Hypertension (High Blood Pressure)

Hypertension is a state of elevated blood pressure. The average adult blood pressure is around 120/80. The first number (systolic) reflects the pressure when the heart is pumping, and the second number (diastolic), the residual pressure in the arteries between beats. Normal systolic blood pressure at rest varies within the range of 100-140 mmHg and diastolic blood pressure fluctuates between 60-90 mmHg. Blood pressure is considered high if it is above 140/90 mmHg, during at least three measurements.

Factors that may contribute to hypertension include age, a family history of the condition; unhealthy lifestyle (i.e. dietary factors, such as too ample salt intake; overweight, sedentary) difficulty with psychological stress; and changes in blood vessel elasticity. However, most of the time, a specific underlying cause is not identified. Therefore, the majority of hypertension cases are labeled as primary (unknown cause) hypertension.

According to the American Heart Association, more than 72 million people in the United States suffer from this condition. However, patients having this medical condition most often do not experience symptoms. So, hypertension is frequently a silent but potentially serious condition that can be reliably spotted through a blood pressure check. In this regard it is of note that, between 1994 and 2004, deaths from hypertension in the U.S. increased by an estimated 15.5%.

Hypertension affects all organs in the body, and when left untreated, may damage kidneys, heart and brain. Ultimately, hypertension may induce heart failure, renal insufficiency, and stroke.

Mild hypertension may respond to a decrease in sodium intake, increased exercise, maintenance of optimum weight, increased relaxation, and eating more fruits and vegetables. When diet and lifestyle modification do not adequately control hypertension, additional measures, like medication, become the standard of care. Severe hypertension – a systolic pressure above 160 or a diastolic pressure above 100 – usually has to be treated by (a combination of) prescription drugs. Also practicing biofeedback exercises may help control blood pressure through its relaxing influence on the nervous system.

Organ functions, like heartbeat, are normally not under conscious control, and are regulated by the so-called autonomic nervous system. However, emotions may partially affect the autonomic nervous system through influencing the limbic part of the brain. Subsequently, the heart rate increases during both physical and psychological stress. By the same token blood pressure is raised through emotions.

Since the autonomic nervous system plays a pivotal role in hypertension, for medication-resistant hypertension, an investigational neurostimulation device1 received marketing approval in Europe in 2011. It is designed to reduce treatment-resistant hypertension by stimulating blood pressure sensors, called baroreceptors, in the carotid artery. Potentially competing concepts to achieve the same goal have been proposed, such as ablating or stimulating of the renal nerves, which play a role in both fluid balance and blood pressure.

1CVRx Barostim Neo

Reviewed July 9, 2012
Mike JL DeJongste, MD, PhD
Executive Officer, International Neuromodulation Society, 1994 - 2003

Department of Cardiology, University Hospital Groningen, Groningen, The Netherlands

Last Updated on Tuesday, April 25, 2017 11:30 AM