Hypertension, High Blood Pressure - What Is It?

High blood pressure (hypertension): what is it?

Arterial blood pressure is the pressure at which blood flows through the arteries. Its level depends on the strength of the heart, the peripheral resistance and compliance of the arteries and other regulatory systems in the body. With high blood pressure, vessels are damaged by the permanently high pressure. In medical terminology, this condition is known as hypertension or arterial hypertension.

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• What is systolic and diastolic blood pressure?
• How are blood pressure values ​​given?
• What role do inheritance and lifestyle play?
• What are the consequences of untreated high blood pressure?

What is systolic and diastolic blood pressure?

As the heart contracts, blood is pumped from the heart into the arteries. The pressure wave can be felt as a pulse in various arteries (e.g. on the wrist). The pressure during the heart's contraction is called the upper or systolic blood pressure. Then the heart relaxes and new blood flows into the heart chambers. The pressure in the vascular system also changes. This phase is known as diastole. The pressure during the relaxation phase of the heart is lower and is also known as the lower or diastolic blood pressure value.

How are blood pressure values ​​given?

The values ​​for measuring blood pressure are given in millimeters (mm) of mercury (Hg). There are historical reasons for this. Long before digital blood pressure measurement, the mercury blood pressure meter was invented by Scipione Riva-Rocci in 1896. A value of 130/70 mmHg means that a mercury column is raised to exactly 130 mm in systole and to 70 mm in diastole. The pressure of the arterial blood is determined by the compression of the arm artery using an inflatable pressure cuff and an aneroid manometer.

What role do inheritance and lifestyle play?

In most cases (85–90 percent) no detectable causal organ disease (eg kidneys or endocrine glands) can be found in people with high blood pressure. In these people, the causes are mainly hereditary factors and / or an unhealthy lifestyle. One speaks of "essential hypertension".

Classification of blood pressure according to office measurements

Blood pressure category	Systolic (mmHg)	Diastolic (mmHg)
Optimal	<120	<80
normal	120-129 and / or	80-84
Highly normal	130-139 and / or	85-89
Grade 1 hypertension	140-159 and / or	90-99
Grade 2 hypertension	160-179 and / or	100-109
Grade 3 hypertension	≥ 180 and / or	≥ 110
isolated systolic hypertension	≥ 140 and	<90

Source: Austrian Blood Pressure Consensus 2019

What are the consequences of untreated high blood pressure?

Increased blood pressure often goes unnoticed for a long time because it often causes no or only uncharacteristic symptoms. The early symptom of hypertension is the restriction of exercise due to shortness of breath. What is particularly feared, however, are the long-term damage and secondary diseases. The risk of developing or dying from disease of the blood vessels, heart, brain (especially stroke) or kidneys in the future is not only influenced by the level of blood pressure, but also by a number of other factors. Known risk factors include:

• Pre-existing diseases of the cardiovascular system: e.g. stroke, coronary heart disease, heart attack, angina pectoris, heart failure, peripheral circulatory disorders, bypass surgery, kidney disease or severe changes in the fundus,
• metabolic syndrome,
• Diabetes mellitus,
• Lipid metabolism disorders,
• Abdominal obesity: waist circumference over 102 centimeters in men, over 88 centimeters in women,
• Age: for men over 55 years, for women over 65 years,
• Smoke,
• Cardiovascular diseases in the family that occurred at a young age (before 55 years for father or brother, before 65 years for mother or sister),
• Increased pulse pressure in older patients with high blood pressure (= difference between systolic and diastolic values ​​greater than 60).

Accordingly, the risk of disease within the next ten years is:

• at low risk less than 15 percent (mortality risk 4–5 percent),
• at medium risk 15-20 percent (mortality risk approx. 5 percent),
• at high risk 20–30 percent (death risk 5–8 percent),
• if the risk is very high, more than 30 percent (risk of death over 8 percent).