Hypertension: A Hidden Danger – Analyzing its Triggers, Measurement Standards, and Grading [i]

Under certain circumstances, such as anger, excitement, or the first brisk walk after a long period of rest, we can directly feel the presence of blood pressure. At these times, due to increased blood pressure, the previously gentle blood flow in the arteries becomes rapid and volatile, creating dangerous flow velocities at the branching points of blood vessels, leading to arterial fragility and rupture. It is normal for blood pressure and pulse to rise during exercise or exertion, as the body requires more oxygen; however, after a short time, once we have returned to calm, blood pressure should return to normal. If blood pressure does not decrease or remains elevated even at rest, this condition is called hypertension. In the early stages of hypertension, patients are almost unaware of its presence. This insidious characteristic is precisely where the danger of hypertension lies. In developed countries, hypertension has become a truly prevalent disease. If left untreated, life expectancy will be significantly shortened. If blood pressure remains above 150/100 (systolic pressure to diastolic pressure) for an extended period, a man's lifespan will be shortened by one-fifth. Among untreated patients, one-fifth suffer from stroke, and more than half die from cardiovascular diseases. Approximately 5% of hypertension cases are caused by underlying medical conditions, hence the term secondary hypertension. Half of these cases are due to kidney disease. Causes of secondary hypertension include: kidney disease (hereditary kidney cysts, kidney injury, radiation-induced kidney damage, nephritis, pyelonephritis); hormonal imbalances (high aldosterone, Cushing's syndrome, pheochromocytoma); medications and preparations (birth control pills, cortisone, alcohol, caffeine, excessive licorice); and other causes (narrowing of arteries, high blood pressure during pregnancy, lead poisoning). In most cases, hypertension is not caused by a single factor. Risk factors for hypertension include: heredity (accounting for 50% of cases); fatigue and other psychological factors; lack of physical activity; alcohol; smoking; improper diet; excessive salt intake; lipid metabolism disorders and being overweight; and diabetes. Regular blood pressure monitoring is essential for understanding one's blood pressure status. Blood pressure is expressed in two numbers, such as "120/80". The first number is the systolic pressure, which is the highest pressure the heart can reach when it contracts; the second number is the diastolic pressure, which is the lowest pressure in the arteries when blood returns to the heart. For accurate measurement, you should sit quietly for a few minutes before measurement and avoid consuming any stimulating foods or drinks for half an hour beforehand. When measuring blood pressure, place your arm at heart level. Blood pressure should be measured at the same time every day, as blood pressure varies considerably throughout the day: it is highest in the morning and lowest at night. For a long time, a blood pressure of 160/90 mmHg was considered normal. Later, it was recognized that these threshold values ​​were insufficient to prevent dangerous consequences. The World Health Organization, the Joint National Committees, and the International Society of Hypertension redefined normal and elevated blood pressure. According to this new regulation, there is no age distinction; a blood pressure of 140/90 mmHg or higher is considered hypertension. The newly set upper limit for the "ideal blood pressure" is 120/80 mmHg. Hypertension is classified into several levels: Ideal (systolic blood pressure <120, diastolic blood pressure <80); Normal (120-129 / 80-84); Fairly Normal (130-139 / 85-89); Slightly High (140-159 / 90-99); Moderately High (160-179 / 100-109); Severely High (180 or above / 110 or above). To determine the severity of extremely high blood pressure, the highest deviation from the norm should be used as the standard. Only by understanding one's own risk level can one live in the safe "green zone" rather than the dangerous "red zone." [i]