What influences
the choice of treatment
for hypertension
According to the recommendation from smarter medicine / Choosing Wisely, the benefits and risks should be carefully weighed before initiating a blood pressure-lowering medication. This decision should be based on your cardiovascular risk (overall risk of experiencing a heart attack or stroke), assessed by your primary care provider. Find out what this means for you.
Risk groups and
those commonly affected
Hypertension increases with age and affects 60% of adults over 60 years of age. Hypertension often does not have one specific cause, but is influenced by many different factors.
Typical
symptoms
Hypertension usually does not cause any noticeable symptoms. It is therefore especially important to check your blood pressure from time to time (at least once every 3 years before the age of 40 and once yearly after that). The goal is to prevent complications early on.
What is hypertension?
Blood pressure is the pressure in the blood vessels. When people talk about hypertension, they usually mean arterial hypertension. Then, the blood pressure is consistently elevated. Slightly different threshold values apply to measurements taken in a doctor’s office.
Complications of hypertension
Complications of hypertension primarily impact the heart and blood vessels, which can be damaged due to the high pressure. Organs with small vessels are especially vulnerable. The most common complications of hypertension are listed below.
Heart attack
Brain bleeding, stroke
Dementia
Heart failure
Damage to the aorta
Kidney failure
Decline in vision
Impaired blood supply to organs
Every treatment has a benefit-risk ratio. With blood pressure-lowering treatment, the benefit depends on the overall cardiovascular risk of an individual. The higher the risk, the higher the treatment benefit. Your primary care provider can calculate your cardiovascular risk and discuss it with you.
What is a person’s
cardiovascular risk?
The cardiovascular (related to the heart and vessels) risk indicates the individual likelihood of developing or dying from a cardiovascular event (usually within the next 10 years). Cardiovascular events include, for example, a heart attack or stroke.
Factors that influence cardiovascular risk:
Hypertension
Age and sex
Family history: parents, siblings, and / or children who suffered a heart attack
or stroke before the age of 60
How can blood pressure
be lowered without
blood pressure medication?
Tap an answer to see the solution immediately.
Smoking
Blood thinner
Lifestyle changes
Lifestyle changes can lower blood pressure by about 5-10 mmHg. Compared to medication that can reduce blood pressure by about 10-20 mmHg, this is quite significant.
Fatty diet
The decision to start medication to lower hypertension should be made individually. Generally, it is indicated when lifestyle changes alone do not allow to achieve target values and the benefits outweigh the risks. Other risk factors need to be considered as well.
Lifestyle changes
that lower blood pressure.
Preventing or lowering hypertension: lifestyle changes are fundamental. You can find more information under «Downloads & further information».
Smoking cessation
Weight control
Regular physical activity
Balanced, low-sodium diet
Stress reduction
FAQ
How is hypertension diagnosed?
To diagnose hypertension, multiple accurate blood pressure readings are required. The diagnosis is best made using a blood pressure log (regular, self-measured readings at home) or a 24-hour blood pressure monitoring. Blood, urine tests, or an ECG are not necessary.
Why do I have hypertension?
Around 50% of all adults have hypertension. In 90% of cases, there is no specific cause. It is usually the result of a combination of many factors. These include age, smoking, alcohol, caffeine, sodium-rich diet, overweight, high blood fats, diabetes, stress, and genetics.
In about 10% of cases, there is actually a specific cause for hypertension. This means that it is caused by an underlying medical condition. Examples include sleep apnea (disrupted breathing during sleep), kidney disease, or certain hormonal disorders. In such cases, it is referred to as secondary hypertension.
What is a balanced, healthy diet?
A balanced, healthy diet is low in sodium and follows a Mediterranean pattern. It is based on the Mediterranean food pyramid. This includes eating plenty of vegetables and fruit, and especially avoiding sweetened drinks and sweets. For more information, see «Downloads & further information».
Summary
The need for blood pressure medication depends not only on your blood pressure measurements, but also on your cardiovascular risk. If you do not have hypertension, it is recommended to check your blood pressure at least once a year. Make lifestyle changes to help prevent hypertension. If you notice an increase over time, consult your primary care provider.
If hypertension is suspected, it is recommended to keep a blood pressure log and discuss the next steps with your primary care provider. In the meantime, start making lifestyle changes.
Downloads & further
information
Discussion with your
primary care provider
Always discuss your thoughts, questions or uncertainties with your primary care provider. If possible, try to go to the appointment well-informed and prepared.