Answer:

For individuals with high blood pressure, strenuous work, prolonged stress, lack of sleep, and working outdoors in harsh weather conditions can lead to sudden spikes in blood pressure. During strenuous activity, the body requires more blood and oxygen, forcing the heart to pump harder and placing greater stress on blood vessels. At night or during periods of stress, the body releases stress hormones that constrict blood vessels and rapidly increase blood pressure. This can cause dangerous complications in the heart, brain, kidneys, damage the retina, and contribute to cognitive decline.

When blood pressure rises, the heart pumps blood with greater force, impacting the walls of blood vessels throughout the body. This pressure causes the vessel walls to stretch and, over time, lose elasticity and become more susceptible to damage. In the brain, high blood pressure can rupture blood vessels, causing cerebral hemorrhage, or block blood flow, leading to cerebral infarction (stroke). In the heart, the coronary arteries that supply blood to the heart muscle can narrow or become blocked due to pressure and atherosclerosis, causing myocardial infarction (heart attack). In the kidneys, damage to small blood vessels gradually impairs their filtering function, leading to kidney failure.

Your long-standing hypertension combined with heavy lifting at night increases your risk of abnormally high blood pressure. Your headaches, dizziness, and fatigue are warning signs of an overloaded system. In middle age (55 and above), blood vessels lose elasticity and are prone to atherosclerosis, increasing the risk of stroke during exertion if blood pressure isn't well-managed.

You should consult a cardiologist soon for a blood pressure check, cardiovascular assessment, evaluation of accompanying risk factors, and adjustment of your treatment plan. Hypertension is a chronic condition requiring regular monitoring. Besides home blood pressure monitoring, schedule check-ups every 3-6 months for the doctor to assess the treatment's effectiveness.

To prevent serious complications, avoid heavy lifting, moving heavy objects, or prolonged work in hot, sunny, or cold, windy conditions. Monitor your blood pressure regularly, especially before and after work shifts, during weather changes, or when experiencing headaches, dizziness, or fatigue. Seek immediate medical attention for any unusual symptoms.

In addition to taking prescribed medication regularly, maintain a relaxed mindset, manage stress, and ensure sufficient daytime sleep if working night shifts. Follow a low-sodium, low-sugar diet, limit fat, alcohol, and processed foods, and include plenty of vegetables, fruits, and potassium-rich foods beneficial for cardiovascular health. Engage in light exercises like slow walking and deep breathing to reduce pressure on artery walls and stabilize blood pressure.

Be aware of early warning signs of heart attack and stroke. Stroke symptoms include sudden severe headache, weakness or numbness on one side of the body, facial drooping, slurred speech, blurred vision, or loss of balance. Heart attack symptoms often involve intense chest pain radiating to the shoulder, neck, and arm, accompanied by shortness of breath, cold sweats, and nausea. Seek immediate medical attention if you experience any of these symptoms, as the critical intervention window is measured in hours.

MSc. MD Nguyen Thi Tuyet

Cardiology Department

Tam Anh General Hospital, Hanoi