Arterial hypertension (high blood pressure) is one of the most common medical conditions worldwide and represents one of the main risk factors for cardiovascular disease.
In Italy, 1 in 3 adults has hypertension, but almost half are unaware of it, because it often causes no symptoms.
For this reason, it is also known as the “silent killer.”

Having high blood pressure means that the heart must constantly work harder to pump blood through the arteries. Over time, this can cause progressive damage to vital organs such as the heart, brain, kidneys, and eyes.

 

What are normal blood pressure values?

Optimal< 120 mmHg & < 80 mmHg

Normal120–129 & 80–84

High-normal130–139 & 85–89

Hypertension≥ 140 mmHg & ≥ 90 mmHg

 

Diagnosis is not based on a single measurement, but on repeated values over time, preferably confirmed with home monitoring or a 24-hour ambulatory blood pressure monitoring (ABPM).

 

Why does hypertension occur?

In 90–95% of cases, there is no single cause (called essential hypertension), but rather a combination of interacting factors:

Non-modifiable factors

• Family history (hypertensive parents or siblings)

• Age (more common after age 50)

• Genetics

Modifiable factors

• Diet high in sodium and low in potassium

• Overweight and obesity

• Sedentary lifestyle

• Smoking

• Excessive alcohol consumption

• Chronic stress and poor sleep quality

• Certain medical conditions (kidney disease, hormonal disorders, sleep apnea)

 

What symptoms may occur?

Very often, none. When present, symptoms may be nonspecific:

• Headache, especially in the morning

• Fatigue or confusion

• Dizziness

• Ringing in the ears (tinnitus)

• Palpitations

• Visual disturbances

• Nosebleeds (rare)

The absence of symptoms does not mean the absence of risk: the only way to know is to measure your blood pressure.

 

Why is it important to treat it?

If uncontrolled, hypertension can lead to:

• Heart attack

• Stroke

• Heart failure

• Kidney failure

• Aneurysms

• Damage to the retina and vision loss

 

Reducing blood pressure significantly decreases these risks: even a reduction of 5–10 mmHg can make a major difference in cardiovascular protection.

 

How is hypertension diagnosed?

In addition to repeated measurements in the clinic, the following may be useful:

• 24-hour ambulatory blood pressure monitoring (ABPM)

• Home measurements

• Blood and urine tests

• Electrocardiogram and echocardiogram

• Evaluation of other risk factors (cholesterol, blood sugar, lifestyle)

 

How is hypertension treated?

1. Lifestyle changes (essential for everyone)

Daily changes can significantly lower blood pressure:

HabitBenefit

Reduce salt intake (< 5 g/day)– 5 mmHg

Lose 5–10% of excess body weight– 5/20 mmHg

Regular physical activity (150 min/week)– 4/9 mmHg

Mediterranean diet rich in fruits/vegetables– 8/14 mmHg

Reduce alcohol (max. 1 drink/day for women, 2 for men)– 2/4 mmHg

Quit smoking huge cardiovascular benefit

Improve sleep and manage stressoverall positive effects

 

Medication (when necessary)

When lifestyle changes are not enough, we use effective, safe, and individualized medications. The most commonly prescribed include:

• ACE inhibitors or ARBs

• Calcium channel blockers

• Diuretics

• Beta-blockers (in selected cases)

 

Treatment must not be stopped or modified without medical supervision: hypertension is a chronic condition and benefits come only with consistency.

 

How to measure blood pressure correctly at home

• Sit down and rest for 5 minutes before the measurement

• Avoid coffee, smoking, or exertion 30 minutes before

• Support your arm at heart level, feet flat on the floor, legs not crossed

• Take 2–3 measurements, 1 minute apart, and record the average

• Measure in the morning and evening for 3–7 days

Always bring your blood pressure log to medical appointments.

 

When to seek immediate medical attention (call 112 / 911)?

If any of the following occur:

• Chest pain

• Difficulty speaking or moving an arm

• Facial asymmetry

• Sudden weakness

• Fainting or severe shortness of breath

• Blood pressure > 180/120 mmHg with symptoms

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Hypertension is very common, but it is also treatable and controllable.
With early diagnosis, healthy habits, and personalized therapy, it is possible to prevent complications and live a long, active life.

Taking care of your blood pressure today means protecting your heart, brain, and entire body for the future.