Hypertension: everything you need to know about high blood pressure

Written in association with: Dr Teresa Castiello
Published:
Edited by: Conor Dunworth

Hypertension, also known as high blood pressure, is a very common condition that can lead to serious complications if left untreated. In our latest article, renowned cardiologist Dr Teresa Castiello explains the dangers of hypertension, as well as its causes, diagnosis and more.

 

How dangerous can hypertension potentially be?

Hypertension is insidious and can be a long-term killer. In its initial stages, it is unlikely to be dangerous, except when presenting as 'malignant hypertension' with elevated blood pressure values. This potentially causes organ damage and requires emergency attention. In many cases, elevated blood pressure can cause long-term damage to multiple organs, including the heart, the blood vessels and the kidneys. 

 

How will I know if I have hypertension?

Sometimes elevated blood pressure may be associated with non-specific symptoms such as headaches, but hypertension is commonly asymptomatic, so you must check it to find out if it is abnormal. To know if you suffer from hypertension, you need to obtain reliable blood pressure measurements, with your own blood pressure machines or with readings obtained at a trusted pharmacy or your GP practice. A 24-hour blood pressure monitor may be also required.

 

What are the leading causes of hypertension?

The most common hypertension is the so-called 'essential hypertension' which means an elevated blood pressure of multi-factorial causes. Lifestyle has a huge implication: overweight or obese people commonly suffer from high blood pressure. However, many other conditions can lead to hypertension, including stress and a lack of exercise. Renal diseases and diabetes are also commonly associated with hypertension and require accurate investigation. There are also secondary causes, such as an endocrine disorder (i.e., Cushing’s syndrome, hyperaldosteronism and pheochromocytoma, thyroid disease, or autoimmune disorders, such as Lupus). Your cardiologist or a hypertension specialist can investigate appropriately. 

 

What are the main risk factors?

Cardiovascular risk factors that make the vessel 'stiff and inflamed' are also responsible for hypertension. Diabetes and obesity are common risk factors, but smoking and dyslipidaemia can also cause direct damage to the blood vessel, damaging the walls and making them less elastic. Additional risk factors are a stressful lifestyle and a history of hypertension in the family. Furthermore, some ethnic groups, such as those of Black African descent tend to have higher blood pressure. 

 

If I am diagnosed with hypertension, what is the next step in the treatment process?

Once you have been diagnosed with hypertension you will need to make sure that the high blood pressure has not already caused some damage to your organs (namely, the heart, kidney and blood vessels). To do so the cardiologist or the hypertension specialist will recommend some blood checks and some diagnostic tests, which may include an echocardiogram, carotid Doppler and renal ultrasound if appropriate.

Once the cause of hypertension has been establsihed, two elements are crucial to treating it: lifestyle changes and, often, long-term therapy. Sometimes lifestyle changes with a healthy body weight and exercise are sufficient to treat high blood pressure but commonly medical therapy needs to be added. Once high blood pressure is diagnosed it is important to regularly take the appropriate medication, lose weight and progressively increase daily exercise. A healthy diet with limited salt intake is also indispensable. If hypertension cannot be reversed by a healthy lifestyle, medication will need to be taken for life, unless a reversible secondary cause is identified and treated. 

Hypertension can be a silent killer. 

The American Heart Association defines elevated blood pressure as above 120/80mmHg. If your blood pressure is above this measurement, lifestyle changes are recommended. When blood pressure is above 130/80 mmHg we are dealing with Stage 1 hypertension and medication is recommended. If your blood pressure is above the normal range, do not wait for organ damage, book a cardiology appointment immediately. 

 

Dr Teresa Castiello is a leading London-based cardiologist. If you have any concerns regarding hypertension or any other heart condition, don’t hesitate to book a consultation with Dr Castiello today via her Top Doctors profile. 

By Dr Teresa Castiello
Cardiology

With over 20 years of medical experience, Dr Teresa Castiello is a leading cardiologist based in London. She specialises in acquired and inherited cardiomyopathyheart failurepreventive cardiology and family screeningsyncopehypertension, and cardiac magnetic resonance. Her decade-long career as a cardiologist has highlighted the importance of prevention and early diagnosis, balancing clinical experience and research. Dr Castiello has a holistic approach, taking into account her patients’ physical and mental well-being and their background, putting the person before his/her disease.

Dr Castiello graduated in medicine and surgery with honours from La Sapienza University, Rome in 2001, where she completed her medical and initial cardiology training (MD). In 2009 she specialised in cardiology at the University Campus Bio-Medico, Rome. Between 2009 and 2011 she dedicated her professional and personal time to three humanitarian missions, in Africa and East Jerusalem. Her longest mission was in Sudan where she worked at the Salam Center for Cardiac Surgery, on the outskirts of the Sudanese capital, Khartoum. Here she screened patients with suspected or documented cardiac diseases to select patients suitable for heart surgery. In Kenya, she tested the suitability to create a cardiac surgery unit and provided training to local staff. In East Jerusalem, she proudly collaborated with a children's NGO.

Following her time in Africa, she returned to Italy, where she earned a consultant cardiologist post at San Raffaele, Rome. Having gained almost ten years of medical experience, she then moved to England where she has since been working in all fields of cardiology with a specific focus on her areas of interest and expertise.

Dr Castiello practises at numerous London hospitals. Presently, she leads the heart failure and cardiomyopathy service at Croydon University Hospital as well as performing cardiac MRIs at St Thomas Hospital.

Thanks to her research commitment, she is leading several clinical trials at Croydon University Hospital, holding the position of a principal investigator. She also has a robust research network nationally and internationally. Since 2018 she has worked as heart failure educational lead (Royal Society of Medicine) for London, which involves organising and teachings for cardiology trainees. She has now been elected President of the Cardiology Section of the Royal Society of Medicine, a leading role for the education of future cardiologists.

Outside of her clinical duties, Dr Castiello is highly committed to national and international medical societies, namely the European Society of Cardiology, and holds many prestigious memberships and fellowships. Specifically, she has been Committee Member of the Patient care of the European Heart Failure Association (HFA) since 2018 and she is now Committee member of the newly formed Digital Health and Patient Care structural committee of  the HFA.   She has authored and co-authored peer-review papers and online educational resources.

Lately Dr Castiello is founder and director of M.I.A.L healthcare (Medici Italiani A Londra), the first Italian-speaking hospital based service in London. M.I.A.L’s model of care offers a patient-centres holistic approach for personalised medicine throughout the entire patient journey. M.I.A.L's long term plan is reinvesting part of the income in humanitarian projects focused on healthcare and education.

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