High blood pressure is the leading risk factor for stroke and a major risk factor for cardiovascular events, including heart attacks. The risk of hypertension increases with age. One in two (50%) 65 years old has high blood pressure and this proportion rises to 90% among those who live to age 85 or older.

What is hypertension? 

Often called "high pressure" in popular language, high blood pressure is characterized by too high blood pressure inside the arteries. It occurs when these blood vessels shrink or harden; the heart must work harder to circulate blood throughout the body.
 
For most people, we talk about high blood pressure when the average pressure is above 140/90 (140 out of 90) mm Hg.

What do the numbers mean?


The first digit (eg, 140) is the pressure in the arteries when the heart contracts and propels the blood into the bloodstream. It's the systolic pressure.
The second digit is lower (eg, 90) because it is the pressure in the arteries when the heart is resting between beats. It's the diastolic pressure.
 
The two numbers are combined to express the blood pressure. The units of measurement for the pressure are millimetres of mercury (mm Hg).

Causes of hypertension 

Rarely, hypertension is caused by another disease (eg a kidney problem ) and can be cured when this disease is treated. In 95% of cases, however, it is not possible to find the exact cause of hypertension. This is called essential hypertension.
 
There are several factors that can increase the risk of developing hypertension or worsening hypertension when you have it. Some of these factors may be changed while others are beyond our control.


Symptoms of hypertension


Hypertension is called the "silent killer" because it is usually not accompanied by any symptoms. As a result, many people with hypertension are unaware of their condition.
Sometimes, when the pressure is very high, it can cause different symptoms, for example:
  • headaches ;
  • dizziness
  • shortness of breath
  • palpitations;
  • vision problems
  • weakness;
  • numbness
In such a case, it is better to consult your doctor as soon as possible. 

Risks and complications on health
 
Hypertension weakens the arteries and imposes extra work on the heart. In doing so, it prematurely wears the arterial vessels and the heart muscle. Hypertension disrupts the good functioning of several organs and contributes to the occurrence of various problems, for example:
  • heart failure ;
  • myocardial infarction (heart attack);
  • kidney failure ;
  • stroke (stroke) ;
  • dementia;
  • retinopathy (eye disease);
  • erectile dysfunction;
  • blood circulation problem in the legs. 

Effective treatment of hypertension is essential to reduce the risk of complications. Its health benefits are real! According to Hypertension Canada, the treatment of hypertension leads to:
  • a 40% reduction in the risk of stroke;
  • a 15% decrease in the risk of myocardial infarction;
  • a 50% reduction in the risk of heart failure.

Diagnosis of high blood pressure
 
Because your blood pressure varies during the day depending on your activity and your emotions, a single high blood pressure measurement does not necessarily mean that you have high blood pressure. 

To make a diagnosis of hypertension, the doctor needs several blood pressure measurements to get an overall picture of the situation. He may see you a few times or prescribe an Ambulatory Blood Pressure Monitoring (ABPM) that measures your pressure for a whole day (day and night). 

For most people, we talk about high blood pressure when the average pressure is above 140/90 mm Hg. Because of the higher risk of cardiovascular events in people with diabetes, these people are diagnosed with hypertension. when their average pressure is greater than 130/80 mm Hg. 

In very old people (over 80 years old), the doctor may tolerate a slightly higher systolic pressure, because of the risk of complications (eg a fall) if the pressure becomes too low. 

Treatment of high blood pressure
 
The treatment of hypertension is based both on the improvement of modifiable factors previously identified and the use of medication.
Sometimes, some people manage to control their high blood pressure by simply changing their lifestyle, but most people will sooner or later need to take medication to lower their blood pressure enough. 

The following lifestyle changes are recommended to lower blood pressure:
  • reduce sodium intake to less than 2,000 mg per day (read nutrition labels to make good grocery choices);
  • maintain a healthy weight and target a body mass index between 18.5 and 24.9: use our BMI calculator ;
  • quit smoking
  • reduce alcohol consumption;
  • Exercise moderate intensity regularly, aiming for 30 minutes most days of the week (eg, walking, cycling);
  • reduce the sources of stress.
The drugs used in the treatment of hypertension are called antihypertensive. There are several categories that act in different ways to lower blood pressure. It is not uncommon to combine multiple antihypertensives of different categories to successfully lower blood pressure. 

It is important to take antihypertensive daily, assiduously, even when the pressure is "beautiful". Antihypertensive does not cure hypertension. Therefore, if you stop taking them the pressure will return to a dangerous level for health.

Measure the pressure in the comfort of the house
 
When you have high blood pressure, it is important to measure the blood pressure on a regular basis to make sure the treatment is effective. An automatic blood pressure monitor, a device that measures blood pressure, is available to measure pressure in the home. These devices are inexpensive and easy to use. To choose the model that best suits our needs, the ideal is to seek advice from the pharmacist. 

It is recommended to measure the pressure twice a day:
  • In the morning, on an empty stomach and before taking your medication;
  • In the evening, before going to bed (or at least two hours after eating).

It takes two measurements each time, about one minute apart (so 4 measurements per day). Some devices can be programmed to take both measurements automatically. 

At the time of measurement, a few guidelines must be followed to obtain reliable and representative results

   
Automatic blood pressure monitors can store a large number of measurements and automatically calculate the average values. We can also note the results in a measurement notebook. 

When measuring pressure in the home, the average pressure is below 135/85 mmHg (except for people with diabetes or very old), because of the pressure is not influenced by the stress of being in the doctor's office (the effect of the white lab coat). For people with diabetes, we aim for an average pressure of less than 130/80 mm Hg, no matter who takes the measure.