The causes of hypertension change with age. Therefore, it is important to take the right preventive measures, adapted to the risks encountered at different stages of life.
From the article you will find out:
- Should we be concerned about hypertension?
- Arterial hypertension in a nutshell
- What is hypertension and who does it affect?
- Causes of high blood pressure in different age groups
- Is there spontaneous hypertension?
- Is hypertension spontaneous and how can we reduce elevated blood pressure?
- Hypertension in young people
- Hypertension in middle-aged patients
- Hypertension in the elderly
- Should we be concerned about hypertension?
Arterial hypertension
Arterial hypertension is common, but initially without major complaints, making it difficult to detect and treat. At the same time, it is the strongest contributor to mortality.
In patients under 40 years of age, secondary hypertension is relatively more common and can be caused by kidney disease, endocrine or anatomical changes.
Hypertension in a nutshell
- Around the world, 10 million people die each year due to hypertension.
- In Europe, 150 million people suffer from hypertension.
- Hypertension is common, but initially without major complaints, making it difficult to detect and treat. At the same time, it is the strongest contributor to mortality.
- In patients under 40 years of age, secondary hypertension is relatively more common, which can be caused by kidney disease, endocrine or anatomical changes.
- Meditation has been officially recognised, among others by the American Heart Association, as a valuable method in the prevention of cardiovascular disease.
- The DASH diet recognised as the most effective for people with hypertension.
What is hypertension and who does it affect?
Hypertension (NT), defined as a systolic blood pressure of more than 140 mmHg and/or a diastolic blood pressure of more than 90 mmHg, already affects one in five citizens of developed countries. This percentage is expected to rise to 33% in the next 10 years.
The prevalence of NT increases with age:
- in people aged 18-40 years it affects 15% of men and 5% of women
- in people aged 40-60 years, affects 30% of both men and women
- in people aged 60+, it affects 55% of men and 60% of women
It is therefore a common disease that does not initially cause much discomfort and is therefore relatively poorly detected and treated. Meanwhile, it is the strongest single chronic mortality factor and a risk factor for kidney or heart failure and ischaemic heart disease and stroke.
Causes of hypertension in different age groups
The causes of NT in different age categories vary somewhat. In patients under 40 years of age, secondary hypertension is relatively more common and may be caused by kidney disease, endocrine or anatomical changes such as stenosis of the renal arteries or aorta.
In view of the prospect of possible treatment for decades in such patients, it is advisable to consider diagnosis of the above-mentioned diseases – their recognition and effective treatment makes it possible to delay the continuous use of medication for many years. This is particularly justified in the case of sudden onset of NT in people without classical risk factors, i.e. non-smokers, overweight and obesity.
Is hypertension spontaneous and how can we reduce the raised pressure?
In the case of spontaneous hypertension, i.e. without the aforementioned secondary diseases, the relatively most common cause may be an increased tension of the sympathetic nervous system, which is part of the autonomic and will-independent nervous system that becomes permanently activated under conditions of chronic stress.
The positive news is that a reduction in such increased pressure can be achieved by systematic physical activity, especially aerobic exercise of moderate or, in time, higher intensity. This must, however, be an activity that causes a transient acceleration of the heart rate, which is initially slight, but over time becomes increasingly higher. This means that systematic walking with the dog may not help much in this regard.
A good initial form of such activity is what is known as brisk walking, e.g. in the 4×4 formula, the most widely researched in the world, which consists of very fast walking in several successive series, combined with rest or slow walking.
For the more active or already implemented, it can be a workout in the HIIT (high intensity interval training) formula.
Both forms of training take a maximum of 20-30 min and produce results when performed systematically 2-3 times a week.
Such regularity is sure to be rewarded with less chronic activation of the sympathetic nervous system and a subsequent normalisation or significant reduction in blood pressure.
The use of psychorelaxation techniques can have a similar effect – meditation has been officially recognised, among others by the American Cardiovascular Society, as a valuable adjunctive method in the prevention of cardiovascular disease.
Hypertension in young people
Relatively common and more typical for younger people is isolated diastolic pressure, i.e. a value of more than 90 mmHg of the second parameter of routine blood pressure measurement.
In this case, dynamic resistance training, i.e. where the muscles perform work against an external resistance with a change in muscle length, can have a very beneficial effect. This results in an increase in blood flow through the muscles during exercise and a chronic reduction in the so-called peripheral resistance that determines diastolic pressure. This type of exercise is reflexively associated with machines in fitness clubs or at least heavy dumbbells. Meanwhile, this type of training can be performed just as effectively and probably more safely at home, thanks to body resistance exercises or resistance bands.
For the youngest patient category, it is important to realise that there are 3 subcategories within normal blood pressure:
- optimal blood pressure (up to 120/80mmHG)
- normal (up to 129/84mmHG)
- high normal (up to 139/89mmHG).
The latter should be treated as a pre-hypertensive state and non-pharmacological management should be undertaken to normalise it.
Hypertension in middle-aged patients
In middle-aged patients, the predominant cause of NT is activation of an endocrine system associated with, among other things, the arteries and kidneys called the RAA system ( from renin-angiotensin-aldosterone). Reducing its activity is achieved with the help of three large groups of drugs (these are the ones contraindicated in pregnancy). Physical activity aimed at reducing or maintaining weight and reducing insulin resistance, which can also activate the RAA, are of course also important.
Adequate diet is very important . The DASH diet is considered to be the most beneficial for patients with NT.
Hypertension in the elderly
A key cause in elderly patients is arterial stiffness, which progresses with age. For this reason, excessive lowering of blood pressure should be avoided and should be maintained within a range close to high normal pressure.
In this group, it is unlikely that normal blood pressure values can be achieved without pharmacotherapy. However, non-pharmacological management, i.e. adequate diet and physical activity, is also very important.
Interestingly, long-term follow-up has shown greater effects on the health of seniors for physical activity than for diet, and for activity alone, greater effects for higher than moderate intensity activity.
Resistance exercise, which is not likely to be associated with exercise for seniors, has a special place here. However, it is worthwhile to carry out dynamic resistance exercises, avoiding or limiting isometric exercises (isometric exercises are exercises that do not change the length of the muscle, they consist of tensing and relaxing specific muscle parts), of course, strictly adapted to the capabilities of the exerciser.
Hypertension is a disease that can even affect you. Silent and invisible at first, but with a very effective plan to make life difficult. That is why you should regularly examine yourself, take care of a proper diet and be physically active.
Author: Dr Sławomir Powierża, cardiologist
Helfio – Comprehensive Improvement in Metabolic Health