High Blood Pressure: Understanding and Managing Arterial Hypertension

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Written By Dr. Adam Mueller

Written and medically verified by Dr. Adam Mueller, a board-certified internal medicine and cardiology expert. His career is focused on the study and promotion of health and preventive care.

Arterial hypertension, commonly known as high blood pressure, is a silent but significant health challenge affecting millions worldwide. Often undetected due to its subtle symptoms, hypertension is a major risk factor for cardiovascular diseases. This comprehensive guide explores the causes, risks, and effective management strategies for arterial hypertension, offering insights for those seeking to understand and control this common health condition.

Understanding Arterial Hypertension

Arterial hypertension, commonly known as high blood pressure, is a critical health concern with far-reaching implications. It is defined as a condition where the blood pressure in the arteries is persistently elevated, leading to increased risk of heart disease, stroke, and other complications. The condition is measured in millimeters of mercury (mm Hg) and is characterized by systolic (the top number) and diastolic (the bottom number) pressures.

Defining Hypertension: American vs. European Guidelines: The criteria for diagnosing hypertension vary slightly between American and European guidelines, reflecting different approaches in the management of this condition.

  • American Guidelines: According to the American Heart Association (AHA) and the American College of Cardiology (ACC), hypertension is defined as a systolic blood pressure of 130 mm Hg or higher, or a diastolic blood pressure of 80 mm Hg or higher. This classification was updated in 2017, lowering the threshold from the previous 140/90 mm Hg, in an effort to encourage earlier intervention.
  • European Guidelines: The European Society of Cardiology (ESC) and the European Society of Hypertension (ESH), however, define hypertension as a systolic blood pressure of 140 mm Hg or higher, or a diastolic blood pressure of 90 mm Hg or higher. This higher threshold is based on research suggesting that the risk of cardiovascular events increases significantly at these levels.
AHA/ACC (2017)ESC/ESH (2018)
Definition of Hypertension
(mm Hg)
≥ 130/80≥ 140/90
Normal Blood Pressure ranges
(mm Hg)
Normal: < 120/80
Elevated: 120-129/<80
Optimal: < 120/80
Normal: 120-129/80-84
High normal: 130-139/85-89
Hypertension Stages
(mm Hg)
Stage 1: 130-139/80-89
Stage 2: ≥ 140/90
Grade 1: 140-159/90-99
Grade 2: 160-179/100-109
Grade 3: ≥ 180/110
Age Specific Blood pressure targets
(mm Hg)
< 65 years: < 130/80
≥ 65 years: < 130/80
< 65 years: 120-129/< 80
≥ 65 years: 130-139/< 80
Comparison of the differences in the definition of arterial hypertension and age specific treatment targets according to the American vs. European guidelines.

Causes and Risk Factors

The causes of hypertension are often a combination of genetic and environmental factors. Genetics play a significant role, with individuals having a higher risk if they have a family history of the condition. Aging is another crucial factor, as the blood vessels naturally stiffen and accumulate plaque over time, increasing the risk of high blood pressure. Lifestyle choices greatly influence the development of hypertension; a poor diet (high in salt), lack of physical activity, excessive alcohol consumption, and smoking all contribute to its onset. Obesity is another major risk factor, as it puts extra strain on the heart and blood vessels. Additionally, underlying health conditions like diabetes and kidney disease can predispose individuals to hypertension. Chronic stress and certain medications, including birth control pills and over-the-counter pain relievers, can also elevate blood pressure. Understanding these risk factors is essential for both prevention and management of hypertension.

The following are the possible causes of high blood pressure summarized:

  • Genetics: A family history of hypertension increases risk.
  • Age: The risk increases with age.
  • Lifestyle Factors: Poor diet (high in salt), physical inactivity, obesity, and excessive alcohol consumption.
  • Medical Conditions: Kidney disease, diabetes, and sleep apnea can contribute to high blood pressure.
  • Stress: Chronic stress can be a contributing factor.

Symptoms of Hypertension

High blood pressure is often called a “silent killer” because it may not present obvious symptoms until significant damage has occurred. Regular monitoring (self-monitoring or a check-up with your general practitioner) is essential for early detection.

While it often goes unnoticed in the early stages, as the condition progresses, symptoms may become more apparent. These can include headaches, particularly in the morning; shortness of breath; nosebleeds; and a feeling of pulsations in the neck or head. Some people may experience dizziness, blurred vision, or frequent nosebleeds, although these are less common. In severe cases, hypertension can lead to more serious symptoms such as chest pain, heart palpitations, and difficulty breathing, which are indicative of potential damage to the heart and other organs. It’s important to note that these symptoms can be subtle and easily overlooked or attributed to other causes. Thus, regular monitoring of blood pressure is necessary for early detection and management of arterial hypertension to prevent complications.

Consequences of Uncontrolled Hypertension

If left untreated, hypertension can lead to serious health issues, including:

  • Heart Disease and Stroke: High blood pressure can cause hardening and thickening of arteries (atherosclerosis), leading to heart attack and stroke.
  • Kidney Damage: It can impair kidney function, leading to kidney failure.
  • Vision Loss: It can damage the delicate blood vessels in the eyes.
  • Sexual Dysfunction: It can lead to erectile dysfunction in men and reduced sexual desire in women.

Managing Hypertension

Effective management of arterial hypertension involves a combination of lifestyle changes and, if necessary, medication.

  1. Healthy Eating: Adopting a diet low in salt, saturated fats, and cholesterol, such as the DASH diet (Dietary Approaches to Stop Hypertension).
  2. Regular Exercise: Regular aerobic exercise is particularly effective in improving hypertension. Engaging in activities like brisk walking, jogging, cycling, or swimming for at least 30 minutes on most days of the week can significantly benefit blood pressure management. Aerobic exercises are excellent for heart health as they enhance cardiovascular efficiency and promote better blood circulation. This type of training reduces the workload on the heart and arteries, thereby lowering blood pressure. Additionally, it helps in weight management, which is also very important in controlling hypertension. Starting with moderate intensity and gradually building up is key, especially for those who are new to regular exercise.
  3. Weight Management: Maintaining a healthy weight can significantly lower blood pressure.
  4. Limiting Alcohol and Quitting Smoking: Both alcohol and smoking can elevate blood pressure.
  5. Stress Management: Techniques like meditation, yoga, or deep breathing can help manage stress.
  6. Medication: In managing hypertension, lifestyle changes are very important but sometimes insufficient. This is where antihypertensive medication, prescribed by your physician, becomes necessary. These medications, which include a range of types each working in different ways, are often necessary to effectively control high blood pressure. While medication can be extremely effective in controlling blood pressure, it should be seen as part of a comprehensive approach to managing hypertension.

Prevention and Regular Monitoring

Preventing hypertension starts with understanding your risk factors and making lifestyle changes. Regularly checking your blood pressure, either at home or by a healthcare professional, is crucial for early detection and management.


Arterial hypertension, while common, is a manageable condition. By understanding its risks, symptoms, and effective management strategies, you can take proactive steps towards maintaining a healthy blood pressure level. Regular check-ups, a healthy lifestyle, and awareness are your best tools in combating this silent health issue.

Disclaimer: The information provided on this website is for informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.