Skip to main content

Hypertension (High Blood Pressure)

Silent, common, and one of the most modifiable cardiovascular risks there is.

Hypertension is sustained blood pressure of 130/80 mm Hg or higher. It damages arteries over years without symptoms, making it a leading cause of stroke, heart attack, and kidney disease. Treatment combines lifestyle change with — for most people — one or two well-tolerated medications.

Causes & risk factors

  • Genetics and family history
  • Age (risk rises steadily after 40)
  • High sodium diet and low potassium
  • Obesity and sedentary lifestyle
  • Chronic stress and poor sleep
  • Kidney disease and sleep apnoea (secondary causes)

Symptoms

  • Usually none — hypertension is typically silent
  • Headaches at very high pressures (>180/110)
  • Nosebleeds in hypertensive emergency
  • Fatigue or blurred vision with end-organ damage

How it's diagnosed

  • Multiple readings over weeks — one clinic reading isn't enough
  • Home blood pressure log (twice daily for a week)
  • 24-hour ambulatory monitoring if readings vary
  • Baseline labs: kidney function, electrolytes, lipids, HbA1c
  • ECG and sometimes echocardiogram to assess heart

Evidence-based treatment

  • DASH diet — rich in fruit, vegetables, low-fat dairy, whole grains
  • Sodium under 2g daily
  • 150 minutes of moderate exercise per week
  • Weight loss of 5-10% if overweight
  • ACE inhibitors, ARBs, calcium channel blockers, or thiazide diuretics
  • Combination therapy when single agent insufficient

Prevention

  • Annual BP screening from age 18
  • Home monitor if family history is strong
  • Limit alcohol to <2 drinks/day men, <1 women
  • Quit smoking

Hypertension (High Blood Pressure) — FAQ

Can hypertension be cured without medication?

Lifestyle changes alone bring stage-1 hypertension to normal in a meaningful minority of people. Most need medication too, especially at stage-2 levels or with cardiovascular risk factors.

Is online consultation good enough for BP management?

Yes for most patients. A home BP log plus periodic labs gives a Cardiologist everything they need to titrate medication and review targets.