Prognosis

Untreated high blood pressure damages the cardiovascular system in the long run. Hypertension promotes calcification of the arteries, which significantly increases the risk of heart attack, stroke and peripheral arterial occlusive disease (PAD). Since the heart has to pump constantly against a too high pressure, it initially becomes enlarged, but in the long run it is damaged and the risk of heart failure increases dramatically.

A derailment of the blood pressure (>200mmHg) even represents a medical emergency, as there is a great danger that the cerebral arteries cannot withstand the pressure and rupture. A large and often fatal cerebral hemorrhage can be the result. It is therefore important to check your blood pressure regularly and to take medication as soon as possible if hypertension is detected.

Even if one does not necessarily feel anything from the high blood pressure itself, it is important to take the medication regularly, because the secondary diseases are serious. Even a blood pressure of 150mmHg, 10mmHg above the target value, reduces life expectancy by 10 years. By taking medication regularly and continuously, the risks of cardiovascular diseases can be reduced considerably, because there are a number of good drugs in this field.

Prophylaxis

Since hypertension is genetically determined to a not inconsiderable extent, it is not always possible to prevent the development of high blood pressure. However, certain risk factors such as smoking, overweight, lack of exercise, alcohol, unhealthy high-fat diet and excessive salt consumption can be eliminated by a suitable lifestyle. Because these behaviors lead in most cases to high blood pressure and lower the life expectancy by many years, although they would be actually avoidable.

Physiological basics

The basic pressure that prevails in the vessels during the filling phase of the heart is called diastolic blood pressure. It is about 80mmHg. The systolic pressure is higher than the diastolic (approx.

120mmHg), because the ejected blood must be pumped against the basic pressure. The systolic pressure is mainly dependent on the so-called afterload. This is the pressure in the arterial vascular system against which the heart must pump.

The higher this pressure is, the more force the heart has to exert to transport the blood to the periphery. The pressure is mainly caused by the vascular resistance of smaller arteries. The higher the resistance, the higher the pressure and the higher the afterload.

Since this is resistance hypertension, the vascular resistance of the arteries is the main point of attack for the systolic antihypertensives. It is also important to know how blood pressure is regulated, because that is where the drugs intervene. The body can effectively increase blood pressure mainly through two substances: Noradrenaline/Adrenaline and Angiotensin.

Norepinephrine and adrenaline drive the heart by increasing the frequency and pumping more volume. In addition, both substances lead to a constriction of the blood vessels, thus increasing resistance and blood pressure. Angiotensin, on the other hand, leaves the heart alone, but also causes narrowing of the blood vessels, thereby increasing arterial resistance and causing an increase in blood pressure.