In today’s article, and based on the latest update of the European Society of Cardiology (ESC) clinical practice guidelines, we will explain everything you need to know to prevent the onset of hypertension, maintain healthy blood pressure levels, measure blood pressure correctly, understand the importance of keeping a blood pressure diary, and learn how genetic knowledge can be applied to the prevention and treatment of this condition. Let’s start at the beginning.

What is blood pressure?

Blood pressure (BP) is the pressure exerted by the blood against the walls of the arteries and is determined both by how much blood the heart pumps and by the resistance to blood flow in the arteries. The more blood your heart pumps and the narrower your arteries are, the higher your blood pressure will be. It is measured in millimetres of mercury (mmHg) and consists of two values:

• Systolic blood pressure (SBP): The first and higher value. It measures the pressure in the arteries when the heart beats.
• Diastolic blood pressure (DBP): The second and lower value. It measures the pressure in the arteries when the heart relaxes.

What do the readings mean and which values are considered healthy?

We have all heard older relatives say things like “mine is high” or “I’ve always had low blood pressure”. But to be more precise, according to the latest ESC guideline update, blood pressure measurements are classified as follows:

Knowing this information allows you to understand your usual blood pressure levels, detect possible increases, and even identify whether you have hypertension, so that you can consult your doctor.

Symptoms of high blood pressure

Most people with hypertension do not experience any signs or symptoms that might alert them. In fact, it is considered a silent disease. Unfortunately, without early detection, symptoms often appear only once the disease has reached an advanced stage, such as heart attack, aneurysm, or other serious complications.

You may now be wondering what your blood pressure is like and perhaps you have never measured it. This is why regular monitoring is so important.

Recording and monitoring blood pressure

Keeping a blood pressure record is recommended for everyone, but for some people it becomes essential. This includes individuals with risk factors that predispose them to hypertension, such as: smokers, people who are overweight or obese, those with diabetes, high LDL cholesterol, age over 64, family history, genetic variants in the AGT and AGTR1 genes, high-salt diets, stress, and others. All of these factors increase the risk of developing hypertension, and knowing this information—measured and guided by multimodal data—can help us with prevention.

Regular blood pressure monitoring allows us to:

• Know our usual blood pressure and establish a personal baseline, which varies from person to person.
• Detect changes and trends over time.
• Consult a doctor in the case of sustained elevation.
• Provide useful data to support a medical diagnosis.

Today, access to blood pressure measurements is easy thanks to home monitors, pharmacies, GP practices, or even at home, as devices are relatively affordable. However, it is important to follow certain recommendations to ensure accurate readings.

How should we measure our blood pressure?

• Before measuring, it is advisable to calm down, breathe deeply, and remain seated comfortably for at least five minutes in a quiet environment.
• The cuff should be placed at heart level, with the back and arm supported to avoid muscle contraction increasing blood pressure.
• Consider what you have consumed. Alcohol or fizzy drinks within 30 minutes prior to measurement can temporarily raise blood pressure. In these cases, wait at least one hour.
• Ensure that clothing is not tight around your arm.
• Try to measure your blood pressure at the same time each day.
• Create your “blood pressure diary” and record systolic, diastolic and pulse values, including date and time.
• Repeat the measurement after 2–3 minutes if results differ significantly.
• If you need to see your doctor, bring your diary with you.

So far, we have explained the benefits of keeping a blood pressure record and how to do it correctly. But we must not forget what we can do to keep our blood pressure under control.

Changing our habits

Our routines and habits can modulate—and therefore prevent—the development of hypertension. But what should we change and how?

Personalised health is increasingly discussed today, but in order to apply it effectively, we need data.

To know which dietary habits to change, we must understand your current diet and salt intake. Likewise, to determine how often you should measure your blood pressure, it is helpful to know your genetic predisposition to hypertension and your individual risk factors. Identifying the key habits to change enables prevention, allows us to anticipate disease, and ultimately helps us live a healthier and longer life.

So… what are you waiting for to measure your blood pressure and understand your risk factors?

References

1. Worldwide trends in hypertension prevalence and progress in treatment and control from 1990 to 2019: a pooled analysis of 1201 population-representative studies with 104 million participants. The Lancet.
2. ESC Guidelines 2021 on cardiovascular disease prevention in clinical practice.
3. Behroozian AA, Beckman JA. Asymptomatic peripheral artery disease: Silent but deadly. Prog Cardiovasc Dis. 2021.
4. Torres Pérez RF et al. Risk factors for essential hypertension and cardiovascular risk. 2021.
5. Nakajima T et al. Nucleotide diversity of the human angiotensinogen gene. Am J Hum Genet. 2002.
6. Potaskalova VS et al. Effect of NOS3 and AGTR1 genotypes on arterial hypertension in overweight patients. Wiad Lek. 2022.