Prognosis for High Blood Pressure

Hypertensive crises. A hypertensive crisis is defined as an exceptional increase in blood pressure to values above 190 mmHg for the systolic pressure or 110 mmHg for the diastolic. The episode is sometimes accompanied by headache, a nosebleed or instability. This complication may arise because the patient is not taking their prescribed antihypertensive medication, they eat too much salt, they take medicines or toxic substances that affect blood pressure, such as anti-inflammatories, cortisone, nasal decongestants, etc.

A doctor must be consulted if the blood pressure remains above 190/110 mmHg for a sustained period (after confirming the value through several readings taken over at least 30 minutes). It is also important to remember that patients must not self-medicate in an attempt to reduce their blood pressure.

Stroke. A stroke occurs when not enough blood reaches a given part of the brain. The main identifiable symptoms of a stroke are a loss of strength in one area of the body, a tingling sensation, an inability to walk or a sudden deterioration in or loss of vision.

If these symptoms emerge, patients should call emergency services immediately or visit a hospital for a better evaluation.

Heart attack or angina (ischaemic heart disease). Poor control over high blood pressure could increase the chance of a heart attack or angina. This complication occurs because not enough blood is reaching the heart and usually manifests as intense pain in the heart, and sometimes also in the left arm or neck, and generally after physical exertion.

If these symptoms emerge, patients should call emergency services immediately or visit a hospital for a better evaluation.

Heart failure. This is the most frequent complication associated with arterial hypertension. Patients with poor control over their blood pressure, and especially those aged over 65, have an increased chance of developing heart failure.

Chronic kidney disease. In cases where blood pressure remains uncontrolled for several years it can lead to chronic kidney disease, in other words the kidneys stop work correctly. Individuals with high blood pressure and diabetes present a greater risk of chronic kidney disease if they do not maintain close control over their blood pressure.

Arterial stiffness. As we age our arteries naturally grow increasingly stiffer and therefore less flexible. A lack of control over blood pressure accelerates this ageing process, particularly in people who continue to smoke, those with diabetes or who are overweight.

Hypertensive retinopathy. Although nowadays it is not very common, sustained hypertension can affect the arteries in the retina and consequently cause vision loss.

Left ventricular hypertrophy. Poorly controlled blood pressure causes the walls of the heart to grow larger and progressively thicker. If this thickening process continues over a long period, then the heart’s walls expand and make it difficult for it to function correctly. This process can be detected with an electrocardiogram or echocardiogram.

Microalbuminuria. Uncontrolled high blood pressure can cause the kidneys to stop working correctly and one of the first signs that can be detected is an excessive excretion of small proteins (albumin) in the urine.