Hypertension

Hypertension

What Does Hypertension Mean?

Hypertension basically means high blood pressure.

There are two types of blood pressure.

Systolic Blood Pressure is the maximum amount of pressure that your heart exerts while beating.

Diastolic Blood Pressure is the amount of pressure in your arteries between heart beats.

The difference between the two values is known as ‘Pulse Pressure’.

How is Blood Pressure Measured?

Blood pressure is usually measured in mmHg which means millimetres of mercury above the surrounding atmospheric pressure. There is a measure for the systolic and diastolic pressure. So, the measurement will be expressed in the following form:

Systolic Blood Pressure / Diastolic Blood Pressure mmHg

A healthy adult reading will be around:

120/80 mmHg

Hypertension starts when then systolic blood pressure is measured at 140 or above and/or the diastolic blood pressure is measured at 90 or above. There is a form of high blood pressure where the systolic pressure is elevated but the diastolic pressure remains in safe levels. This is known as Isolated systolic hypertension. Further there are three grades of hypertension. See the chart below for further information:

Categorisation Systolic Blood Pressure (mmHg) Diastolic Blood Pressure (mmHg)
Optimal <120 <80
Normal 120-129 80-84
High Normal 130-139 85-89
Stage One Hypertension 140-159 90-99
Stage Two Hypertension 160-179 100-109
Stage Three Hypertension >=180 >=110
Isolated Systolic Hypertension >=140 <90

How Does Hypertension Occur?

There are two main categories of hypertension - primary (sometimes referred to as ‘essential’) and secondary. Primary hypertension usually begins in middle or old age and is understood to be caused by a combination of long term lifestyles patterns and genetics whilst secondary hypertension comes about earlier in life and usually has a clear cause such as an endocrine disorder, kidney disorder or even the usage of certain types of medication. It is known that blood pressure is a heritable trait with around 30% of blood pressure variance being attributable to genes. The factors that underlie blood pressure are many and varied. It is an incredibly complex field of medical study however apart from genetics, there are clear associations between certain lifestyle patterns and increased risk of hypertension.

Guidelines to Follow for Hypertension

The course of action to be taken when dealing with hypertension should be discussed with your GP and other specialists if necessary. Following are some general guidelines to reduce your risk of developing or increasing your blood pressure:

Things to Avoid:

Things to Increase:

What are the Symptoms of Hypertension?

(& Why Hypertension it is a Silent Killer)

It’s very important to understand that in most cases there are no obvious signs or symptoms to be noticed with hypertension. Occasionally people experiencing severe hypertension can exhibit headaches, nosebleeds and shortness of breath however this may not be the case. For this reason, it is crucial to have regular check ups with your GP to have your blood pressure measured. If you are young and healthy then it may be safe to have your blood pressure checked every 3-5 years however to be on the safe side, you should have it checked every year especially as you grow older.

What Can Hypertension Cause?

Atherosclerosis

Hypertension can cause a thickening and hardening of the artery walls which is called Atherosclerosis. Why does that happen? Because the arteries are responding to the increased blood pressure by “pushing back” against that pressure. This causes them to harden and thicken which leaves less space for the blood to flow which in turn leads to increased blood pressure. It’s a vicious cycle really and it needs to be identified as early as possible so that effective measures can be taken to keep in under control.

Aneurysm

Increased blood pressure can cause a rupture of the artery wall which then begins to bulge. This is referred to as an aneurysm. Aneurysms are quite dangerous as they rupture and lead to internal bleeding that may be life threatening.

Heart Problems

Some of the heart problems associated with hypertension include angina, arrhythmia and even heart attack. This is due to the reduced blood flow to the heart that results from the thickening of arteries.

Brain Problems

Some of the brain complications that may stem from chronic high blood pressure are mini stroke, stroke, dementia and mild cognitive impairment.

Kidney Problems

The kidneys may become scarred or even fail. This issue is even more common for those who have both hypertension and diabetes.

Eye Problems

Hypertension can lead to issues with your eyes such as damage to the retina, fluid build-up under the retina and or damage of the optic nerve that may result in internal bleeding within the eye and subsequent loss of vision.

Those are some of the main complications that hypotension can cause but there are many more so please consult with a medical professional if you are concerned that a particular health issue or symptom is related to your blood pressure.

How Does Hypertension Affect Daily Life?

Hypertension can be a very dangerous condition as it may cause damage to your organs and blood vessels. As a result, you may be more likely to encounter complications such as heart attack or stroke, heart failure, aneurysm. Hypertension can also limit blood flow to your brain which may result in reduced learning abilities, trouble with memory and/or understanding and can even lead to dementia. As you can see, the flow-on effects of high blood pressure can manifest in many ways so it is difficult to give a concise list of how it could affect your daily life. Needless to say, the effects will not be pleasant so keeping your blood pressure under control is a high priority.

Where are Hypertension Headaches Located?

A hypertension headache usually manifests as a feeling of pressure all over the head sometimes described as a ‘hair band’ pain. These headaches may come about due to a sudden change in blood pressure however as mentioned there are often no symptoms until your blood pressure gets to dangerous levels so if you are having pressure headaches and are concerned about your blood pressure it’s best to see a GP as soon as possible.

Are Hypertension Headaches Dangerous?

Yes! It’s not so much that the headache itself is dangerous but that if you are having hypertension headaches you are experiencing quite severe hypertension which is a very dangerous health problem that needs to be taken seriously. If you suspect that you or someone you know is experiencing symptoms of hypertension, seek professional medical advice as soon as possible.

Will Hypertension Go Away? / Can Hypertension Be Cured?

Primary or essential hypertension can not be cured but it can be successfully managed with a combination of medication and lifestyle changes (see ). Secondary hypertension can be cured as it may be the result of other health issues which once resolved also allow the blood pressure to return to healthy levels. Medical investigation will be needed to find out if you have primary or secondary hypertension, so diagnosis is always the first step. From there, your doctor will make recommendations for you to follow and you need to make sure you follow their advice as closely as possible.

Will Hypertension Kill Me?

Can hypertension kill you? Well, yes but it will likely come about due to an associated complication. There are many different bodily systems that may come under pressure and begin to break down in the case of chronic hypertension. Heart disease and stroke are some of the most common causes of death especially in modern western societies and they are certainly correlated with high blood pressure. Remember, you are in the driving seat and you don’t have to wait to have a serious medical complication. Work actively with your GP and specialists to get your blood pressure under control. You may find the lifestyle changes difficult at first, but they could end up enhancing your quality of life more than you realise.

Are Hypertension and Glaucoma Related?

There is a specific type of hypertension known as ‘Ocular Hypertension’ that refers specifically to the tension of the fluid within the eye. Ocular hypertension is the primary risk factor for Glaucoma so in this sense they are related however it’s important to understand that it’s possible to have ocular hypertension without having regular hypertension and vis versa. There is evidence of direct correlations between changes in systemic blood pressure and changes in intraocular pressure so reducing your blood pressure may help with your glaucoma however you must seek advice from a qualified medical professional in order to treat such serious conditions.

Can Massage Help with Hypertension?

The short answer is YES (but don’t rely on it as your only treatment).

Many studies have shown that massage may be helpful as a complimentary therapy in the treatment of hypertension. A systematic review of the use of massage therapy for essential hypertension found that massage has an important role to play in the management of hypertension and that combining massage with medication may be more effective than using medication in isolation.

In another study, a group of women diagnosed with hypertension were given massage treatment for ten consecutive days and had their blood pressure tested one minute before the massage, one minute after the massage and five minutes after the massage. Almost all measures of blood pressure were decreasing consistently. The only reading that didn’t decrease was the diastolic blood pressure which was measured five minutes after the treatment.

Another study conducted in 2013 and published in the International Journal of Preventive Medicine found that massage was able to significantly lower blood pressure in pre-hypertensive women and concluded that massage is a “safe, effective, applicable and cost effective intervention” for controlling blood pressure.

A study in the UK in 2002 set out to test the effects of myofascial trigger point massage on the back, neck and shoulders on the cardiovascular system. They found that the massage treatment reducing both heart rate and blood pressure. There was also a significant increase in parasympathetic nervous system activity (the relaxation response or “rest and digest” mode). The participants also reported an improvement in levels of muscle tension and emotional state following the treatments. The authors concluded that myofascial trigger point massage was effective for activating cardiac parasympathetic activity and improving measures of relaxation.

Using Massage for Stress Management May Help Reduce Blood Pressure

Chronic stress can indirectly lead to elevated blood pressure. How does this occur? In two ways, firstly during the stressful events we enter a fight or flight state and part of the bodies response to this is to increase the heart rate and blood pressure. The body does this because there is a perceived threat to the safety of the organism. Secondly, there are other longer lasting hormones that are released into the body to help it deal with prolonged stress. One of the primary hormones that is released from the adrenal glands is called cortisol (also known as hydrocortisone).

Cortisol is perfectly healthy if it is released occasionally in response to a genuine threat to your safety however if cortisol levels are elevated for longer periods of time the hormone can start to have negative effects on your health such as activating inflammatory mast cells, stimulating the release of norepinephrine (another short-term stress hormone), and up-regulating certain chemicals in the amygdala that condition a fear-based stress response. The workings of the endocrine system and its interaction with other bodily systems is incredibly complex. The exact mechanisms underlying stress-induced cortisol dysfunction have not yet been identified by scientists. What is known however is that chronic stress eventually leads to cortisol not functioning as intended.

That was all a bit technical now wasn’t it? but the takeaway I want to leave you with is that we don’t need to know exactly how it all works to know that consistently lowering stress levels will improve adrenal function and improve our health. We all need to find healthy ways of coping with stress and your toolkit would be sadly lacking without a regular massage.

Conclusion

As you can see, massage can be a very helpful complimentary therapy for lowering blood pressure. It should not be the only strategy you have to manage stress and hypertension. It will work best if combined with appropriate medications and other lifestyle recommendations such as quitting smoking, increasing exercise, reducing salt intake, having a healthy diet and learning some form of conscious relaxation techniques.


References

Delaney J, Leong K, Watkins A, Brodie D. The short-term effects of myofascial trigger point massage therapy on cardiac autonomic tone in healthy subjects. J Adv Nurs. 2002;37(4):364-371. doi:10.1046/j.1365-2648.2002.02103.x

Givi, Mahshid. “Durability of Effect of Massage Therapy on Blood Pressure.” International Journal of Preventive Medicine 4.5 (2013): 511–516. Web.

Hannibal K, Bishop M. Chronic Stress, Cortisol Dysfunction, and Pain: A Psychoneuroendocrine Rationale for Stress Management in Pain Rehabilitation. Phys Ther. 2014;94(12):1816-1825. doi:10.2522/ptj.20130597

Klein B. Intraocular pressure and systemic blood pressure: longitudinal perspective: the Beaver Dam Eye Study. British Journal of Ophthalmology. 2005;89(3):284-287. doi:10.1136/bjo.2004.048710

Poulter N, Prabhakaran D, Caulfield M. Hypertension. The Lancet. 2015;386(9995):801-812. doi:10.1016/s0140-6736(14)61468-9

Tobe S, Gilbert R, Jones C, Leiter L, Prebtani A, Woo V. Treatment of Hypertension. Can J Diabetes. 2018;42:S186-S189. doi:10.1016/j.jcjd.2017.10.011

Walaszek R. Impact of classic massage on blood pressure in patients with clinically diagnosed hypertension. Journal of Traditional Chinese Medicine. 2015;35(4):396-401. doi:10.1016/s0254-6272(15)30115-1

Xiong X, Li S, Zhang Y. Massage therapy for essential hypertension: a systematic review. J Hum Hypertens. 2014;29(3):143-151. doi:10.1038/jhh.2014.52