Diagnosis

A doctor can use various methods to clearly differentiate between uniquely high blood pressure and manifest hypertension. Usually, the patient is asked to measure his/her own blood pressure several times on several days. It is important to sit or lie down for a few minutes before the measurement.

Upper arm monitors are more accurate than wrist monitors. Another possibility is the 24-hour blood pressure measurement, in which a blood pressure cuff is put on at the doctor’s office, which measures the blood pressure at certain intervals over 24 hours and thus creates an accurate blood pressure profile of the patient. This profile enables an assessment of the average blood pressure as well as the blood pressure development during the day and at night. In order to rule out the possibility of a narrowing in the arteries of one arm, the blood pressure should be measured on both arms the first time. In addition, if high blood pressure is detected, blood should be taken and examined for indications of the above-mentioned diseases that may cause secondary high blood pressure.

How dangerous is it?

A blood pressure that is only measured once too high should not cause those affected any concern – it is completely harmless and occurs regularly in healthy people in the context of physical strain, pain or psychological stress. A control of the blood pressure in regular intervals of for example 1-2 years is nevertheless recommended. On the contrary, long-term chronic high blood pressure is very dangerous without appropriate treatment: in the western world it is one of the most common causes of strokes, heart attacks and kidney damage.

The longer a high blood pressure persists, the more damage is done to the vessels of the affected person.The result is a fatty and hardening of the vessels, which is professionally called “arteriosclerosis“. Arteriosclerosis can affect all organs and leads to a variety of problems. As already mentioned, it often manifests itself as a stroke or heart attack, but it can also lead to impaired vision due to damage to the eyes or to kidney hypofunction due to damage to the kidneys.

Furthermore, a long-standing high blood pressure can directly damage organs and thus cause, for example, heart failure or cerebral hemorrhage. After several years, sufferers often develop an additional “arterial occlusive disease” of the legs, which can lead to pain when walking, to wound healing disorders and in the worst case to amputation of the foot or leg. Vascular damage occurs much earlier if, in addition to high blood pressure, there are other vascular-damaging diseases such as diabetes or obesity, or if the affected person smokes.

Relatively seldom an existing high blood pressure can derail to very high values of mostly over 230/130 mmHg. Then such a “high blood pressure crisis” can cause headaches, cerebral hemorrhages or heart attacks. Depending on the level of blood pressure, practically all patients suffer consequential damage after years without adequate treatment. Therefore, appropriate treatment is important for every person affected.