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blood pressure

High Low Pressure

Generality

The minimum high pressure is the medical condition in which the diastolic pressure value constantly exceeds 90 mmHg.

In general, the minimum high pressure falls within a context of hypertension, therefore in a state in which even the systolic pressure is constantly, and exceedingly, above the norm (therefore not only higher than 120 mmHg, but also of 140 mmHg).

Brief review of the concept of arterial pressure and high blood pressure

Arterial pressure is the force that blood exerts against the walls of blood vessels, following the pump action carried out by the heart.

Measured in millimeters of mercury ( mmHg ) and in a state of rest, blood pressure is usually defined by the values ​​of systolic pressure and diastolic pressure :

  • the systolic pressure (or maximum or " maximum " pressure) is the arterial pressure of when the heart contracts
  • the diastolic pressure (or minimum or " minimum " pressure) is the arterial pressure of when the heart is relaxing.

In a healthy individual, resting blood pressure can have systolic blood pressure values ​​between 90 and 120 mmHg and diastolic blood pressure values ​​between 60 and 80 mmHg.

According to the medical-scientific community, the optimal arterial pressure at rest is equal to or slightly less than 120 (p. Systolic) / 80 (p. Diastolic) mmHg.

The permanent rise, in a state of rest, of the arterial pressure beyond the value of 120/80 mmHg lays the foundation to talk about:

  • Pre-hypertension, if blood pressure does not exceed 139/89 mmHg,
  • Hypertension or high blood pressure, if the arterial pressure exceeds more or less abundantly the 139/89 mmHg.

If pre-hypertension represents an alarm bell that warns of the presence of something abnormal, high blood pressure is a clinically relevant medical condition, which - in the absence of adequate treatment - can degenerate into complications (primarily atherosclerosis ) and potentially deadly.

Which factors the blood pressure value depends on:

  • Force of contraction of the heart
  • Systolic range
  • Heart rate
  • Resistance in peripheral arteries
  • Elasticity of the aorta and large arteries (vascular compliance)
  • Intravascular

What is the minimum high pressure?

The minimum high pressure is the condition in which the diastolic pressure at rest is constantly higher than the value of 90 mmHg, ie the pressure level for the "minimum" that marks the border between the state of pre-hypertension and the state of hypertension.

In other words, with the terminology "high minimum pressure" the doctors refer to a state whose peculiarity is a particularly high resting diastolic pressure, higher than 90 mmHg.

As a rule, the high minimum pressure falls within a context of hypertension, therefore in a state in which even the systolic pressure is constantly and exceedingly above the norm (therefore not only higher than 120 mmHg, but also of 140 mmHg).

Causes

Minimum high blood pressure may result from a state of essential hypertension or from a state of secondary hypertension .

  • Essential hypertension is a hypertensive state that does not depend on a precise and easily recognizable cause, but on a combination of factors such as, for example, overweight, obesity, a sedentary lifestyle, high intake of dietary salt, hereditary or familial predisposition to hypertension, aging, hormonal imbalances of various kinds and depression
  • Secondary hypertension is a hypertensive state whose origin is a very specific condition / circumstance, which can be for example a serious kidney disease, a severe cardiac anomaly, a hormonal disease (eg: Cushing's syndrome, hyperthyroidism, etc.), diabetes, sleep apnea syndrome, pregnancy, use of certain drugs (eg, corticosteroids, birth control pills, NSAIDs, etc.), renal artery stenosis, alcohol abuse, drug use ( ex: cocaine, amphetamines etc.) or the abuse of licorice.

Therefore, from what has just been reported, it can be concluded that the causes of high minimum pressure are numerous and consist, in some cases, in several combined factors and, in other cases, in a single specific condition, which can be a disease, a particular condition or a certain behavior.

Curiosity

When an individual suffers from high minimum pressure, there is a tendency to omit the fact that the same subject also has a high maximum pressure, as it is so-called "discounted" information.

This same argument, however, is not valid when we talk about high maximum pressure; in these circumstances, in fact, it is good to specify the pressure level of the so-called minimum, since there are cases, especially in the elderly population, of high systolic pressure in which the diastolic pressure is normal.

The phenomenon - more common in the elderly than in the adult - of raising the maximum single pressure is called isolated systolic hypertension .

Risk factors of high minimum pressure

Superimposable to the risk factors of high blood pressure, the risk factors of the high minimum pressure consist in:

  • Old age. Aging is responsible for an inevitable process of hardening of the arterial vessels, which, among other effects, also involves the increase of arterial pressure;
  • Familial predisposition to hypertension;
  • Belonging to the African, African-American and Caribbean race. Reliable medical studies believe that the predisposition of Africans, African-Americans and the Caribbean to hypertension and minimal high blood pressure has a genetic basis;
  • Excess salt in the diet. The intake of salt in the diet begins to be dangerous, for the health of the human being, when it exceeds 6 grams per day;
  • Sedentary lifestyle. A particularly sedentary lifestyle is often associated with overweight or obesity, which is two of the main risk factors for hypertension;
  • Overweight and obesity. According to the most reliable estimates, one third of people with high blood pressure (and minimal high blood pressure) are overweight or suffer from obesity.

    Overweight and obesity affect blood pressure, elevating it, because they put the heart under stress;

  • Regular consumption of large quantities of alcohol. Among alcoholics, hypertension and minimal high blood pressure are two widespread problems;
  • Smoking and smoking in general. Tobacco smoke leads to an increase in blood pressure, because it contains substances with a vasoconstrictor effect and because it determines the formation of atherosclerotic plaques (NB: atherosclerosis is, at the same time, the cause and effect of hypertension);
  • Frequent / constant use of certain drugs. The drugs in question include the aforementioned NSAIDs, corticosteroids and birth control pills, some antitussives, nasal decongestants and selective serotonin reuptake inhibitors;
  • Stress;
  • Insomnia and reduced number of hours devoted to sleep at night;
  • Presence of chronic diseases, such as diabetes, some kidney diseases or sleep apnea syndrome.

As can be seen from this list, many of the risk factors of high minimum pressure (as well as hypertension) are behaviors contrary to a healthy lifestyle. Therefore, one should not be surprised if one of the main rules for the prevention of minimum high blood pressure (and hypertension) is to lead a healthy lifestyle.

Symptoms and complications

Along with the other alterations induced by hypertension, the minimum high pressure represents a subtle condition, as it almost never causes symptoms, but acts in the shadows, developing very serious complications and, sometimes, deadly consequences.

When is the minimum high pressure causing symptoms?

The high minimum pressure causes symptoms, when, in a context of hypertension, the diastolic pressure and the systolic pressure increase abruptly and exceed, respectively, the value of 110-120 mmHg and the value of 180 mmHg.

In medicine, when the arterial pressure reaches the aforementioned levels of minimum pressure and maximum pressure, it is called a hypertensive crisis .

The possible symptoms of hypertensive crises consist of:

  • Sudden headache, pulsating and charged to the whole head;
  • Heavy head feeling;
  • Ringing in the ears (tinnitus);
  • Dizziness;
  • Cold sweats;
  • Nose blood;
  • Dyspnea and heart disease;
  • Sense of oppressive anxiety;
  • Nausea and vomit;
  • Vision problems (visual blurring, scintillating phosphenes, pinpoint amaurosis, etc.).

Complications

The continuation of the minimum high pressure, and of the hypertensive state to which it is generally associated, leads to profound damage to the blood vessels. Identified mainly in atherosclerosis, this profound vascular damage has negative repercussions on the blood supply to the body's organs, which, precisely because of a lower blood supply, are themselves victims of damage.

Among the various organs of the body, those that are most affected by the prolonged presence of high minimum pressure and resulting atherosclerosis are:

  • Heart and blood vessels (cardiovascular system).

    At the heart level, the main problems are: myocardial infarction (or heart attack ) and heart failure (or heart failure ).

    On the vascular level, however, the most common complications are: aortic dissection (or aortic dissection ), aneurysm formation and peripheral arterial disease .

  • Brain.

    At the cerebral level, the prolonged presence of minimal high pressure significantly increases the risk of hemorrhagic stroke and induces stenosis (ie the narrowing) of the arterial vessels of the brain, a phenomenon that favors the development of a form of dementia known as vascular dementia .

  • Kidneys.

    The kidneys are the object of a loss of function, because the high minimum pressure and the hypertensive state that accompanies it determine, in the long run, a narrowing of the renal arteries (therefore less blood flows to the kidneys) and damage to renal structures fundamental, such as glomeruli, tubules, etc.

  • Eyes.

    At the ocular level, prolonged alteration of blood pressure levels causes stenosis of the arteries that supply the blood retina; receiving less blood, the retina develops damage, which is responsible for vision problems and visual loss.

  • Reproductive organs.

    Men with minimal high blood pressure tend to suffer from erectile dysfunction, while women with minimal high blood pressure suffer from a certain drop in libido .

What is atherosclerosis?

Atherosclerosis is the process of hardening and thickening of arterial vessels of medium and large caliber, complicated by the formation of atheromas on the inner wall of the aforementioned type of vessels.

The atheromas are plaques of lipidic material (mostly cholesterol), protein and fibrous, which, in addition to obstructing the lumen of the arteries and preventing blood flow, can also become inflamed and fragmented. The fragmentation of an atheroma is responsible for the dispersion, in the bloodstream, of moving bodies, which can occlude small arteries, also located very far from the site of origin of the same atheroma.

Diagnosis

The high minimum pressure and the hypertensive state to which it generally accompanies are easily diagnosed through the simple measurement of arterial pressure, using a sphygmomanometer .

However, an accurate diagnosis of high minimum pressure (and hypertension) cannot be limited to the simple observation of elevated resting blood pressure levels, but must also focus on the search for the triggering causes and on the characteristics of the ongoing problem. This explains why the doctors, when faced with a case of minimal high blood pressure, subject the patient to an accurate physical examination and a precise medical history, sometimes even prescribing:

  • Blood tests ;
  • Urine tests ;
  • An electrocardiogram, an echocardiogram and an exercise test ;
  • Radiological examinations, such as chest CT or chest radiography;
  • A pressure holter .

Why look for the causes that trigger the minimum high pressure?

The identification of the causes and factors favoring the minimum high pressure is important, because it allows the most appropriate therapy planning.

Curiosity: how often is it good to measure blood pressure?

As a result of the possible consequences of hypertension and its subtle nature, doctors recommend measuring arterial blood pressure every two years, starting at 18 years of age, and every year, starting at age 40.

Therapy

The therapy of the minimum high pressure and the typically associated hypertensive status is based on the important goal of bringing the maximum pressure and minimum pressure levels back to normal.

To achieve this, the following are fundamental:

  • Respect for the DASH diet ;
  • The reduction, in the case of overweight or obesity, and the maintenance of body weight within the limits considered normal;
  • The regular practice of physical exercise;
  • Avoid all those bad behaviors that induce the pathological rise of blood pressure;
  • Undergo antihypertensive drug therapies, if the aforementioned treatments prove to be insufficient or the blood pressure increase is very high;
  • Undergo an appropriate causal therapy, if the hypertension condition is secondary.

DASH diet

The DASH diet is a dietary regimen specifically designed for people with high blood pressure levels (so even for those with minimal high blood pressure).

The key points of the DASH diet are different and include:

  • The invitation to consume a lot of fruit and vegetables, because these are foods rich in dietary fiber;
  • The invitation not to consume more than 5-6 grams of salt a day;
  • The abolition of the addition of salt to foods;
  • The reduction in the intake of saturated fats to less than 7% of the total daily calories;
  • The abolition of the consumption of preserved food by means of cooking salt;
  • The recommendation to prefer low-fat milk and milk derivatives;
  • The consumption of pasta and whole grains, instead of pasta and refined cereals, due to the higher fiber content of the former;
  • Consumption of fish from 2 to 3 times a week.

A dietary approach based on the principles of the DASH diet, in addition to ensuring a control of blood pressure, also promotes the reduction of excess fat.

To learn more about the DASH diet theme: Example DASH Diet

Body weight reduction

For patients with minimal high blood pressure, hypertension and weight problems (overweight or obesity), doctors recommend achieving and maintaining a body mass index ( BMI or BMI ) between 18.5 and 24.9 kg / m2 ( normal weight), as this is of enormous benefit to health. In fact, medical-scientific studies have shown that:

  • Every 10 kg lost, obviously by an obese and hypertensive person, benefits from a drop in blood pressure, both in the maximum values ​​and in the minimum values, oscillating between 5 and 20 mmHg;
  • Each kg lost by a person needing to lose weight lowers the pressure by 1 mmHg.

Maintaining the normal weight condition is important to keep blood pressure under control and avoid elevations.

Physical exercise

For patients who need to reduce their blood pressure, doctors recommend at least 30 minutes of aerobic physical activity (ie brisk walking, running, swimming, cycling) at least 5 times a week.

Curiosity

30 minutes of brisk walking, practiced 3 to 5 times a week, reduce arterial pressure by 4-9 mmHg.

Behaviors to avoid

In the presence of high minimum pressure, it is essential to avoid three bad habits: smoking, abusing alcohol (it is also one of the key points of the DASH diet) and sleeping a few hours a night.

drugs

There are several drugs with the ability to reduce blood pressure, both in the minimum values ​​and in the maximum values. The drugs in question include:

  • Diuretics, such as so-called thiazide diuretics, chlorthalidone and indapamide;
  • Beta blockers;
  • Calcium channel blockers;
  • Renin-angiotensin system inhibitors (or ACE inhibitors);
  • Direct-acting vasodilators;
  • Angiotensin II receptor antagonists (or sartans);
  • Drugs for the so-called hypertensive emergency.

To learn more: Hypertension drugs

Example of causal therapy

In a context of minimal high pressure due to secondary hypertension, the causal therapy - that is the cure of the triggering cause - is a cornerstone of the therapeutic plan, which is added to all the other treatments described above.

An example of causal therapy is the administration of synthetic thyroid hormones, in the presence of hypertension due to hypothyroidism.

Other useful treatments: stress control

Patients with minimal high blood pressure and hypertension can benefit from relaxation techniques, such as yoga, which teach how to control stressful situations.

Learning to control stress is important, especially when stress contributes to the pathological rise of blood pressure.

Prognosis

The high minimum pressure and the hypertensive state that accompanies it are a very dangerous condition, whose non-treatment drastically increases the risk of developing complications with lethal consequences (eg: heart attack, stroke, aneurysm etc.).

Curiosity

Among those who know they are hypertensive, only 25% manage to keep the disease under control and to bring their pressure back to normal.

Prevention

Minimizing salt consumption, maintaining body weight as normal, practicing regular aerobic exercise, not smoking, limiting alcohol consumption and adopting a diet rich in fruit and vegetables are the main recommendations of doctors, when the topic of discussion is prevention of high minimum pressure and, more generally, of hypertension .

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