High blood pressure (=hypertension) belongs firmly in the circle of the so-called “widespread diseases”. In the western world it is assumed that 30% of the population is affected. As the word high blood pressure correctly suggests, it is a matter of excessive blood pressure.
Since this high pressure is usually manifested in the vascular system, especially in the arteries, it is called arterial hypertension. How it develops can be easily imagined using the model of a garden hose. In order to be able to water flowers properly, a certain water pressure at the end of the hose is necessary.
You can get this pressure either by putting more water in the hose, opening the tap more or by sending the same amount of water through a thinner hose. Applied to our vascular system, this means that the blood pressure depends on how much blood flows through the system and how narrow our vessels are. Only a sufficient amount at the end of the vascular system with a pressure that is not too high and not too low can supply all our organs properly.
The amount of blood that flows is controlled by the heart by pumping more or less strongly or simply beating faster or slower. And the tightness of our vessels is controlled by nerve tracts around the vessels. These nerve tracts control whether the muscle cells in the vessels tense up and narrow it or whether they relax and the vessel expands.
These mechanisms are used in the drug therapy of high blood pressure to normalize the “degenerated” blood pressure. A systolic “upper” value of 140mmHg (mmHg=millimeter of mercury: unit of measurement of blood pressure) and a diastolic “lower” value of 90 mmHg are considered the limit for high blood pressure. The risk of suffering unnoticed late effects of elevated blood pressure increases rapidly with increasing blood pressure values.
To prevent such late damage to the vascular system, heart, brain, kidneys and many other organs, consistent treatment of high blood pressure is absolutely essential. The basic therapy of each treatment consists of general measures such as weight normalization, low-salt diet (max. 6g of table salt per day), Mediterranean diet (lots of fruit, salad & vegetables with little animal fat), no blood pressure-increasing medication (e.g. cortisone, pill) and changing lifestyle habits (no coffee, hardly any alcohol, no cigarettes, learning relaxation techniques).
25% of patients with mild hypertension can be helped sufficiently and their blood pressure values can be improved enormously in this way, so that no further therapy is necessary. In addition to these general measures, medication plays a prominent role in the therapy. As a rule, this is a long-term therapy.
Unfortunately, for the affected person this often means a lifetime of medication. The drugs can either be administered alone as so-called step therapy or as a combination therapy. With the step therapy one holds oneself only once to a preparation and only with insufficient effect additionally other preparations are used and combined, until the desired effect occurs.
The combination therapy is different: Here, different drugs are combined from the beginning to achieve the target blood pressure. In the selection of the drugs, 5 groups of active ingredients in particular have become established. Drugs of first choice are so-called diuretics, beta blockers, ACE inhibitors, AT1 blockers and calcium antagonists.
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