Half of people with high blood pressure do not know it
Hypertension means arteries stay under persistently high pressure, usually without any warning symptoms. About ninety to ninety-five percent of cases are primary, driven by lifestyle and genes with no single fixable cause, and half of those affected remain unaware until a routine check or an unrelated visit to a doctor.
Readings come as two numbers: systolic pressure first, diastolic second, both in millimetres of mercury. For most adults at rest, under 120 over 80 counts as normal. A systolic figure of 120 to 129 with a diastolic under 80 is labelled elevated. Stage 1 hypertension begins when readings sit at or above 130 over 80, and stage 2 at 140 over 90; children are judged on different thresholds. Monitoring over a full 24 hours as someone goes about their day appears to give a truer picture than a single measurement in a clinic.
The stakes are large. Roughly a third of the world's population has high blood pressure, and in 2019 it was thought to contribute to 19 percent of all deaths, about 10.4 million people. It raises the risk of stroke, heart attack, heart failure, atrial fibrillation, kidney disease, vision loss and dementia. Left untreated for years, it can damage the retina, thicken the heart muscle and injure the kidneys. Headaches, dizziness or ringing ears are sometimes reported, but these may reflect anxiety rather than the pressure itself.
Primary hypertension is nudged upward by salty diets, extra weight, smoking, inactivity and drinking. The remaining 5 to 10 percent, called secondary, has an identifiable trigger such as kidney disease, narrowed kidney arteries, hormone disorders or the contraceptive pill, and these causes often leave their own fingerprints. Cushing's syndrome can bring a rounded face and a fatty hump behind the neck; an overactive thyroid causes weight loss despite hunger, a racing pulse and trembling; a narrowed aorta can leave the legs with lower pressure than the arms; and a pheochromocytoma produces sudden surges with sweating and palpitations.
Losing weight, exercising, eating less salt, cutting alcohol and improving diet all bring pressure down. When that is not enough, drugs follow, and up to three taken together control pressure in about 90 percent of patients. Treating readings above 160 over 100 is linked to longer life, whereas the benefit of medicating the band between 130 over 80 and 160 over 100 remains disputed across reviews.
Source: Hypertension
