The systolic blood pressure is too high


If your blood pressure value has been measured for the first time, further examinations should be carried out as early as possible to determine whether the high blood pressure is permanent or whether the measured blood pressure value was only exceptionally high. In the first few years, permanent (chronic) high blood pressure only causes symptoms in very few of those affected, which is why it is usually only discovered by chance through a control measurement. It is important to take the blood pressure value that is too high for the first time, despite the lack of symptoms, seriously and to have it examined further - it becomes dangerous if the disease persists for a long time. Over many years, high blood pressure damages blood vessels throughout the body and leaves traces in particular on the heart, brain, kidneys and eyes.

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Causes of Elevated Systole

On the one hand, if your blood pressure is too high for the first time, it can be an indication that high blood pressure persists. On the other hand, the cause can also be completely harmless: the blood pressure also rises in healthy people in various situations, but after a few minutes of rest it falls below the limit value of 140/90 mmHg. A rise in blood pressure is typical during physical exertion, in acute or chronic pain or in purely psychological stressful situations. This is a completely normal mechanism of the body, which occurs in phases with an increased need for oxygen and nutrients in the muscles, lungs and brain - such as during exercise (see also: High blood pressure and exercise) - to ensure sufficient transport of blood in the body's circulation.

It differs from person to person how much the blood pressure changes in the respective stressful situations - for many, even a slight excitement can cause blood pressure fluctuations of 30 mmHg. Even a visit to the doctor can trigger a certain amount of excitement, which is reflected in the blood pressure measurement as excessively high blood pressure. This phenomenon is called "white coat hypertension". If the blood pressure is too high, although a certain rest period has been taken before the measurement, this is more indicative of a permanently increased high blood pressure that requires treatment.

In about 90% of those affected, a direct cause is never found. Doctors refer to this as "primary high blood pressure" or "essential hypertension". Why so many people suffer from primary high blood pressure is still not exactly known and is often the subject of research. It is known that certain conditions increase the risk of primary high blood pressure. This includes, for example, an unfavorable genetic predisposition: if parents or grandparents have high blood pressure, the risk of developing it also increases. Age also plays a role - high blood pressure is much more common in old age and very rarely occurs under 30 years of age. Important factors that promote high blood pressure and at the same time can be influenced by the patient are:

  • Obesity and lack of exercise

  • an unhealthy and salty diet

  • Smoking and drinking too much alcohol

  • persistent stress

Furthermore, various pre-existing diseases can trigger high blood pressure - these include sleep apnea syndrome, various kidney diseases, arteriosclerosis, hormonal diseases and many more.


To clearly differentiate between a one-time high blood pressure and a manifest one high blood pressure a doctor can use different methods. As a rule, the patient is asked to measure your own blood pressure several times over several days. It is important to sit or lie down for a few minutes before taking the measurement. Upper arm measuring devices are more precise than measuring devices for the wrist. Another possibility is that 24-hour blood pressure measurement, in which a blood pressure cuff is put on at the doctor's, which measures the blood pressure at certain intervals over 24 hours and so on accurate blood pressure profile created by the patient. This profile enables a Assessment of the average blood pressure as well as the Development of blood pressure over the day and night. To rule out the possibility of a narrow arteries in one arm, the blood pressure should be measured on both arms the first time. In addition, if high blood pressure is detected, blood should be taken and examined for indications of the diseases described above that can secondary to high blood pressure.

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How dangerous is it

A blood pressure measured just once too high should not cause those affected to worry - it is completely harmless and occurs regularly in healthy people in the context of physical exertion, pain or psychological stress. However, it is recommended to check the blood pressure at regular intervals of, for example, 1-2 years. On the contrary, longstanding, chronic high blood pressure is very dangerous without proper treatment: in the western world it is one of the most common causes of strokes, heart attacks and kidney damage. The longer the high blood pressure persists, the greater the damage to the blood vessels of those affected.

The result is fatty and hardening of the vessels, which is known as "arteriosclerosis". Atherosclerosis can affect all organs and leads to a variety of problems. As already mentioned, it often manifests itself as a stroke or heart attack, but it can also lead to poor eyesight through damage to the eyes or to underactive kidney function through damage to the kidneys.

Furthermore, a long-standing high blood pressure can directly damage organs and thus cause, for example, a weak heart or cerebral hemorrhage. After several years, those affected often also develop an "arterial occlusive disease" of the legs, which can lead to pain when walking, impaired wound healing and, in the worst case, amputation of the foot or leg. Vascular damage occurs much earlier if, in addition to high blood pressure, there are other vascular-damaging diseases such as diabetes or obesity or if the person concerned smokes.

It is relatively rare for an existing high blood pressure to derail to very high values ​​of mostly over 230/130 mmHg. Such a "high blood pressure crisis" can then cause headaches, cerebral haemorrhage or heart attacks.

Depending on the level of blood pressure, practically all sufferers suffer consequential damage after years without adequate treatment. Therefore, appropriate treatment is important for everyone affected.

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When do you have to be treated for increased systole?

A blood pressure measured once too high does not require any therapy. Therapy should only be initiated when a doctor has clearly identified chronic high blood pressure and the associated cause. With most forms of high blood pressure - especially primary hypertension - from values ​​of 140/90 mmHg, an attempt should be made to reduce the blood pressure at rest (if possible below the exceeded value). This target value applies in particular to young people in whom the disease is expected to persist for many years and can cause greater damage as a result. In people who already have arteriosclerosis or other diseases that can damage blood vessels, the therapy should be observed very strictly.

People with multiple previous illnesses such as impaired kidney function, diabetes or heart attack should, if prescribed by their doctor, even achieve values ​​below 135/85 or 130/80. In older patients, however, the doctor can set the target values ​​slightly higher, because blood pressure medication is more likely to cause malaise and low blood pressure in older people, and due to the frequent use of several medications, trigger other undesirable effects more often than in younger people.

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The second blood pressure value is also too high

Even a second blood pressure value measured too high can only be an indication that a permanent blood pressure value has occurred high blood pressure consists. The examinations described above should be carried out to clarify the cause precisely, because bOnly repeated measurements under resting or everyday conditions are indicative of high blood pressure requiring treatment. In particular, if the first or second measurement revealed increased blood pressure values ​​at rest or without previous stress, a cause should be sought together with a doctor - regardless of the age of the person affected. Untreated high blood pressure can significantly shorten life and severely reduce the quality of life, especially in old age. An effective therapy started early on effectively prevents secondary diseases and is usually well tolerated. Therefore, increased blood pressure values ​​should be taken seriously and, in the event of illness, the therapy should be strictly adhered to despite the lack of symptoms.