Cardiology private practice Berlin

High Blood Pressure – what is it exactly?

High blood pressure, also known as arterial hypertension, is one of the major risk factors that can promote, among other things, a heart attack or stroke if it is not detected in time. In Germany alone, about 30 million people are affected.

In my private cardiology practice, high blood pressure is one of the most common diagnoses. This is one of the reasons why I would like to answer this typical patient question in my blog:  What does it mean, too high blood pressure?

What is it exactly? Blood pressure and hypertension

Our arterial vascular system is a tapering pipe system that supplies the organism with oxygen and nutrients. It is elastic and resembles a garden hose with an upstream water pump. At rest, the heart beats slowly; under stress, it beats much stronger and faster to supply the muscles, among other things. As a consequence, the (blood) pressure in the pipe system increases. On the bike, under maximum load, we can reach blood pressure values around 200 mmHg systolic or more. When measuring blood pressure, we distinguish between a higher (systolic) and lower (diastolic) value.

The vascular system continuously supplies our organs with blood

The healthy vascular system is elastic and is first stretched slightly with each pulse and then contracts again. At the end of this phase, the aortic valve closes to prevent the blood from flowing back into the heart. At this moment we measure the lower diastolic value. The two values are averaged to give a mean blood pressure. This pulsatile system ensures that all organs are continuously supplied with sufficient blood. The pulse can then also be felt on the wrist.

When does one actually speak of high blood pressure?

Blood pressure is divided into several categories. One speaks of a so-called optimal blood pressure (systolic value is below 120 mmHg, diastolic below 80 mmHg), of a normal blood pressure (systolic between 120 and 130 mmHg, diastolic below 80-84 mmHg) and a high normal blood pressure (systolic between 130 and 140 mmHg, diastolic 85-90 mmHg). Only when the upper, i.e. systolic value, is permanently at 140 mmHg or higher and the lower, diastolic value is at 90 mmHg or higher, do we speak of high blood pressure.

Normal blood pressure fluctuations

Nervousness, excitement, stress, sport, or above-average alcohol consumption can throw blood pressure out of balance and temporarily increase it. This is just as normal as blood pressure fluctuations that change during the course of the day. At night, for example, blood pressure drops. As long as the increase is temporary, everything is within the normal range and there is no reason to worry.

To summarise: When we are at rest, blood pressure should be low. When we are under physical or mental stress, on the other hand, it rises physiologically (healthy) for a short time.


When can we speak of a diagnosis of “high blood pressure” or “hypertension”?

The diagnosis of high blood pressure is made when several individual blood pressure measurements show values above 140 to 90 mmHg. The diagnosis can also be made with the help of a long-term blood pressure measurement, but here other threshold values are used by averaging the values.

 High blood pressure can be treacherous because it usually does not announce itself. Many patients are diagnosed with arterial hypertension by chance. Therefore, you should regularly attend cardiological check-ups and measure your blood pressure yourself from time to time. Pharmacies offer a service for measuring blood pressure.

From the age of about 30, it is advisable to make an initial appointment with a cardiologist, who will then carry out specific check-ups and preventive examinations to rule out high blood pressure or other cardiovascular diseases.


How can I tell if my blood pressure is too high?

Those affected often feel no symptoms at first, as high blood pressure develops gradually, and our body adapts to the new pressure conditions. As a rule, high blood pressure develops in the second half of life. Men usually develop arterial hypertension at a younger age, which is often due to an existing unhealthier lifestyle. Women, on the other hand, are somewhat more protected by female hormones until the menopause and are therefore less likely to develop hypertension before the menopause. However, the risk almost evens out after the menopause. In addition, the interpretation of supposed symptoms in women is more complex in terms of differential diagnosis, since typical menopausal signs such as sleep disorders, nervousness, hot flushes, dizziness, reduced performance, headaches or mood swings can also be possible signs of hypertension.

Other very clear signs of high blood pressure can be palpitations, heart palpitations (cardiac arrhythmia), shortness of breath, unusual nervous trembling or increased anxiety. If you notice these symptoms very distinctly, you should consult a doctor immediately or call an emergency doctor in case of acute complaints.

NOTE: Long-term blood pressure measurement and ECG without cuff.

In my cardiology practice in Berlin Mitte, I use the SOMNOtouch™ NIBP long-term blood pressure device. It is without a cuff and very easy to use. Just book it via the Doctolib online appointment. You can easily take the measurement at home and return the device the next day.