What is high blood pressure?
High blood pressure, medically known as hypertension, describes a persistently elevated pressure in the arteries. The heart has to pump continuously against increased resistance, which can place a long-term strain on blood vessels, the heart and other organs. Because hypertension rarely causes symptoms, it is often discovered by chance during a routine check-up – not without reason is it called the "silent risk factor".
In Austria, an estimated one in four adults is affected. The frequency rises markedly with increasing age.
Blood pressure values: when do we speak of hypertension?
Blood pressure is expressed as two values: the systolic (upper) and the diastolic (lower) value, measured in millimetres of mercury (mmHg). The European Society of Cardiology (ESC) uses the following classification for values measured in the practice:
- Optimal: below 120 / below 80 mmHg
- Normal: 120–129 / 80–84 mmHg
- High-normal: 130–139 / 85–89 mmHg
- Grade 1 hypertension: 140–159 / 90–99 mmHg
- Grade 2 hypertension: 160–179 / 100–109 mmHg
- Grade 3 hypertension: from 180 / from 110 mmHg
A single elevated reading is not yet a diagnosis. Only repeatedly raised values – ideally supplemented by a 24-hour measurement or self-measurements at home – confirm the diagnosis. This also helps to identify the so-called "white coat effect", where blood pressure is higher in the surgery than in everyday life.
Measuring correctly – what to bear in mind
- Sit quietly for 5 minutes before measuring
- Rest the arm at heart level, use a cuff size suited to the upper arm circumference
- Do not measure directly after coffee, nicotine or physical exertion
- Take two measurements 1–2 minutes apart and note the average
Causes of hypertension: why does high blood pressure develop?
In around 90 per cent of those affected, what is known as primary (essential) hypertension is present. Here, no single cause can be identified; rather, several factors act together. In the remaining 10 per cent or so, a secondary form is responsible, for instance kidney disease, hormonal disorders or certain medicines.
Non-modifiable risk factors
- Age: Blood vessels lose elasticity over the years.
- Genetic predisposition: Hypertension tends to run in families.
- Sex: Men are more frequently affected in younger years; after the menopause the risk evens out.
Modifiable risk factors
- Overweight, particularly around the abdomen
- Lack of physical activity
- High salt intake
- Excessive alcohol consumption
- Smoking
- Chronic stress and lack of sleep
- An unfavourable diet with many processed foods
Accompanying conditions such as diabetes mellitus, elevated blood lipid levels or obstructive sleep apnoea can also influence blood pressure.
What are the possible consequences of untreated high blood pressure?
Persistently elevated values damage the inner walls of the blood vessels and promote arteriosclerosis. Possible consequences include:
- Heart attack and coronary heart disease
- Stroke
- Heart failure
- Impaired kidney function
- Damage to the retina
- Erectile dysfunction
Early diagnosis and consistent treatment can significantly reduce the risk of these secondary diseases.
Lowering blood pressure through lifestyle: what can I do myself?
Lifestyle measures are among the most important building blocks in the treatment of hypertension. For mildly elevated values they may be sufficient on their own to stabilise blood pressure. Where medication is needed, they can help to keep the dose as low as possible. The following measures are well supported by studies:
1. Adjust your diet
A plant-based, Mediterranean diet is recommended, including:
- plenty of vegetables, fruit, pulses and wholegrain products
- fish and high-quality plant oils (e.g. olive oil, rapeseed oil)
- moderate consumption of dairy products
- as little processed meat and sugar as possible
The so-called DASH diet ("Dietary Approaches to Stop Hypertension") has also proved effective.
2. Reduce salt intake
The WHO recommends a maximum of 5 grams of salt per day. Since a lot of salt is hidden in bread, sausages, cheese and ready meals, it is worth checking ingredient lists. Fresh herbs and spices are a flavourful alternative.
3. Exercise regularly
At least 150 minutes of moderate aerobic activity per week are recommended, such as brisk walking, cycling, swimming or Nordic walking. Additional strength training on two days a week can enhance the effect. Even small changes, like taking the stairs instead of the lift, count.
4. Reduce weight
Losing just a few kilograms can already noticeably lower blood pressure. A waist circumference below 94 cm in men and below 80 cm in women is considered favourable.
5. Limit alcohol, stop smoking
Alcohol raises blood pressure in a dose-dependent way. It is advisable to include alcohol-free days during the week. Smoking damages blood vessels in addition – quitting is worthwhile at any age.
6. Manage stress and sleep well
Chronic stress activates the sympathetic nervous system and can drive blood pressure up. Helpful approaches include:
- relaxation techniques such as yoga, breathing exercises or progressive muscle relaxation
- regular breaks and sufficient sleep (7–8 hours)
- social contacts and hobbies
When should I seek medical advice?
A medical assessment is sensible in the case of:
- repeatedly measured values of 140/90 mmHg or higher
- a family history of cardiovascular disease
- accompanying symptoms such as dizziness, headache, nosebleeds or shortness of breath
- existing risk factors such as diabetes, overweight or kidney disease
During the consultation, the values are interpreted, possible causes are investigated and – if necessary – drug treatment is discussed. Lifestyle measures always remain an important companion.
Conclusion
High blood pressure is common, but it can be treated well. Anyone who knows their values, has them checked regularly and pays attention to a balanced lifestyle can make a significant contribution to their own cardiovascular health. Physical activity, a plant-based diet, less salt and alcohol, and a mindful approach to stress are key building blocks.
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This article does not replace medical advice.