Analysis of symptoms of elevated blood pressure, screening populations, and patterns of blood pressure fluctuations

What are the manifestations and symptoms of elevated blood pressure?

For most hypertensive patients, the increase in blood pressure is a gradual process. Therefore, most people may have had elevated blood pressure for a long time without any symptoms. If blood pressure is usually not high, but suddenly rises, the patient may feel dizzy, have a headache, etc. Patients with heart disease may experience chest tightness, palpitations, or even angina. Therefore, the determination of whether blood pressure is elevated is mostly discovered through regular blood pressure measurement. For adults, blood pressure should be measured at least once every two years, or take advantage of various opportunities to measure their blood pressure frequently.

Who needs to have their blood pressure monitored and screened?

The following groups are at high risk and are generally required to have their blood pressure measured every six months.

(1) High blood pressure [systolic blood pressure 130-139 mmHg and/or diastolic blood pressure 85-89 mmHg]. (2) Overweight (BMI 24-27.9 kg/m²) or obese (BMI ≥ 28 kg/m²); and/or abdominal obesity: waist circumference, men ≥ 90 cm (2.7 ft), women ≥ 85 cm (2.5 ft). Body Mass Index (BMI) = weight (kg) / height (m²)

(3) Family history of hypertension (first or second-degree relatives).

(4) Long-term high-salt diet.

(5) Long-term excessive alcohol consumption [daily consumption of ≥ 100 ml (2 liang) of baijiu (Chinese liquor).]

(6) Age ≥ 55 years.

Why does blood pressure fluctuate? What are the patterns in blood pressure changes?

Humans are active organisms, constantly changing, whether at rest, in motion, calm, or tense… Therefore, blood pressure inevitably fluctuates within a certain range. When well-rested, blood pressure will be lower; when tense or anxious, blood pressure will be higher. When measuring blood pressure, rest for at least 5 minutes before taking the measurement to minimize the influence of the factors mentioned above. The criteria for hypertension are also based on at least three non-daily elevated readings after the subject has rested calmly for 5 minutes before a diagnosis of hypertension is made.

Most people also exhibit the following characteristics: blood pressure begins to rise upon waking in the morning due to various excitatory factors; the morning is the period with the highest blood pressure; it slightly decreases during midday rest; it rises slightly again in the afternoon; and it reaches its lowest point at night. This forms a two-peak, one-trough pattern, figuratively described as a spoon shape.

Most people may not have high blood pressure when they are young, but it gradually increases with age. Therefore, in terms of age distribution, the proportion of people with hypertension is higher among older individuals. Around age 60, diastolic blood pressure begins to decrease, while pulse pressure gradually increases. That is, as people age, most experience increased systolic blood pressure, decreased diastolic blood pressure, and increased pulse pressure. This is also a manifestation of weakened vascular elasticity and gradual hardening of the arteries.