Evaluation and Management of Pulmonary Hypertension in Noncardiac Surgery: A Scientific Statement From the American Heart Association
90% Of People With High Blood Pressure May Need More Treatment, Study Finds
Recent research from the University of Gothenburg highlights a concerning issue: many people with high blood pressure, also known as hypertension, may not be receiving adequate treatment.
Hypertension is a leading cause of illness and premature death worldwide, making it a critical public health issue. In Sweden alone, more than a quarter of all adults suffer from this condition, which significantly increases the risk of serious health problems such as heart attacks and strokes.
Hypertension is a major risk factor for cardiovascular diseases, yet the optimal blood pressure levels for preventing heart attacks and strokes in certain groups of patients remain unclear.
Several studies conducted by the University of Gothenburg aimed to clarify this by examining the relationship between different blood pressure levels and the risk of these life-threatening events.
In one study, researchers focused on older patients with hypertension who had no previous history of heart attacks or strokes.
The findings were striking: patients with systolic blood pressure (SBP) below 130 mmHg had a 40% lower risk of heart attacks or strokes compared to those with SBP in the 130-139 mmHg range.
Specifically, 5.2% of patients with SBP between 130 and 139 mmHg experienced a heart attack or stroke during the study's follow-up period, compared to only 3.4% of those with SBP below 130 mmHg.
This study included 5,041 older patients, providing robust evidence that stricter blood pressure control could significantly reduce the risk of these events.
Another study from the same research group examined the risk of hemorrhagic stroke—a type of stroke caused by bleeding in the brain—in patients with atrial fibrillation, a common heart rhythm disorder.
This study included 3,972 patients who were being treated with blood-thinning medications like Warfarin or Eliquis.
The results showed that patients with systolic blood pressure between 140 and 179 mmHg had twice the risk of hemorrhagic stroke compared to those with SBP in the 130-139 mmHg range.
In the higher blood pressure group, 1.4% of patients suffered a hemorrhagic stroke during the follow-up, compared to just 0.7% in the lower blood pressure group.
These findings further emphasize the importance of maintaining lower blood pressure levels to reduce the risk of serious complications.
A third study, which analyzed data from 259,753 patients, revealed that the treatment of hypertension is often insufficient.
The study found that nine out of ten patients either had poor blood pressure control, high blood cholesterol levels, or were smokers—factors that all contribute to an increased risk of heart attack and stroke.
The researchers concluded that an unnecessarily high number of people in Sweden suffer from heart attacks, strokes, or premature death due to inadequate treatment of hypertension.
These studies collectively suggest that many patients with hypertension could benefit from more aggressive treatment strategies.
Lowering blood pressure and cholesterol levels through medication, or making lifestyle changes such as quitting smoking, could significantly reduce the risk of heart attacks and strokes.
For those concerned about managing high blood pressure, it is crucial to stay informed about the latest research and treatment options.
While medication is often necessary, lifestyle changes such as a healthy diet, regular exercise, and avoiding smoking can also play a significant role in controlling blood pressure and improving overall health.
The research, led by Johan-Emil Bager and colleagues, was published in journals like Brain and Behavior.
These findings underscore the importance of effective hypertension management and suggest that more stringent blood pressure control could save lives by preventing heart attacks, strokes, and other related health problems.
If you care about high blood pressure, please read studies about unhealthy habits that may increase high blood pressure risk, and drinking green tea could help lower blood pressure.
For more information about high blood pressure, please see recent studies about what to eat or to avoid for high blood pressure, and 12 foods that lower blood pressure.
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Everything You Need To Know About High Blood Pressure (Hypertension)
You may be more likely to have high blood pressure due to your genetics, age, and whether you have certain health conditions. Treatment may include medication and lifestyle changes.
Your blood pressure measurement takes into account the amount of blood passing through your blood vessels and the amount of resistance the blood meets while the heart is pumping.
High blood pressure, or hypertension, occurs when the force of blood pushing through your vessels is consistently too high. In this article, we'll cover the basics of hypertension, including its symptoms, causes, how it's treated, and more.
Narrow arteries create more resistance for blood flow out of the heart. The narrower your arteries, the more resistance there is, and the higher your blood pressure will be. Over the long term, the increased pressure can cause health issues, including heart disease.
Hypertension is quite common. Since guidelines changed in 2017, nearly half of American adults have high blood pressure, according to the American Heart Association.
Hypertension typically develops over several years, usually without causing any symptoms. But even without symptoms, high blood pressure can cause damage to your blood vessels and organs, especially the brain, heart, eyes, and kidneys.
Early detection is important. Regular blood pressure readings can help you and a doctor notice any changes. If your blood pressure is elevated, a doctor may have you check your blood pressure over a few weeks to see if the number stays elevated or falls back to typical levels.
Treatment for hypertension includes both prescription medication and healthy lifestyle changes. Without treatment, it could lead to health issues, including heart attack and stroke.
Your blood pressure reading consists of two numbers:
Five categories define blood pressure readings for adults:
A blood pressure reading is taken with a pressure cuff. It's important to have a cuff that fits for an accurate reading. An ill-fitting cuff may deliver inaccurate readings.
Blood pressure readings are different for children and teenagers. Ask your child's doctor for the healthy ranges for your child if you need to monitor their blood pressure.
There are two types of hypertension. Each type has a different cause.
Essential (primary) hypertensionEssential hypertension, also called primary hypertension, develops over time. Most people have this type of high blood pressure.
A combination of factors typically play a role in the development of essential hypertension:
Secondary hypertension often occurs quickly and can become more severe than primary hypertension. Several conditions that may cause secondary hypertension include:
Secondary hypertension may also be a side effect of certain medications.
Hypertension is generally a silent condition. Many people won't experience any symptoms. It may take years or even decades for the condition to reach levels severe enough that symptoms become apparent. Even then, some people may attribute these symptoms to other causes.
Getting regular blood pressure readings is the best way to know if you have hypertension. Most doctors' offices take a blood pressure reading at every appointment.
Symptoms of severe hypertension, such as in a hypertensive crisis, can include:
Read more: "Symptoms of High Blood Pressure (Hypertension)"
Because hypertension is often a silent condition, it can cause damage to your body for years before symptoms become obvious. Without treatment, you may face serious, even fatal, complications.
Hypertension can damage your arteries, making them tougher, tighter, and less elastic. This damage makes it easier for deposits to collect in your arteries and restrict blood flow through your body, affecting multiple systems.
Complications of hypertension include:
Read more: "The Effects of Hypertension on the Body"
Diagnosing hypertension is as simple as taking a blood pressure reading. Most doctors' offices check blood pressure as part of a routine visit. If you don't receive a blood pressure reading at your next appointment, feel free to request one.
If your blood pressure is elevated, a doctor may request more readings over the course of a few days or weeks. Doctors rarely diagnose hypertension after just one reading. They'll need to see evidence of a sustained problem.
That's because your environment can contribute to increased blood pressure, like the stress you may feel by being at the doctor's office (known as "white coat syndrome"). Also, blood pressure levels change throughout the day.
If your blood pressure remains high, a doctor will likely conduct more tests to rule out underlying conditions. These tests can include:
If a doctor diagnoses you with primary hypertension, lifestyle changes may help reduce your high blood pressure. If lifestyle changes alone aren't enough, or if they stop being effective, they may prescribe medication.
Medications for hypertensionMany people go through a trial-and-error phase with blood pressure medications. A doctor may need to try different medications until they find one or a combination that works for you.
Some of the medications used to treat hypertension include:
Read more: "11 Common Blood Pressure Medications"
Treating secondary hypertensionIf a doctor discovers an underlying issue causing your hypertension, treatment will focus on that other condition. For example, if a medication you've started taking is causing increased blood pressure, your doctor will try other medications that don't have this side effect.
Sometimes, hypertension is persistent despite treatment for the underlying cause. In this case, a doctor may work with you to develop lifestyle changes and prescribe medications to help reduce your blood pressure.
Treatment plans for hypertension often evolve. What worked at first may become less useful over time. Your doctor will continue to work with you to refine your treatment.
High blood pressure, also known as hypertension, is a common health issue in the United States. Treatment for hypertension varies depending on factors such as the severity of your condition and which medications a doctor thinks will work best for you.
In many cases of hypertension, lifestyle changes can be powerful tools for managing — or even reversing — high blood pressure. These changes include incorporating more nutritious fruits and vegetables into your diet, getting more physical activity, limiting your sodium intake, and limiting your alcohol consumption.
Because hypertension often presents with no symptoms, checking your blood pressure regularly is important. Severe hypertension can cause serious health issues, so the sooner you receive a diagnosis, the sooner you can begin to manage it.
Can Pain Cause High Blood Pressure?
Evidence suggests chronic pain can affect the mechanism that regulates blood pressure, causing blood pressure to become too high.
High blood pressure, also known as hypertension, is when the pressure inside the blood vessels is consistently too high. Pain and hypertension often occur together.
As a 2020 study notes, persistent pain and high blood pressure often occur together.
Researchers investigated the prevalence of self-reported hypertension among 43,789 people seeking treatment from pain clinics in Australia.
Researchers found that hypertension:
Researchers note that biological factors, such as low baroreceptor sensitivity, may also play in the relationship between pain and hypertension.
The baroreflex is a homeostatic mechanism inside the body that helps regulate blood pressure. It relies on special receptors near the heart called baroreceptors, which monitor blood volume and blood pressure.
Chronic pain can reduce baroceptor sensitivity, causing blood pressure to rise.
As the study explains, certain factors may also increase a person's risk of developing both chronic pain and hypertension. These include:
According to the Centers for Disease Control and Prevention (CDC), the following conditions and lifestyle factors may cause or contribute to high blood pressure:
According to the American Heart Association (AHA), high blood pressure rarely causes symptoms. The only way for a person to determine that they have high blood pressure is to measure it.
A doctor or pharmacist can measure a person's blood pressure using a device called a blood pressure monitor.
Alternatively, people can purchase a blood pressure monitor online or from their local pharmacy and monitor their blood pressure at home.
What the numbers meanBlood pressure monitors display two values:
Both values are measured in millimeters of mercury (mm Hg).
According to the AHA, high blood pressure stage 1 is defined as a systolic value between 130 and 139 mm Hg or a diastolic value between 80 and 89 mm Hg.
A systolic value of 140 mm Hg or higher and a diastolic value of 90 mm Hg or higher indicates high blood pressure stage 2.
Figures higher than these indicate a hypertensive crisis, which is a medical emergency.
How to get an accurate readingThe AHA recommends taking two blood pressure readings in quick succession, especially if the first is higher than normal. A person should then note both readings and contact a doctor if they have any concerns.
Getting an official diagnosisTo officially diagnose high blood pressure, a doctor may request a person get their blood pressure checked on two or more visits. The doctor will then take the average of these readings.
To manage high blood pressure, people may need to make certain lifestyle changes. In some cases, doctors may also recommend medications to achieve and maintain a healthy blood pressure.
Lifestyle changesThe AHA recommends the following lifestyle changes to help manage high blood pressure:
The Food and Drug Administration (FDA) lists the different types of blood pressure medications doctors may prescribe to help lower blood pressure. These drugs include:
People should contact a doctor if they experience persistent or worsening pain or if their blood pressure readings indicate that they have high or elevated blood pressure.
According to the AHA, normal blood pressure readings should have a systolic value of less than 120 mm Hg and a diastolic value of less than 80 mm Hg.
Elevated blood pressure is defined as a systolic value between 120 and 129 mm Hg and a diastolic value of less than 80 mm Hg.
High blood pressure stage 1 is defined as a systolic value between 130 and 139 mm Hg or a diastolic value between 80 and 89 mm Hg.
A person can also consider contacting a doctor if they have risk factors for high blood pressure.
Below are some answers to frequently asked questions about pain and high blood pressure.
How does pain affect blood pressure and heart rate?The relationship between pain and blood pressure is complex. One theory is that chronic pain reduces the sensitivity of special receptors called baroreceptors, which monitor blood volume and blood pressure. This makes the baroreceptors less able to detect blood pressure changes and adjust blood pressure accordingly. As a result, blood pressure may rise.
Can inflammation cause high blood pressure?Tissue damage causes the body's immune cells to release signaling molecules called inflammatory cytokines. These molecules promote the inflammatory process that allows the body to repair itself.
However, chronic inflammation causes persistently high levels of inflammatory cytokines, which can affect the body's blood vessels and kidney function.
Because the blood vessels and kidneys play a major role in regulating blood pressure, impairments in either can lead to high blood pressure.
Pain and high blood pressure often occur together. Research suggests that chronic pain can reduce the sensitivity of special receptors near the heart, called baroreceptors, which help regulate blood pressure.
This may raise blood pressure. Certain health conditions and lifestyle factors, such as stress, obesity, and low physical activity, may also increase a person's risk of developing both chronic pain and high blood pressure.
High blood pressure rarely causes symptoms. Monitoring it is the only way to know for certain that someone has it. Anyone whose blood pressure readings fall outside the healthy range should contact a doctor for further advice and treatment.
The treatment for high blood pressure typically involves lifestyle changes, such as following a low sodium diet, limiting alcohol intake, and not smoking. In some cases, doctors may also prescribe medications to help lower blood pressure.
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