In brief
Hypertension does not hurt — that is both its defining feature and its main danger. People find out about it either at a routine measurement or through a complication. Let us start with the numbers and what follows from them.
More than half of all errors happen at the measurement stage. The rules are simple: sit quietly for 5 minutes, no coffee or smoking for half an hour beforehand, sit with your back supported and legs uncrossed, arm at heart level, with a cuff sized to your upper arm and placed on bare skin. Take two readings a minute apart and record the average. Morning and evening for a week — a home diary like this gives the doctor more than a single reading in the consulting room.
Separately: wrist readings and casual measurements at a pharmacy are not suitable for making a diagnosis.
The updated 2024 European guidelines introduced an intermediate category of elevated blood pressure, and the logic is now as follows: values below 120/70 are considered optimal; the range from roughly 120/70 to 139/89 is regarded as elevated blood pressure requiring cardiovascular risk assessment; and sustained office readings of 140/90 and above correspond to arterial hypertension. For home measurements the thresholds are about 5 mmHg lower than office ones. The exact category and treatment target are determined individually — by age, coexisting conditions and overall risk.
With elevated blood pressure and no high risk, lifestyle comes first, and it is not a formality: limiting salt, losing weight, regular aerobic exercise, limiting alcohol, stopping smoking, getting sleep back on track. In a hot climate, fluid intake deserves particular attention: dehydration and loss of electrolytes affect both blood pressure and how well medication is tolerated.
For confirmed hypertension, and for elevated blood pressure combined with high cardiovascular risk — a previous event, diabetes, kidney damage. Treatment is selected individually and is usually a low-dose combination, because this is more effective and better tolerated than a single drug at the maximum dose. It must be taken continuously, not "when the pressure goes up": courses of treatment do not work for hypertension.
Hypertension rarely comes alone. Assessment includes blood and urine tests, evaluation of kidney function, a lipid profile, glucose, an ECG and, where indicated, echocardiography. The new European guidelines specifically emphasise the need to check the kidneys in patients with cardiovascular disease — more on this in our review of the ESC guidelines.
At GMS a cardiologist consultation is AED 750; ECG (AED 400) and echocardiography (AED 1,100) are performed in the clinic, and their results are discussed at the appointment. Samples for lab tests and the cardiovascular risk profile (AED 350) are taken in the clinic; once the results are ready, we go over them at a free follow-up visit.
Under the 2024 European guidelines, values below 120/70 are optimal. The range from roughly 120/70 to 139/89 is elevated blood pressure that calls for cardiovascular risk assessment, and sustained office readings of 140/90 and above correspond to hypertension. Home thresholds are about 5 mmHg lower than office ones.
Sit quietly for 5 minutes, with no coffee or smoking for half an hour beforehand; back supported, legs uncrossed, arm at heart level, a cuff sized to your upper arm on bare skin. Take two readings a minute apart and record the average, morning and evening for a week. Wrist devices and casual pharmacy readings are not suitable for diagnosis.
For confirmed hypertension, and for elevated blood pressure combined with high cardiovascular risk — a previous event, diabetes or kidney damage. Without high risk, lifestyle comes first: salt, weight, aerobic exercise, alcohol, smoking, sleep. Medication is taken continuously, not only when the pressure goes up.
This article is for information only and does not replace a consultation. If you have symptoms, see a doctor.
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