Approximately 874 million people suffer from hypertension, i.e. increased blood pressure, which is almost a quarter of the global adult population. Due to the large burden of this disease, a desire for increased public awareness and the resulting promotion of countering the disease, 17 May was designated World Hypertension Day (1, 3).
Normal blood pressure or normotension is defined as the value of 120/80 mmHg, while in hypertension, systolic blood pressure is persistently elevated above 140 mmHg and diastolic blood pressure above 90 mmHg. Hypertension is involved in the development of many, especially cardiovascular diseases. Eating food containing an excessive amount of sodium (overly salted food is highly problematic) or insufficient potassium, excessive intake of alcohol, smoking, and even illicit substance use contribute to its development. It can also develop as a result of commonly used medicines such as Aspirin, pathological conditions, physical inactivity or insomnia, and is influenced by age, gender and genetic factors (2, 3).
How to act against hypertension?
If we are not eager to use medicines, the most effective measures proved to be weight loss, increased dietary potassium intake and reduced sodium intake, increased physical activity, reduced alcohol intake and a suitable diet. According to treatment guidelines, antihypertensives must be used sometimes. They are categorised into several classes. First-line treatment includes ACE inhibitors (inhibitors of angiotensin-converting enzyme, the enzyme involved in blood pressure regulation), angiotensin II receptor antagonists, dihydropyridine calcium channel antagonists and thiazide diuretics.
They are prescribed in monotherapy and often in combination. ACE inhibitors and angiotensin II receptor antagonists inhibit the renin-angiotensin-aldosterone system, which is involved in blood pressure regulation, and according to clinical studies, these medicines are particularly useful in patients with heart failure and diabetic nephropathy. With their action, dihydropyridine receptor antagonists dilate the blood vessels, while thiazide diuretics stimulate urinary sodium excretion. In patients with heart failure, beta-blockers are also used, which reduce the amount of blood ejected from the heart with each heart beat. In certain clinical circumstances, there are also more novel medicines available, e.g. SGLT2 inhibitors used in patients with type 2 diabetes. Other types of treatment are also available, such as the stimulation of specific nerve pathways; they are usually used in hypertension highly resistant to therapy with antihypertensive medicines (3).
Hypertension is, therefore, a major global problem that can be analysed in many ways. It is important to sufficiently inform the public and encourage regular measurement and control of blood pressure to prevent the consequences or more severe complications of hypertension.
Sources:
[1] https://www.nijz.si/sl/svetovni-dan-hipertenzije
[2] https://www.nhlbi.nih.gov/health-topics/high-blood-pressure
