing can be said: As complex as our tube-like vascular system for blood distribution is, it is also susceptible to external influences. Acute increases in blood pressure can also be seen during physical exertion, anger and fear, whereby the blood pressure drops rapidly again when the patient is at rest. Here it also becomes clear why permanent stress and anxiety disorders are associated with a chronic increase in blood pressure.


Blood pressure measurements are the basic diagnostic tool for determining hypertension. However, an increased value with a single measurement says little. To determine hypertension, blood pressure should be measured three times a day for at least a week and a table should be kept. The measurements should always be taken at the same times so that comparable values ​​can be obtained and the circadian rhythm becomes visible, because typical fluctuations in blood pressure can occur in the daily rhythm.

It is also important to ensure that the measurement is carried out in the idle state. The patient should therefore sit down and pause for about five minutes before the measurement takes place. In addition, according to the German High Pressure League, care should be taken to ensure that the measuring devices are placed approximately at the level of the heart. Because “if the measuring point is below the heart height, the measured values ​​are too high. If the measuring point is above the heart height, the values ​​are too low, ”explains DHL.

To date, blood pressure is usually determined with the help of an inflatable cuff, whereby according to the German High Pressure League, it must be ensured that the inflatable part is on the inside of the upper arm, the closure is on the outside and the tube is pointing downwards. The correct height for attachment is "two cross fingers above the elbow."

The cuff should not be tightened too tightly to avoid falsifying the results. Special cuffs are available for people with particularly strong or particularly thin upper arms. Although some blood pressure monitors also allow measurements on the wrist, according to the high-pressure league, "errors can occur more frequently because the arm position can vary more." New devices would therefore only start measuring when the measuring point is at heart level and the arm position is correct .

If the blood pressure is measured by the doctor, this is often accompanied by a certain nervousness of the patient, which in itself can lead to an increase in blood pressure and falsified results. If this so-called "white coat effect" is suspected, independent measurements by the patients in their home environment are advised.

As part of the diagnosis, after confirmation of the hypertension by the blood pressure measurements, it is also necessary to determine possible causes of secondary hypertension and to assess the cardiovascular risk, as well as to recognize end organ damage and comorbidities, as stated in the “Guidelines for the Management of Arterial Hypertension ", Published by the European Society of Cardiolgy, the European Society of Hypertension, the German Society for Cardiology and the German Hypertension League. The "personal history, family history, physical examination, laboratory diagnostics and other special diagnostic tests" are important steps on the way to a reliable diagnosis.

In the case of suspected hypertension, the patient's history includes asking the patient about previous increases in blood pressure in the patient and about known secondary hypertension in the family environment. The intake of drugs and medication should also be checked. In addition, accompanying symptoms such as sweating, headache, dizziness, visual disturbances, anxiety, muscle weakness and so-called tetania (motor disorders and sensations due to overexcitability of the muscles and nerves) are queried. Risk factors such as eating habits, a lack of physical activity or tobacco consumption must also be checked.

In addition to blood pressure measurements, the physical examination includes palpation of the kidneys, eavesdropping on the abdomen and chest, examination of the complexion and the search for possible indications of Cushing's syndrome. Laboratory examinations are also used for diagnostics. Here, the "Guidelines for the Management of Arterial Hypertension" recommend starting with a relatively simple basic examination and, if indicated, moving on to more complex examinations, if indicated.

According to the treatment guidelines, the basic examination includes determining the values ​​of "hemoglobin and / or hematocrit, fasting glucose, total cholesterol, LDL cholesterol, HDL cholesterol, fasting triglycerides, potassium and sodium in serum and uric acid in serum." Also a so-called GFR determination of Serum creatinine, urine analysis and a 12-lead ECG are planned. If there are suspicions of causal diseases, further examinations include an echocardiogram, a long-term or exercise ECG, ultrasound examinations of the neck vessels, peripheral vessels and chest as well as a fundus mirror. Basically, the body mass index and waist size are also determined as part of the physical examination.

Diagnostic options in naturopathy

In naturopathy, depending on the focus, diagnostic options are used that provide causal information even before a pathological change can be clinically determined. In the diagnosis of ants, reddened conjunctiva, visibly serpentine temporal arteries and a red complexion are, for example, indications of hypertension, although the latter sign may also be constitutional. An underlying heart or kidney weakness sometimes becomes apparent early on through fluid accumulation on the eyelids.

In the eye diagnosis, the heart and kidney sectors are examined for signs of weakness with an iris microscope. In addition, the so-called arcus lipoides or "fat ring" can indicate high cholesterol and fat metabolism disorders. Especially in the event of sudden high blood pressure values ​​and in young hypertension patients, a lookout for interference fields is made, especially in the form of root-treated teeth, tonsils, paranasal sinuses and scars that have resulted from injuries or operations. The lifestyle, especially in the area of ​​nutritional behavior, is inquired and analyzed in detail in order to be able to design a suitable diet for the person concerned.

The discussion also identifies possible conflict and stress factors - for example at the workplace, in relationships or in the personal history of the person concerned - that could aggravate or cause the symptoms. An individually tailored treatment plan can then be created and implemented from the collected information and data.

Hypertension treatment

The therapeutic measures required for secondary hypertension depend primarily on the possible underlying diseases, but they must generally take into account the severity of the hypertension and the overall health risk.

Moderate forms of primary high blood pressure are today also treated in conventional medicine mostly without the use of medicines, but only on the basis of lifestyle changes (healthy eating, sufficient exercise, reducing excess weight, avoiding tobacco and alcohol).

If, in addition to high blood pressure, there are other cardiovascular risk factors, such as overweight or diabetes, these can usually no longer be dealt with simply by changing your lifestyle. Here, antihypertensive drugs are an important means of minimizing the risk of life-threatening cardiovascular damage. The blood pressure reaches values ​​of more than 180/110 mmHg the immediate use of blood pressure medication becomes necessary, even if no other risk factors are added.

Therapy should essentially take two pathomechanisms into account: overactivity of the sympathetic nervous system and excess volume due to excessive sodium retention, renal insufficiency or excessive aldosterone levels. However, according to the Deutsches Ärzteblatt International, approximately four to five percent of patients are resistant to therapy.

In the case of moderate forms of primary hypertension, the treatment guidelines initially recommend that you change your lifestyle against hypertension over a period of several months. "Lifestyle changes are crucial in the prevention of hypertension, but are equally important in its treatment," the experts write in the "Guidelines for the Management of Arterial Hypertension". The treatment guideline cites the essential measures as "Limiting the salt intake to 5 to 6 grams per day", "Limiting alcohol consumption to not more than 20 to 30 grams of alcohol per day for men and not more than 10 to 20 grams per day for women . "

In addition, an "increased consumption of vegetables, fruits and dairy products with a low fat content is recommended." Furthermore, regular exercise such as "moderate dynamic training, for at least 30 minutes on 5 to 7 days a week" is advised and the guidelines see the weight loss to a BMI of 25. The waistline should be less than 102 centimeters for men and 88 centimeters for women, as long as there are no contraindications, the treatment guidelines recommend. High blood pressure patients who smoke are advised to stop smoking and to seek therapeutic support in case of doubt.

Regarding the available blood pressure medication, the treatment guidelines explain that there are five large substance classes available, between which no clinically relevant differences could be found in a large number of randomized controlled studies. According to the "Guidelines for the Management of Arterial Hypertension", diuretics, beta-blockers, calcium antagonists, ACE inhibitors and angiotensin receptor blockers "are all equally suitable for initial and long-term treatment, be it as monotherapy or combination therapy."

However, the absolute and relative contraindications must of course be taken into account and the use should be made according to specific indications. For example, gout is an absolute contraindication to the use of diuretics and asthma, a contraindication to beta blockers.
[GList slug = ”10 tips for high blood pressure”]

Naturopathy for high blood pressure

Many aspects of naturopathy can already be found in the lifestyle changes mentioned above, although the holistic approach to naturopathic therapy is much more important. The interplay of nutritional therapy, exercise therapy, relaxation techniques, medicinal herbs, homeopathic remedies and other naturopathic procedures is the key to success here. The treatment should be individually tailored to the patient.

As an alternative to salt, certain herbs (for example basil and lovage), onions and garlic are suitable for the diet. They give the food a spicy taste and can also help lower blood pressure. Fruits and vegetables should anyway make up a high proportion of the daily food intake due to the minerals they contain.

Various medicinal plants can also be used against high blood pressure, with herbal tea blends made from hawthorn blossoms, lemon balm, mistletoe and valerian have proven their worth many times over. Depending on the individual symptoms, additional medicinal plants can also be added to the tea blends. For example, diuretic plants such as goldenrod, horsetail or nettle contribute to a drop in blood pressure. However, caution is advised here, as these can be contraindicated in various symptoms such as kidney disease.

Other home remedies for high blood pressure from the food sector include apple cider vinegar, honey, red berries or pomegranates. Naturally, black cumin oil is also sometimes used as a nutritional supplement. Furthermore, various essential oils, which are released into the room air via a so-called arm lamp, can help to lower blood pressure. Essential oils of lavender, marjoram or lemon balm are particularly suitable here.

So-called hydrotherapy has also proven itself as a naturopathic method in the treatment of hypertension. The water applications were made known by the pastor Sebastian Kneipp, who used them in the 19th century to treat various ailments. The external applications in the form of washes, baths, castings and wraps act according to the German Hypertension League "like an irritant therapy that can change the organism."

However, in the case of hypertension patients, it is first necessary to get used to the hydrotherapeutic stimuli. Then they are carried out on one part of the body and the water is always led from the heart away to the heart. Cast iron castings are appropriate at the start, later the casts are switched to, the high pressure league reports. Extreme cold applications must be avoided, however, as these can sometimes drastically increase blood pressure. "Large-scale cold stimuli such as swimming in cold water, cold showers or a cold shower after physical exertion or a visit to the sauna can raise blood pressure," warns the German High Pressure League.

In contrast, regular morning alternating showers, rising arm baths or rising foot baths in the evening would have a positive effect on moderately increased blood pressure. The so-called Kneipp cure with its combination of hydrotherapy, nutritional therapy, exercise therapy, phytotherapy (herbal medicine) and order therapy (for relaxation and stress relief is one of the most promising naturopathic approaches against arterial hypertension.

Due to the negative effects of stress and psychological stress in arterial hypertension, psychotherapeutic elements, such as the use of relaxation techniques, are an essential element of high blood pressure therapy in naturopathy. Autogenic training, yoga, tai chi or qigong are good ways to support stress relief or to avoid the emergence of stress. So they often serve to normalize blood pressure.

Even if the effectiveness of homeopathy is controversial from a scientific point of view, many people trust homeopathic remedies. Here, for example, Glonoinum is used for acute high blood pressure and Rauwolfia is used for milder forms of hypertension. In the field of Schüssler salt therapy, the Schüssler salts No. 7 (Magnesium phosphoricum) and No. 8 (Sodium chloratum) are among others used to treat hypertension. However, the use should only be made in consultation with experienced therapists or a doctor.

Altogether, naturopathy offers an enormously broad spectrum of different methods for the relief of high blood pressure, whereby only an extract of the possibilities has been compiled here. Which methods are ultimately used should be individually coordinated between therapists and patients. Ein Gang zum Arzt ist bei Hinweisen auf Bluthochdruck allerdings in jedem Fall erforderlich, um schwerwiegender Ursachen der Beschwerden auszuschließen und zu einer gesicherten Diagnose zu gelangen. (jvs/fp)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Dipl. Geogr. Fabian Peters, Dr. med. Andreas Schilling


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ICD-Codes für diese Krankheit:I10, I11, I13, I15, I27ICD-Codes sind international gültige Verschlüsselungen für medizinische Diagnosen. You can find e.g. in doctor's letters or on disability certificates.

Video: Hypertension Explained Clearly - Causes, Diagnosis, Medications, Treatment (January 2023).