What You Need To Know About Uncontrolled Hypertension

Blood pressure is the pressure that blood applies against your arteries as it flows. It is determined by the force your heart uses to pump blood and the resistance to blood flow in your arteries.

Blood pressure usually rises and falls throughout the day, depending on your activity level and other factors. However, persistent high blood pressure can cause serious damage to your cardiovascular system.

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What is uncontrolled hypertension?

Hypertension refers to blood pressure (BP) that remains elevated over a significant amount of time. It is usually indicated by a systolic blood pressure reading of over 130mm Hg (top number) and/or a diastolic pressure reading of over 80mm Hg (bottom number).

 Uncontrolled hypertension refers to a  systolic BP equal to or higher than 140mm Hg and diastolic BP equal to or higher than 90mm Hg.

Uncontrolled hypertension is a serious health condition that affects many people worldwide. According to the CDC (Centers for Disease Control and Prevention), approximately 47%,¹ or 116 million people in the United States, suffer from hypertension. Among them, nearly 37 million have uncontrolled hypertension.

Uncontrolled hypertension is a major risk factor for heart attack (myocardial infarction), stroke, chronic kidney disease, and vascular disease.

Fortunately, uncontrolled high blood pressure is easily detectable, and you can work with a healthcare professional to get it under control.

What causes uncontrolled hypertension?

Multiple factors can contribute to uncontrolled hypertension. These include high salt intake, not sticking to an anti-hypertensive diet and therapy, alcohol intake, physical inactivity, smoking, and obesity.

Other factors associated with uncontrolled hypertension include underlying medical conditions and other diseases.

High salt intake

Salt contains sodium, a mineral that occurs naturally in many foods. When you ingest too much of it, the body holds extra water to wash away the salt, and this added amount of water stresses the heart and arteries.

Over time, high salt intake can lead to high blood pressure. The heart is forced to work harder to pump blood throughout the body, increasing blood pressure in the arteries. If left unchecked, the increased blood pressure can cause abnormal enlargement of the heart's left chamber and ultimately weaken the heart muscle.

Reducing salt/sodium intake is a great start to controlling high blood pressure. The following tips can help you reduce salt intake:

  • Don't place salt on the table

  • Buy food products marked unsalted, sodium-free, or low-sodium

  • Choose sodium-free seasoning mixes and herbs

  • Read nutrition labels and opt for ones with the lowest sodium content

  • Try salt substitutes like lemon, parsley, garlic, rosemary, thyme, celery seed, cilantro, onion powder, and sage

Unhealthy diet

One of the leading causes of uncontrolled hypertension is an unhealthy diet. Foods that contain saturated fats cause weight gain, which is a risk factor for high blood pressure. Fat also hardens the arteries, forcing the heart to pump harder.

Avoid or limit foods like butter, cheese, and whole milk products that contain saturated fat. Monounsaturated fats found in olive oil and canola oil, as well as polyunsaturated fats found in sunflower oil, are healthier for you. However, it is best only to eat them in moderation.

Too much sugar in your diet can lead to uncontrolled high blood pressure. It affects the production of nitric oxide (NO), which helps expand blood vessels. Hypertension can develop if the body doesn't have enough nitric oxide to maintain the flexibility of blood vessels.

Excess sugar also leads to obesity and diabetes, which are risk factors for hypertension. 

What dietary changes can help control blood pressure? 

The DASH diet helps with lowering blood pressure. It includes foods rich in calcium, magnesium, and potassium and helps to reduce sodium intake. It advocates for whole grains, fresh fruits and vegetables, modest amounts of protein, and nuts and legumes.

Other daily nutrient goals of the DASH diet include limiting calories to 55% carbohydrates,  dietary cholesterol to 150 grams, and 30 grams of fiber.

A heart-healthy diet is naturally low in fat and should include whole grains, fruits, and vegetables. Limit how much processed and fatty foods you eat. Lean proteins like skinless chicken, fish, lean meat, soy, and fat-free or 1% dairy products are good for the heart.

It's also crucial that you get into the habit of reading labels when shopping for food and choosing ones with heart-healthy ingredients. 

Obesity

About 42.5% of the US population² is obese, and nearly half of US adults have hypertension. That's not a coincidence.

Obesity is used to describe individuals with a body mass index (BMI) of 30 or higher. It is a major health risk, especially since excess weight makes it more difficult for the heart to pump blood throughout the body. The extra effort strains blood vessels, and as a result, they resist blood flow, elevating blood pressure even further.

Obesity and hypertension are a deadly combination that increases the risk of cardiovascular disease. The risk is potentially higher if you carry a lot of weight around the abdomen. Excess weight strains the kidneys as it damages tiny blood vessels, and these vessels thicken and limit blood flow, making it harder for the kidneys to filter out waste and fluids from the blood.

When your body can't get rid of excess fluids, your heart is strained further, increasing blood pressure.

Making certain lifestyle changes can help reduce weight and normalize blood pressure. According to the American Heart Association, even losing a few pounds can significantly impact the cardiovascular system.

Incorporating more physical activity through exercise is a great way to get started. Commit to at least 150 minutes of exercise each week to help get your blood pressure under control. 

Additional risk factors for uncontrolled hypertension

In addition to high sodium intake, unhealthy diet, and obesity, there are other risk factors for uncontrolled hypertension. These factors include:

  • Age: Risks of high blood pressure rise as you age (it is more common in men over age 63 and women over age 65)

  • Race: Hypertension is more common in black people and tends to develop at an earlier age than in white people

  • Excess alcohol intake: Drinking too much alcohol can damage the heart over time

  • Chronic conditions: Diabetes, kidney disease, and sleep apnea increase your risk of hypertension

  • Tobacco: Smoking temporarily increases blood pressure while tobacco chemicals damage the walls of blood vessels with time, increasing the risk of hypertension

  • Family history: Hypertension tends to run in families

What are the symptoms of uncontrolled hypertension?

You can have hypertension without any symptoms. The best way to know for sure is to have your blood pressure checked regularly by a healthcare provider.

However, you may experience certain symptoms when blood pressure first rises or during a hypertensive crisis. These include:

  • Headaches

  • Shortness of breath

  • Dizziness or lightheadedness

  • Nosebleeds

  • Blurry vision

  • A feeling of anxiety or that something is not right

  • Chest pain or discomfort

It's worth noting that dizziness can also be a symptom of low blood pressure. Some symptoms like nosebleeds and chest pain tend to occur when blood pressure levels are extremely high

What happens when uncontrolled hypertension is prolonged?

Excessive pressure on your blood vessel walls can damage your arteries and organs. The longer it goes undiagnosed and untreated, the greater the damage.

Some of the potential complications include heart attack or stroke, poor quality of life, and disability. Lifestyle changes and treatments can control blood pressure, reducing the risk of complications.

Damage to the arteries

Healthy arteries are strong, elastic, flexible, and have smooth inner walls. When fats and other unhealthy substances accumulate in the arteries, blood pressure rises and damages the inner lining. Eventually, the arteries lose their flexibility, limiting blood flow to the rest of the body.

The constant pressure of moving blood through damaged arteries may cause a wall section to bulge. This is called an aneurysm and can form in any blood vessel. It often develops in the aorta, the large main blood vessel in the chest and abdomen. It can be life-threatening due to internal bleeding if it bursts.

Damage to the heart

Uncontrolled hypertension damages the heart in many ways. Damaged arteries have a hard time supplying blood to the heart, leading to an irregular heartbeat, chest pain, or a heart attack.

Hypertension forces the heart to pump blood at a higher pressure throughout the body. Over time, the strain can result in a thicker left ventricle, increasing the risk of a cardiovascular event - a heart attack, heart failure, or cardiac death.

Over time, prolonged uncontrolled hypertension weakens the heart muscle and reduces its efficiency. The heart eventually becomes too overwhelmed and starts to fail, resulting in heart failure. This is when the heart is unable to provide adequate blood and oxygen to the tissues of the body.

Damage to the kidneys

The kidneys filter blood, removing excess fluids and waste. This process requires healthy blood vessels, and when hypertension damages arteries, the kidneys' ability to work efficiently is compromised.

Kidney scarring occurs when the blood vessels within the kidneys are damaged, making them unable to filter blood effectively. When fluid and waste accumulate in the bloodstream to dangerous levels, kidney failure can occur. 

Damage to the brain

Proper brain function requires a constant, nourishing blood supply. When high blood pressure compromises that, it can damage the brain in multiple ways, including stroke, mild cognitive impairment, mini-stroke (transient ischemic attack), and dementia.

Blood vessels damaged by prolonged hypertension are narrow and may rupture or leak. In some cases, they develop blood clots that make their way to the brain. This inhibits blood flow and supply of oxygen to the brain, resulting in a stroke.

A mini-stroke, also known as a transient ischemic attack (TIA), occurs due to a brief disruption of blood flow to the brain.

Some people may develop vascular dementia if blocked or narrow blood vessels limit blood flow to the brain for prolonged periods.

Hypertension may also lead to mild cognitive impairment, such as changes in memory and understanding.

Damage to the eyes

Hypertension can damage the delicate blood vessels around the eyes, leading to optic neuropathy, retinopathy, and choroidopathy. 

Retinopathy occurs when blood vessels in the retina are damaged, and it can cause blurred or complete vision loss.

Choroidopathy is the buildup of fluid under the retina, while optic neuropathy refers to damaged optic nerves, leading to bleeding within the eye or vision loss. 

Sexual dysfunction

Many men who suffer from uncontrolled hypertension experience erectile dysfunction. This is because damaged blood vessels result in inadequate blood supply to the penis.

Women can also experience sexual dysfunction due to hypertension. The condition reduces blood flow to the genitals, resulting in lack of arousal, difficulty achieving orgasm, or vaginal dryness. 

The lowdown

The good news about uncontrolled hypertension is that a healthcare professional can easily detect it with regular health checks. You can treat it with successful lifestyle changes and medications once the doctor makes a diagnosis.

Start with small changes like eating whole instead of processed foods, taking the stairs instead of the elevator, brisk walking for 30 minutes each day, reducing fats from your diet, and limiting alcohol intake.

Additionally, you must take any prescribed medicine exactly as directed by your physician. Be sure to consult a doctor before starting a new workout routine or diet, especially if you have an underlying medical condition.

Take your blood pressure seriously; following your doctor's instructions will lower the risks of complications like heart failure or stroke and improve your overall health.

  1. Facts about hypertension | Center for Disease Control and Prevention

  2. Adult obesity facts | Center for Disease Control and Prevention

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