Hypertension

Blood pressure is the pressure that occurs in the blood vessels as the blood is driven from the heart into the body and later back to the heart. High blood pressure makes the heart pump work harder and can be serious if you do not get it treated. The risk of cardiovascular disease and kidney problems in particular increases if you have high blood pressure.

These are, for example, diseases such as stroke and heart attack. You also have an increased risk of heart failure, kidney disease, dementia and impaired blood circulation in the legs. The kidneys can be impaired by high blood pressure.

Most people need treatment of high blood pressure with drugs to lower blood pressure effectively.

You can get high blood pressure if you are pregnant. It is called pregnancy poisoning and is usually detected at a check with the midwife.

Symptoms of high blood pressure

Many who have too high blood pressure feel nothing at all. Sometimes you may have mild symptoms of high blood pressure, such as mild headache and fatigue. But those symptoms may also have several other causes. The only way to know for sure if your blood pressure is elevated is by measuring it.

At very high blood pressure you can get clearer symptoms such as severe headaches and shortness of breath. It is a life-threatening condition that is unusual.

When and where should I seek care?

Check your blood pressure if you suspect or are worried that you have high blood pressure. You can do this at a health center or at some pharmacies. Many health centers can be contacted by logging in. 

If you have a blood pressure that is 140/90 or higher without other symptoms, contact a health care provider. You do not need to seek care elsewhere if it is closed. Wait until the health center opens.

If you have the following symptoms, contact a health care center or on-call reception as soon as possible.

  • You have a measured blood pressure of 230/130 or higher without any other symptoms
  • You are pregnant and have a measured blood pressure of 140/90.

You do not need to seek care elsewhere if it is closed. Wait until the on-call reception or medical center open.

If it’s in a hurry

Immediately contact a health center or an on-call clinic if you have the following problems:

  • You suspect you have high blood pressure and get severe headaches or shortness of breath.
  • You are pregnant and have a measured blood pressure of 160/110 or higher.

If it is closed at the health center or on-call reception, seek care at an emergency room.

Investigations

All adults should check their blood pressure at some point. You can do that at a health center or at some pharmacies. You can then make a new measurement after about five years. You should have your blood pressure checked once a year if it is around 140/90 mmHg, ie near the upper limit of what is considered healthy. The district nurse or the company nurse can advise when it is time to discuss the measurement values ​​with a doctor.

Here you can read about blood pressure measurement.

The upper pressure is most important

The so-called upper pressure called the systolic is what best predicts the risk of complications. This is especially true if you are over fifty years. One reason is that the overpressure increases more with age the stiffer the blood vessel walls in the artery. It reflects the degree of stiffness but also atherosclerosis, which is also sometimes called atherosclerosis.

An increase in the lower so-called diastolic pressure can be detrimental, especially for younger people. Unhealthy lifestyles with, for example, a lot of alcohol can be a cause of high depression.

Only a high overpressure means a greater risk than when both pressures are high. Isolated systolic blood pressure increase means that the upper pressure is higher than 140 mmHg while the lower pressure is as it should be, ie below 90 mmHg. It is the most common type of high blood pressure from about the age of 65. You should receive the same treatment for it as when both pressures are elevated.

Other investigations

The doctor does a regular body examination when multiple measurements at multiple visits to the district nurse or company nurse have shown that you have elevated blood pressure at rest. You may submit one or more blood tests and often an ECG is taken. Usually, a urine sample is taken to determine the level of protein in the urine.

The studies should show if blood pressure has damaged any organs, or if there may be any disease that has caused high blood pressure. The blood test tells the doctor about the following:

  • Salts in the blood.
  • Renal function.
  • Blood fats, mainly cholesterol.
  • The level of blood sugar to exclude diabetes.

Urine tests for protein, among other things, indicate if the kidneys have been affected by high blood pressure and diabetes.

The risk of getting type 2 diabetes is greater if you have high blood pressure. About three in four people with type 2 diabetes also have a previous or concomitant increase in blood pressure that requires treatment.

What can I do for myself?

It is often enough to start with changing your lifestyle if you only have a slight rise in blood pressure. It may not affect the pressure itself so much, but it can reduce the risk of cardiovascular disease.

Blood pressure is influenced by how much you weigh. Therefore, it can be good to lose weight if you weigh too much. A weight loss of just a few pounds can lower both blood pressure and blood fat and blood sugar levels. Together, it probably contributes to reducing the risk of cardiovascular disease. Regular exercise such as walking, cycling or swimming has also been shown to lower the pressure slightly.

Stress can also be a cause of high blood pressure. It may then be good to try to do something about it, for example through exercises in so-called mindfulness.

Excessive alcohol consumption is a common and often underestimated cause of hypertension. To drink less alcohol then leads most often to a marked decrease in blood pressure.

Salt or not salty?

The importance of salt for blood pressure is debated, but eating less salt is usually included in the dietary advice to lower the blood pressure. Most likely, the effect of reduced salt intake varies between individuals. It is of the greatest importance to some elderly people or people with heredity for high blood pressure and so-called genetic salt sensitivity.

An adult should not eat more than 5-6 grams of salt per day, ie about one teaspoon. But most people eat significantly more than that, often without being aware of it. Most of the salt is hidden in meat products, bread, cold cuts, and ready-to-eat foods. But it is good to try to reduce salt intake on your own as far as possible, especially if you have high blood pressure. A good start is to be frugal with salt if you cook and not salt extra on the food at the table. There are also potassium-rich so-called light salts which can be an alternative.

The right diet can help

It is not proven that a particular diet significantly lowers blood pressure, but a varied diet with plenty of fruits and vegetables can contribute to it.

Licorice can raise blood pressure

Licorice contains a substance that can raise blood pressure in some people. Even small amounts of licorice can affect the blood pressure of these individuals. If you feel unsure, you can always talk to your doctor.

Treatment of high blood pressure

There is no absolute limit when you should take medicines for high blood pressure. If you have a blood pressure of 160/100 mmHg or higher, you are usually given tablet treatment, although other risk factors are missing.

In the border area between 140/90 and 160/100, the decision depends on other risk factors such as age, having cardiovascular disease in the genus, diabetes, blood fats, and smoking. Having high blood pressure is riskier if you have diabetes at the same time and then you usually get drugs at even lower blood pressure than the border area. Thus, it is not only the measured blood pressure level that determines if you should start taking medicines, but the doctor looks at the overall risk of cardiovascular disease. 

You can always discuss with your doctor about when it is time to start taking medicines. Once you start taking medicines, you must continue for a long time, often for the rest of your life. 

Target blood pressure

The blood pressure level you should try to achieve with the treatment is below 140/90 mmHg. Especially in the elderly, it is more difficult to get the overpressure down and sometimes you have to settle for pressure of 150-160 / 90 mmHg.

You should try to bring the pressure down to a level around 140-130 / 85-80 mmHg if you have diabetes, kidney disease or a very high risk of cardiovascular disease. For many, blood pressure should also fall below 130/80 mmHg and this is especially true among younger people. How low the blood pressure should depend on how long you have had diabetes and if you have any other illnesses. Checking your blood pressure is at least as important as checking your blood sugar to avoid complications if you have diabetes. This is especially true if you have type 2 diabetes

Treatment with drugs

The purpose of treatment to lower elevated blood pressure is primarily to reduce the risk of complications such as stroke, heart attack, heart failure and kidney disease in the longer term. The treatment only provides some protection.

You can expect the treatment to reduce the risk of getting a stroke by about a third and the risk of having a heart attack by just over a tenth. When it comes to the risk of a heart attack, it is even more affected by the level of blood fats. Here, control of blood fats plays a bigger role. Quitting smoking is also important to reduce the risk.

Blood pressure-lowering drugs

There are several different medicines that lower blood pressure. If blood pressure is lowered sufficiently, a combination of two or more different drugs is often required. The doctor usually prescribes two different medicines in a low dose for you than one in high dose because it gives a better effect and fewer side effects.

Right to information

The healthcare staff should tell you what treatment options are available. They should make sure you understand what the different options mean, what side effects are available and where you can get treatment. That way you can help decide which treatment is right for you.

In order for you to be active in your care and make decisions, it is important that you understand the information you receive. The healthcare staff is obliged to make sure that you do so. Ask questions. You can also ask to have the information written down so you can read it peacefully.

What is the cause of high blood pressure?

For most people with high blood pressure, it is not possible to find a single cause. Several circumstances may be involved, such as the following:

  • You have hereditary tendencies for high blood pressure.
  • You have obesity or obesity.
  • You’re stressed.
  • You eat foods that contain a lot of fat and sugar.
  • You drink a lot of alcohol.
  • You are exposed to constant noise or other environmental factors.

Blood pressure and then mainly overpressure also increases with age. This type of hypertension is most commonly called primary or essential hypertension.

Illness can be behind

In more than one in ten people with high blood pressure, the condition depends on a single cause. It is then called secondary hypertension and is a common cause if you are young and have very high blood pressure.

The most common cause is kidney disease or endocrine disruption. Other causes may be side effects of drugs such as birth control pills as well as pregnancy complications or more severe hormonal disorders. In these diseases, excessive amounts of different hormones are formed and it can raise blood pressure.

Congestion of the upper cardiac portion of the large body pulmonary artery called coarctatio leads to increased pressure only in the upper body half. The constriction can be operated and it is usually done during childhood. Afterward, blood pressure will usually be as it should be. 

In some cases, very high blood pressure can become as it should be again when you have been treated for another disease, such as constricted blood vessels to the kidneys. There are also technical or operative treatments, but they are only suitable for a few patients with high blood pressure.

A common condition

Elevated blood pressure is one of the most common reasons for going to regular doctor’s visits.

The distribution between women and men looks different at different ages. Among younger people and middle age, high blood pressure is more common in men. In the elderly, on the contrary, high blood pressure is then more common in women.

When does it become a disease?

Moderately elevated blood pressure is not a disease. It is rather a condition that involves an increased risk, much like smoking or driving too fast. It is if the high blood pressure has started to affect the heart, brain or kidneys so that you become aware of it as part of a disease process.

Complications

An untreated high blood pressure eventually leads to damage to the body’s blood vessels in the form of stiff blood vessels and vein fat.  This can, in turn, lead to stroke, heart attack or heart failure. The risk of damage to the heart, the brain, and the vascular system increases the more other conditions and living habits you have that increase the risk.

Blood vessels in the kidneys, eyes, and legs can also be damaged by high blood pressure.

More information

The National Board of Health and Welfare draws up national guidelines for the treatment of various diseases, including heart disease and stroke. The guidelines provide recommendations on how, for example, health care, social services, and dental care should prioritize their resources. They are based on unified science and proven experience.

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