Hypertension

Hypertension is blood pressure that stays too high over time. It is generally diagnosed at clinic readings of 140/90 mmHg or above, or home and ambulatory averages of 135/85 mmHg or above, though targets differ slightly between guidelines.

It rarely causes symptoms, yet over years it strains the arteries, heart, brain, kidneys and eyes. It is the leading treatable cause of stroke and a major cause of heart attack, heart failure and kidney disease. Lowering it reduces these risks substantially, and treatment is usually lifelong.

Symptoms

• Usually none, which is why it needs to be measured
• Headache, typically only with very high readings
• Nosebleeds in some people
• Blurred vision
• Breathlessness or chest discomfort when the heart is affected
• Findings of organ strain on tests, such as protein in the urine or a thickened heart wall

Causes and risk factors

In about nine in ten people there is no single cause. Genes, ageing arteries, excess salt, excess weight, alcohol, inactivity and stress combine. A specific cause is more likely if you are young, if pressure is very high or resists three medicines. These causes include kidney disease, narrowing of a kidney artery, excess aldosterone from the adrenal gland, sleep apnoea, thyroid disease, rare adrenal tumours and coarctation of the aorta. Anti-inflammatory painkillers, the combined pill, decongestants, steroids and liquorice can also raise pressure.

How it is diagnosed

• Repeated measurement: Correct cuff size, seated and rested, on more than one occasion and in both arms initially.
• 24-hour ambulatory or home monitoring: Confirms the diagnosis and detects white-coat and masked hypertension.
• Blood and urine tests: Kidney function, potassium, glucose, cholesterol, and urine albumin.
• ECG and echocardiography: Show thickening of the heart muscle from long-standing pressure.
• Eye examination: The retina shows the state of small blood vessels.
• Tests for secondary causes: Aldosterone to renin ratio, kidney artery imaging or a sleep study, when the pattern suggests them.

Treatment options

• Lifestyle measures: Less salt, weight loss, regular exercise, limited alcohol and a diet rich in vegetables and fruit each lower pressure by several points.
• ACE inhibitors or angiotensin receptor blockers: Common first choices, especially with diabetes or kidney disease. Not used in pregnancy.
• Calcium channel blockers: Amlodipine and similar. Ankle swelling is the main side effect.
• Thiazide-like diuretics: Indapamide or chlortalidone, often as part of a combination tablet.
• Add-on medicines: Spironolactone for resistant hypertension, then beta blockers or alpha blockers.
• Treating a secondary cause: Adrenal surgery, kidney artery angioplasty in selected cases, or CPAP for sleep apnoea.
• Renal denervation: A catheter procedure for carefully selected people with resistant hypertension. The average effect is modest.

When it is urgent

A reading of 180/120 mmHg or higher together with chest pain, breathlessness, severe headache, confusion, visual loss, weakness or seizures is an emergency: call for help locally. The same reading without symptoms should be rechecked after rest and discussed with a doctor within days. In pregnancy, high pressure with headache, visual disturbance or upper abdominal pain needs same-day care.

Travelling to Türkiye for treatment

Hypertension is managed through repeated readings and dose changes over months, so ongoing care should be local. A visit suits a one-off assessment: 24-hour monitoring, a check for organ damage and a search for secondary causes in resistant or early-onset cases, with a written plan for your own doctor. Bring your home readings and current medicines.

Send your reports, scans and a short history and a Clinic-Y coordinator replies within 24 hours with suitable teams and written, all-inclusive proposals side by side. Reviewing your case is free.

Frequently Asked Questions