Garlic increases your blood pressure

high blood pressure

high blood pressure (arterial hypertension): Permanently elevated blood pressure values ​​of at least 140/90 mmHg. Around 25% of the adult population and half of those over 50 years of age suffer from high blood pressure, with just under a third of those affected being unaware of it. But even unnoticed, high blood pressure can lead to severe organ damage and must therefore be treated. In addition to a more health-conscious lifestyle with abstinence from nicotine, weight reduction and exercise, above all antihypertensive drugs are used.

As Blood pressure derailment (Hypertensive emergency) refers to acute blood pressure values ​​above 230/130 mmHg. Then there is a risk of confusion, seizures or serious complications such as acute stroke, acute left heart failure with pulmonary edema or aortic dissection. An immediate reduction in blood pressure by an (emergency) doctor and admission to a clinic are required!

Leading complaints

  • Often asymptomatic
  • Headache on waking, especially in the back of the head
  • Palpitations, sharp chest pain
  • Frequent nosebleeds
  • Difficulty breathing during exertion
  • Spells of dizziness, ringing in the ears, blurred vision, confusion.

For underlying hormonal disorders:

  • Muscle weakness, noticeably high thirst and frequent urination, unusual sweating, pronounced changes in weight.

With blood pressure derailment:

  • Possibly blurred vision, dizziness, severe headache, shortness of breath, heart pain or tearing pain in the chest or stomach area, impaired consciousness or symptoms of paralysis.

When to the doctor

In the next few days if

  • high blood pressure values ​​are measured for the first time
  • Symptoms such as nosebleeds for no reason (except in adolescents during puberty), blood in the urine or headache on waking increase
  • body shape, weight, thirst, urination, sweating or exercise capacity change noticeably
  • Palpitations, dizziness or visual disturbances occur.

Immediately to the doctor or to the hospital if the blood pressure readings

  • consistently above 200/130 mmHg
  • Do not lower yourself with the drugs prescribed by the doctor
  • are associated with malaise.

The illness

High blood pressure is present when values ​​of 140/90 mmHg and more have been determined during repeated measurements on different days and at different times at rest.

Depending on the systolic and diastolic blood pressure values, doctors differentiate between the following blood pressure states

  • Optimal blood pressure: <120/80 mmHg
  • Normal blood pressure: <130/85 mHg
  • High normal blood pressure: 130 / 85-139 / 89 mmHg
  • Grade I hypertension: 140 / 90–159 / 99 mmHg
  • Grade II hypertension: 160 / 100-179 / 109 mmHg
  • Grade III hypertension:> 180/110 mmHg
  • Hypertensive emergency:> 230/120 mmHg

There are also those isolated systolic hypertension with systolic values> 140 mmHg and diastolic values ​​<90 mmHg, which occurs mainly in older people. If the diastolic blood pressure values ​​are permanently> 120 mmHg, one speaks of a malignant hypertension, which leads to severe retinal changes and kidney damage.

Forms and causes

High blood pressure can develop due to various causes, in many cases the triggering factors combine, the doctor then speaks of a multifactorial genesis. So lead z. B. stiffened arteries and increased blood volume lead to increased pressure in the vascular system. The CNS and hormones can also cause the blood vessels to constrict and thus cause blood pressure to rise. The actual trigger for these processes often remains unclear.

So is the triggering cause in the essential hypertension (primary hypertension, idiopathic hypertension, over 90% of all high blood pressure patients) unknown. The familial accumulation shows that hereditary factors play an important role in the development of high blood pressure. In addition, an unhealthy lifestyle favors the development of essential hypertension, e.g. B.

  • Smoke
  • increased coffee, alcohol and salt consumption
  • Sedentary lifestyle
  • Overweight (obesity)
  • Stress.

In women, high blood pressure is often linked to the hormonal changes after menopause, without knowing the exact relationships. Before menopause, women are less likely to have high blood pressure than men.

The secondary hypertension on the other hand, is a high blood pressure that arises as a result of another disease. This occurs in about 5–10% of hypertensive patients. In contrast to essential hypertension, secondary hypertension is curable if the underlying cause is eliminated.

  • The kidneys in particular can influence blood pressure through the release of substances that affect blood pressure and the amount of urine excreted. Many chronic kidney diseases are therefore also associated with high blood pressure, e.g. B. glomerulonephritis.
  • In addition, a narrowing of the artery responsible for the kidney blood flow (renal artery stenosis) simulates a blood pressure that is too low, which also triggers hypertensive reactions (renal hypertension). If you wait too long to clear the constriction, the high blood pressure may become "fixed" and persist despite surgery.
  • 50% of patients with sleep apnea syndrome develop high blood pressure. Here the doctors suspect that the constant stress caused by the lack of oxygen during sleep drives up the blood pressure.
  • A number of diseases of the endocrine glands (such as diseases of the adrenal gland, thyroid gland, parathyroid gland and pituitary gland) can, in addition to other symptoms, also increase blood pressure, e.g. B. at
  • Taking various medications, e.g. B. the "pill" or cortisone, high blood pressure can develop.
  • In addition to the luxury foods nicotine and alcohol, regular high consumption of liquorice (> 250 g / day) also leads to high blood pressure.
  • Vascular malformations are also possible causes of high blood pressure. So z. B. in coarctation of the aorta, in which the increased blood pressure readings are typically only limited to the arms.

Course and complications

Long-term increased blood pressure leads to thickening of the left ventricular muscles, because the left ventricle has to pump against the permanently increased vascular resistance of the arteries. The thickened heart muscle, however, needs correspondingly more oxygen for its increased performance. This additional requirement can be so pronounced that the coronary vessels no longer guarantee sufficient blood flow to the heart muscle and angina pectoris occurs when the patient is exerted. In the further course, the heart muscle becomes exhausted and cardiac insufficiency develops as well as a tendency to cardiac arrhythmias and arteriosclerotic vascular changes such as e.g. B. CHD, PAD or renal artery stenosis.

In many patients, essential hypertension, obesity and impaired glucose and fat metabolism occur together. This complex of symptoms is known as the metabolic syndrome and is associated with a particularly high risk of the cardiovascular diseases described above.

Diagnostic assurance

Because blood pressure is also subject to natural fluctuations in healthy people and changes from minute to minute, individual measured values ​​must not be given too much importance. So z. For example, the internal tension during visits to the doctor means that ~ 30% of the blood pressure values ​​measured there (mostly too high) are not confirmed during controls (white coat hypertension).

In the case of fluctuating blood pressure values, the mean value from at least 12 measurements distributed over a week is to be regarded as a reliable blood pressure value. Long-term blood pressure measurement is also ideal for determining the actual blood pressure. It has the advantage that it also takes into account the nocturnal blood pressure values.

In the case of newly discovered high blood pressure, the doctor must first clarify whether it is an essential or secondary form and whether there is already any consequential damage. He therefore checks whether there is a known family predisposition to high blood pressure and whether there are risk factors or indications for cardiovascular diseases, kidney diseases or hormonal disorders.

This is usually followed by laboratory examinations, EKG, echocardiography, ultrasound examinations of the abdomen and kidney area and a urine examination. If renal artery stenosis is suspected, color duplex sonography, digital subtraction angiography (DAS) or MR angiography lead to the diagnosis.

At the fundus of the eye, the consequences of high blood pressure are visible comparatively early through changes in the small blood vessels. In case of doubt, this can be the decisive factor for treatment, even if the high blood pressure values ​​are only slightly elevated. Since the eyes represent a part of the brain, the reflection of the retina is very important in hypertensive patients. The doctor can draw conclusions about the blood flow in the brain from the blood flow in the fundus.

treatment

Whether and how far the blood pressure should be reduced depends on the overall risk of cardiovascular diseases, the general condition and the wishes of the patient. In the case of secondary high blood pressure, however, the underlying disease or the trigger must be treated. This means, for example, positive pressure ventilation at night with a CPAP mask in the case of sleep apnea syndrome, the replacement of the "pill" with other contraceptives if this has led to high pressure or the dilatation of a narrowed renal artery with the catheter.

Start of therapy

  • The current European guidelines recommend for a slight Grade I hypertension (Blood pressure values ​​from 140/90 to 159/99 mmHg) initially an attempt lasting several months to lower the blood pressure values ​​with the help of lifestyle changes such as weight reduction and abstinence from nicotine. If this does not succeed, antihypertensive drugs are used.
  • A Grade II hypertension (> 160/100 mmHg) should be treated immediately with medication. This does not release the patient from cooperation: the move towards a healthier lifestyle with no nicotine and exercise is also essential.
  • At High normal blood pressure Up to 139/89 mmHg, drug treatment is indicated if there are additional risk factors such as diabetes, lipid metabolism disorders, smoking, high alcohol consumption, obesity, physical inactivity, advanced age or high blood pressure in blood relatives or if heart and kidney damage or arteriosclerotic changes in the blood vessels are already due to high blood pressure .
  • In the isolated systolic hypertension The doctor only starts drug therapy from systolic values ​​above 160 mmHg.
  • A new start of antihypertensive therapy in people over 80 years of age should only be started at systolic blood pressure values> 160 mmHg.

Target values

If the patient has decided on antihypertensive therapy, the doctor aims to lower the systolic blood pressure value to 140 mmHg and lower the diastolic value to 90 mmHg. A target blood pressure of 140/85 mmHg should be achieved in diabetics.

The SPRINT study received a lot of attention in 2015. She came to the result that in non-diabetics with a high cardiovascular risk the total mortality can be reduced significantly if the systolic blood pressure is lowered to values ​​around 120 mmHg. The study results also suggest consistent treatment for mild hypertension.

In older people over 65 years of age, the doctor sometimes tolerates blood pressure values ​​up to 160/100 mmHg without treatment, if there is a known tendency to dizziness and falls, or if previous attempts at treatment with high-pressure medication have led to dizziness or other difficult-to-bear side effects.

Basic Actions - Change of Lifestyle

Changing behavior towards a healthy lifestyle lowers blood pressure by about 10 mmHg. This not only reduces the number of blood pressure medication required, but with only slightly to moderately elevated blood pressure values, drug therapy may even become superfluous. In practice, however, far too few patients are willing to take the strenuous path of changing their lifestyle, even though this involves other risk factors in addition to high blood pressure, e.g. B. the blood lipids and also the psychological constitution can be influenced very favorably - which tablets cannot do. You can read under "Your pharmacist recommends" which measures are particularly effective and tips on how to carry them out.

Pharmacotherapy

For the drug therapy of high blood pressure, the attending physician has seven groups of active substances available, which he can prescribe individually or in combination. Which drug is used and when is repeatedly adapted by medical societies to the results of current studies (and unfortunately it is not entirely free from the influence of pharmaceutical companies).

In addition, the choice of medication depends on the individual comorbidities and tolerability. So is z. B. a beta blocker for blood pressure treatment in patients with bronchial asthma is unfavorable. ACE inhibitors sometimes cause an uncomfortable dry cough and then have to be replaced with another active ingredient, such as a sartan.

The following Antihypertensive drugs are currently recommended:

  • ACE inhibitors lower blood pressure by widening the blood vessels, influencing the heart's activity and increasing the excretion of fluid in the healthy kidney. These include B. Benazepril, Captopril, Cilazapril, Enalapril, Fosinopril, Lisinopril, Moexipril, Perindopril, Quinapril, Ramipril, Trandolapril, Zofenopril.
  • AT1 blockers (sartans) act in a similar way to ACE inhibitors and can replace them in the event of intolerance (e.g. irritable cough or Quincke's edema). These include B. candesartan, eprosartan, irbesartan, losartan, olmesartan, telmisartan, valsartan.
  • Calcium channel blockers lower blood pressure by widening the blood vessels; some also slow down the heart rate. These include B. amlodipine, diltiazem, felodipine, isradipine, lercanidipine, manidipine, nifedipine, verapamil.
  • Diuretics initially promote the excretion of fluids and saline and permanently cause the blood vessels to widen. They are often combined with other high blood pressure medicines. These include B. amiloride, chlortalidone, furosemide, hydrochlorothiazide, indapamide, piretanide, torasemide, spironolactone, triamterene, xipamide.
  • Beta blockers lower blood pressure by relieving the heart and reducing the heart rate. These include B. Acebutolol, Atenolol, Betaxolol, Bisoprolol, Carvedilol, Celiprolol, Esmolol, Metoprolol, Nebivolol, Pindolol, Propranolol.

The following are considered reserve drugs today:

  • Alpha 1 blockers (Alpha-receptor blockers) and Antisympathotonics: These active ingredients directly or indirectly influence the action of the sympathetic nervous system on the vascular tone and thus expand the blood vessels. You are z. B. indicated for hypertension during pregnancy. These include B. clonidine, doxazosin, prazosin, terazosin, urapidil.
  • Renin inhibitors like aliskiren directly inhibit the blood pressure increasing hormone renin. It is mainly used in hypertensive crises or when a combination of two or three of the recommended active ingredients cannot reduce high blood pressure sufficiently. However, renin inhibitors must not be combined with ACE inhibitors or sartans.
  • Substances with a direct vasodilator effect (Vasodilators), which lower blood pressure by lowering arterial resistance. These include B. Dihydralazine, Minoxidil and as short-acting drugs the so-called. Nitrates such. B. Nitroprusside Sodium.

Monotherapy or Combination Therapy?

There are various recommendations as to whether high blood pressure should initially be treated with monotherapy or with a combination of different active ingredients. For very frail patients, over 80-year-olds or patients with grade I hypertension and low cardiovascular risk, doctors initially only prescribe one active ingredient, e.g. B. an ACE inhibitor, a sartan or a diuretic. If its effect is insufficient, the doctor can either increase the dosage or add a second active ingredient to the therapy.

Doctors start therapy for grade II hypertension with a combination of two or if the patient is at high cardiovascular risk. From grade II hypertension and in patients who have an increased risk of cardiovascular diseases, a two-pack combination is usually started immediately. Typical combinations are e.g. B. ACE inhibitor or sartan plus diuretic or calcium channel blocker; A beta blocker is chosen as a combination drug in patients with CHD. If the desired blood pressure cannot be achieved with the combination of two, a third active ingredient is added (ACE inhibitor or sartan plus Diuretic plus Calcium channel blocker). The full effect of high-pressure medication only occurs after 2 to 6 weeks. Some combinations of active ingredients are already offered by the pharmaceutical industry in a single tablet, so that the number of tablets to be taken daily is reduced.

Note: Physicians should exercise caution when patients receiving calcium channel blockers require antibiotic treatment. The combination of antihypertensive agents with the antibiotics clarithromycin and erythromycin causes a sharp drop in blood pressure. The risk for patients of going into shock as a result increases six-fold with erythromycin and four-fold with clarithromycin. The antibiotic azithromycin is an alternative to treating bacterial infections in affected patients.

Operative therapy

If all drug attempts to adjust blood pressure fail, the doctor speaks of therapy-resistant high blood pressure. In order to help these patients, too, various procedures are in clinical trials:

  • Baroreceptor Activation Therapy (BAT). Stimulation of the pressure receptors (baroreceptors) in the carotid artery with implanted stimulation electrodes. In this way, the pressure receptors are simulated that the pressure in the vessels is high, and counter-regulation occurs with a drop in blood pressure. Several hundred patients worldwide have been treated with the method so far. About 3/4 of those affected had blood pressure drops of 20–30 mmHg. The clinical trials are ongoing and final recommendations are not yet possible.
  • Renal denervation. Here the doctors try to decouple the kidney from the sympathetic nervous system (the "stress nervous system"), which permanently lowers the blood pressure. To do this, they push a catheter into the renal artery and obliterate the autonomic nerve fibers in the blood vessel with electricity. The process is also still in clinical testing and is partly controversial.

forecast

The earlier high blood pressure is recognized and treated, the lower the risk of secondary damage developing. There are various clinical scoring systems for assessing the individual cardiovascular risk from high blood pressure and other risk factors, such as: B. the Procam score and the ESC score (links to the scores under Additional information).

Your pharmacist recommends

Prevention

High blood pressure is one of the risk factors for the development of arteriosclerosis, heart failure, CHD, stroke, kidney dysfunction or circulatory disorders of limbs, which the patient can influence himself. You should therefore check your blood pressure once a year from the age of 30 and every six months from the age of 50 (in several individual measurements) in order to be aware of the development of high blood pressure in good time. This is especially true if a parent or sibling is known to have high blood pressure. A healthy lifestyle has also been shown to prevent high blood pressure. Researchers found six factors that significantly reduced the risk of the disease:

  • Normal weight
  • half an hour of intense exercise every day
  • Reluctance to consume alcohol
  • Diet with lots of fruit, vegetables and whole grain products
  • Diet with little red meat, sausage and sweet drinks

What you can do yourself

Medical therapy. Side effects of high pressure medication (such as performance kinks or potency problems) are unfortunately common. In any case, it is better to think about a product change together with the doctor than to simply stop taking tablets. Sometimes all that is required is patience. Step z. If, for example, you feel tired or dizzy at the beginning of a blood pressure treatment, this does not have to be a drug intolerance, but can be a consequence of the unusual normal blood pressure, to which the body first has to get used to.

Take your blood pressure medication regularly and over a long period of time. This is the only way to ensure the effectiveness of the treatment. If the blood pressure values ​​are too high or too low after a while, discuss possible therapy changes with your doctor.

As a high blood pressure patient, afford your own blood pressure monitor for self-measurement, this makes it easier to check the blood pressure setting. The German High Pressure League regularly checks blood pressure monitors and awards a seal of approval for their measurement accuracy. Make sure that your measuring device has such a seal of approval. Always measure at the same time of day and in the same place, e.g. B. on a Sunday morning before breakfast.

Body weight. At the beginning there is the normalization of body weight. The loss of 1 kg excess weight causes the blood pressure to drop by at least 1–2 mmHg.

Nutrition. Use as little table salt as possible, because consuming too much salt can increase blood pressure. The German Nutrition Society recommends that people with high blood pressure limit the intake of table salt (sodium chloride) with their food to a maximum of 6 g per day. 6 g table salt is roughly equivalent to a level teaspoon full of salt. According to the German Nutrition Society, table salt intake is currently too high for around 70% of women and around 80% of men. The majority is supplied through processed foods and the consumption of meals prepared outside the home. In order to reduce salt consumption, the consumption of processed foods should be reduced and the consumption of unprocessed foods such as vegetables and fruits should be increased. It is advisable to use less salt and more spices when preparing food. It is easier to reduce your salt intake if you do so in small steps so that you can get used to the weaker salt taste.

Special text: The salt in the soup

A diet rich in potassium and fiber with lots of fruits (bananas are the ultimate supplier of potassium, even dried fruits offer a lot of it), whole grain products and vegetables lower blood pressure. Tomatoes may also have antihypertensive effects.

So-called discharge days, e.g. B. one fruit, juice or rice day per week can lead to a measurable reduction in blood pressure through dehydration and desalination of the body.

Alcohol. Reduce alcohol consumption. Men should drink a maximum of 20–30 g and women 10–12 g of alcohol per day. 20 g of alcohol correspond to about 0.5 l of beer or 0.25 l of wine - quantities that do not require any radical cuts.

Move. For high blood pressure patients, regular endurance training is an important measure for natural blood pressure regulation. Training that you do two to three times a week for initially 30 minutes and later 45 minutes is ideal. It is important to ensure that the intensity of the workload is even during physical activity so that dangerous blood pressure peaks do not occur - "Running without breathing" can be the motto for this.

Before starting any strength training, an initial sports medical examination is recommended. The training should take place under the supervision of trained personnel. In addition, blood pressure should be measured before each training session. If the values ​​are too high, it makes more sense to pause. It is essential to avoid press breathing and competitive situations that could encourage you to exceed your physical capacity. Perhaps there are also outpatient, sport-oriented high pressure groups in your area where the training programs take place under medical supervision.

Other burdens. Avoid (persistent) stressful situations at work and in family, look for opportunities to relax and ensure you get enough sleep. Both shift work and long-distance travel with jet lag can increase blood pressure.

Cold stimuli such as swimming in cold water, cold showers or a cold shower after physical exertion or a visit to the sauna can raise blood pressure. On the other hand, regular (morning) alternating showers, increasing arm baths or foot baths with a herbal bath additive (e.g. thyme or lemon balm) in the evening have a positive effect on moderately high blood pressure. If the blood pressure is very high, you should not go to the sauna.

Complementary medicine

Herbal medicine. The most frequently used antihypertensive phytopharmaceuticals include garlic extracts, which, in addition to their antihypertensive properties, are said to have a protective effect on blood vessels. 600–900 mg of dry garlic powder extract per day (corresponds to a small toe) lower systolic blood pressure by around 8 mmHg, and diastolic by 5 mmHg. Garlic is also available as coated tablets (e.g. Sapec® coated tablets or Kwai®N coated tablets). In order to supply the required amount of active ingredient, however, depending on the preparation, 3 to 9 coated tablets must be taken daily.

Stressed patients with moderately high blood pressure often benefit from medicinal plants that promote relaxation such as valerian root, lemon balm leaves or lavender as a complementary measure to mind-body or relaxation therapy.

Because of possible side effects (e.g. depressive moods) and sometimes dangerous interactions with other drugs and with alcohol, many authors advise against preparations with Rauwolfia (Rauwolfia serpentina).

Homeopathy. Homeopathy knows various constitutional remedies that can be used for mild high blood pressure, e.g. B. Arnica, Belladonna, Kalzium carbonicum, Natrum muriaticum, Nux Vomica and Sulfur. In addition, various complex agents (e.g. Auro-cyl® Homoeopath. Funct.-Complex Drops, Antihypertonicum-Weliplex®) are available.

Hydrotherapy. Those who like to bathe and suffer from moderately high blood pressure can try to regulate their blood pressure with carbonic acid baths. For this purpose, carbonic acid is added as a bath additive (available in the pharmacy) in warm water (about 30 ° C), the bath should not last longer than 20 minutes.

Physical therapy. High blood pressure cannot be significantly reduced with massages, but high blood pressure patients benefit from the mental and muscle-relaxing effect.

Acupuncture. Needling individual points can regulate a slightly increased blood pressure, but acupuncture can usually only do little if the blood pressure is very high.

Further information

  • www.hochdruckliga.de - website of the German High Pressure League e. V., Heidelberg: Information about causes and treatment options for high blood pressure as well as self-help groups in your area. There is also a patient guide available for download as a pdf.
  • www.hochdruckliga.de/messgeraete-mit-pruefsiegel.html: Website of the German High Pressure League with listed tested measuring devices.
  • Link to various scores on the website of the BNK (Federal Association of Resident Cardiologists): www.scores.bnk.de/index.html.

Authors

Dr. med. Dieter Simon in: Gesundheit heute, edited by Dr. med. Arne Schäffler. Trias, Stuttgart, 3rd edition (2014). Revision and update: Dr. med. Sonja Kempinski | last changed on at 15:23


Important note: This article has been written according to scientific standards and has been checked by medical professionals. The information communicated in this article can in no way replace professional advice in your pharmacy. The content cannot and must not be used to make independent diagnoses or to start therapy.