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High blood pressure

Hypertensio arterialis · Vysoký krevní tlak (hypertenze)

What it is

Sustained pressure above 140/90 quietly damages arteries, kidneys, eyes and brain.

Symptoms & signs

  • Usually none
  • headaches or nosebleeds only when very high
  • found on measurement

🚩 Get help if…

  • call 112 / 911 now Very high pressure with chest pain or breathlessness
  • call 112 / 911 now Very high pressure with weakness, confusion or blurred sight
  • see a doctor soon Readings of 180/120 or more without symptoms
  • see a doctor soon Severe headache with a high reading

Where it strikes

Medical treatment

  • ACE inhibitor or ARB trials support
  • Calcium channel blocker trials support
  • Thiazide diuretic trials support
  • Spironolactone for resistant pressure mixed evidence
  • Home monitoring to confirm and track it — treatment that lowers pressure by 10 mmHg cuts strokes by about a quarter and heart disease by about a sixth; the absolute gain is large at high risk, small at low risk trials support
  • Renal denervation — FDA-approved 2023; lowers pressure by only a few mmHg mixed evidence

Natural & lifestyle

  • Salt under 5 g/day
  • DASH diet
  • potassium-rich foods
  • 150 min exercise/week
  • weight loss
  • alcohol limits
  • slow breathing practice

Emerging & experimental

  • Baroreflex activation therapy
  • zilebesiran (RNAi, twice-yearly dosing)

Alternative, off-label & anecdotal

Approaches used outside the guidelines, with what their supporters report and what testing has found so far.

  • Beetroot juice and dietary nitrate — trials show a modest drop in pressure trials support
  • Isometric hand-grip training — small trials show a drop as large as one drug mixed evidence
  • Hibiscus tea — several small trials lower pressure mixed evidence
  • Garlic extract — meta-analyses show a moderate drop in treated and untreated hypertension mixed evidence
  • Magnesium and coenzyme Q10 — small effects in meta-analyses early / small studies
  • Earthing/grounding — proponents report calmer pressure; not properly tested anecdotal / traditional

ICD codes