Hypertension Does Not Show Symptoms Without Causing Organ Damage

One in three adults in Turkey suffers from hypertension.

In Turkey, one in three adults has hypertension. Dr. Ayşegül Karahan Zor, a Cardiologist at Anadolu Health Center, pointed out that two-thirds of the 15 million hypertensive patients, which is approximately 10 million people, are unaware they have the condition. She emphasized the importance of regular blood pressure monitoring for early detection of hypertension, stating, "In cases of hypertension, treatment needs to be planned comprehensively, and the patient must follow this plan throughout their life and adopt a healthier lifestyle. Hypertension, by itself, is not fatal, but if left untreated, its consequences can be deadly."

Dr. Ayşegül Karahan Zor, a Cardiologist, explained that hypertension is defined as the elevated blood pressure in the blood vessels above normal levels. "The heart performs rhythmic and periodic movements to pump the blood necessary for the vitality of tissues throughout the body. These are contractions and relaxations. When the heart contracts, the blood in the heart cavity is pushed into the arterial system. After this, a relaxation phase occurs, during which the heart fills again with blood. This process continues periodically. The pressure the blood exerts on the walls of the arteries at a specific moment is called blood pressure (tension). When the heart contracts, the pressure is called systolic blood pressure (large tension), and during the relaxation phase, it is called diastolic blood pressure (small tension). These pressure values vary depending on our movements and emotions throughout the day; sometimes the values decrease, and sometimes they rise. However, when the pressure remains consistently high, it is hypertension, a condition that must be treated."

The Result of Hypertension: Heart and Vascular Diseases

Dr. Ayşegül Karahan Zor, a Cardiologist at Anadolu Health Center, emphasized that the most important consequence of untreated hypertension is heart and vascular diseases. "When blood pressure cannot be sufficiently controlled, other significant outcomes include brain hemorrhage and stroke, heart failure and heart attacks, kidney failure, and vision loss. If blood pressure remains uncontrolled, it can lead to 51% of heart failure, 33% of strokes, and 21% of deaths related to cardiovascular diseases. Studies show that high blood pressure treatment is beneficial in reducing cardiovascular and kidney-related side effects and lowers the death rates from stroke and heart disease," she explained.

Hypertension Does Not Show Symptoms Without Causing Organ Damage

Dr. Ayşegül Karahan Zor stated that approximately 1 billion people worldwide are affected by hypertension. "According to the TEKHARF study and the Turkish Hypertension and Kidney Diseases Association's study, the prevalence of hypertension in the adult population (aged 18 and older) in our country is 31.8%, meaning one in three people (27.5% of men and 36.1% of women), approximately 15 million people, have hypertension. Even more importantly, two-thirds of them are unaware of their condition. Hypertension is a disease that does not show symptoms until it causes organ damage," she said.

Dr. Ayşegül Karahan Zor explained that the only way to diagnose hypertension is by regularly measuring blood pressure. She added that the ideal blood pressure is 120/80 mmHg or lower, while values above 140/90 mmHg are considered hypertension. She recommends lifestyle changes such as improved nutrition, reduced salt intake, weight loss, controlled alcohol consumption, and increased vegetable and fruit consumption, as well as more frequent blood pressure monitoring. The goal in hypertension treatment is to normalize blood pressure and reduce organ damage caused by high blood pressure. Dr. Karahan Zor explains that treatment varies based on whether the patient has any other accompanying diseases, their cardiovascular risk, and whether there is any organ damage caused by hypertension. She continued, "If the patient has no other cardiac risk factors, such as diabetes, high cholesterol, or smoking, and we find their blood pressure slightly to moderately elevated, we initially recommend lifestyle changes. This is either as an initial treatment before starting medication or as an adjunct in patients already on medication. We encourage patients to limit salt intake, lose weight if they are overweight, and engage in regular exercise. At least 30 minutes of walking three times a week is essential. We also advise them to pay close attention to their diet. When they focus on fruits and vegetables, increase fish consumption, and prefer meals cooked with olive oil (8-10 servings of vegetables and fruits, 2-3 servings of low-fat foods and dairy, reducing fat and cholesterol intake), their blood pressure decreases."

Hypertension Treatment Is Lifelong
Hypertension treatment lasts a lifetime, and medications need to be taken continuously. If a side effect occurs due to the medication, it should be changed or discontinued under the guidance of a doctor.

The Cause of Hypertension Is Unknown

Dr. Ayşegül Karahan Zor emphasized that in about 90-95% of hypertension cases, no specific cause can be identified, though risk factors such as obesity, smoking, poor nutrition, and family history are considered. "This group is referred to as primary (essential) hypertension. In 5-10% of cases, hypertension develops secondary to another disease. These diseases include kidney problems, endocrine disorders, birth control pills, amphetamine-like drugs, excessive thyroid hormone use, nonsteroidal anti-inflammatory drugs (NSAIDs), cold medications, appetite suppressants, and some antidepressants, which can cause elevated blood pressure. Discontinuing these medications can bring blood pressure back to normal. Smoking has both short- and long-term effects on hypertension. The short-term effects are directly related to its vasoconstrictive effects. Every cigarette raises blood pressure for about 15 minutes. When another cigarette is smoked, it increases again and never returns to normal. Continuous smoking throughout the day can cause significant, sustained increases in blood pressure over time," she concluded.

Hypertension Is Treatable

Dr. Zor continued, "If the patient has no cardiac risk factors, such as diabetes, high cholesterol, or smoking, and we find their blood pressure to be slightly to moderately elevated, we initially recommend lifestyle changes. There is strong evidence showing that lifestyle changes effectively control blood pressure and thus hypertension. We recommend this either as a starting treatment before beginning medication or as an adjunct to treatment in patients already on medication. Our recommendations include starting with salt restriction (less than 6 grams per day), weight loss if the patient is overweight, and regular exercise. A minimum of three 30-minute walks per week is required. We also advise patients to pay close attention to their diet. When they focus on a diet rich in fruits and vegetables, increase fish consumption, and prefer meals with olive oil (8-10 servings of vegetables and fruits, 2-3 servings of low-fat foods and dairy, reduced fat and cholesterol intake), their blood pressure decreases."

Hypertension Threatens Children Too

Dr. Ayşegül Karahan Zor pointed out that although essential hypertension was rare in childhood, it has become more common in children today. "In the past, when we saw hypertension in children, we thought it was usually due to another condition, such as kidney dysfunction, aortic coarctation (a disease of the aortic vessel), or certain hormonal disorders in children. However, now we are seeing essential hypertensive patients in childhood as well. As in adults, there is a direct relationship between obesity, insulin resistance, blood fats, inactivity, and blood pressure in children. Excess weight gained in childhood is an important determinant of cardiovascular risk in young adulthood. In hypertensive children, if they are obese, they should be encouraged to lose weight, and just as in adults, salt and calorie restriction should be applied," she explained.

Common Misconceptions About Hypertension

False: "I'm old, so it’s normal for my blood pressure to be over 140/90 mmHg."
True: No, everyone should aim for a blood pressure below 140/90 mmHg, except for those with chronic kidney failure and diabetes.

False: "Blood pressure medication ruins my kidneys."
True: On the contrary, if blood pressure medication is not used, the kidneys get damaged. Hypertension is one of the leading causes of kidney failure.

False: "Blood pressure medications are addictive, and after a while, they stop working. That’s why I shouldn’t take them for long periods."
True: Hypertension medications are not addictive; they should be used continuously.

False: "I stopped taking my medication, and my blood pressure is normal now. I don't need to take medication anymore."
True: Many changes caused by hypertension are reversed with long-term medication use. In patients who start medication before vascular changes occur, they may not experience an immediate rise in blood pressure after stopping the medication. However, after three to four months, blood pressure will start to rise again. Since it often shows no symptoms, the patient may come back years later with very high blood pressure and complications. That’s why hypertension is not a disease that goes away.