In recent years, there has been increased attention on the connection between our skin, the body’s largest organ, and various diseases. The skin can provide insights into our overall health and may signal the presence of existing health issues or potential risks. This is particularly evident in the signs of facial aging, such as wrinkles, changes in skin color, hair loss, and graying, which are often associated with an older appearance and potential health problems. But is this a fair assessment?
The relationship between skin aging and specific conditions like hypertension can be intricate and challenging to pinpoint. Hypertension is often a silent condition, silently affecting individuals for some time before they become aware of their high blood pressure. Furthermore, diagnosing and treating high blood pressure (typically defined as readings over 130-140/80-85 mmHg) requires a comprehensive assessment, including repeated blood pressure measurements and considering other health conditions like diabetes before initiating treatment. It’s worth noting that hypertension becomes more common as people age, often regarded as a condition associated with aging due to the biological changes that lead to high blood pressure. However, elevated blood pressure can also result from other factors like obesity, kidney disease, excessive alcohol consumption, sleep apnea, or other medical issues. The impact on the skin depends on the degree and duration of high blood pressure and the conditions associated with it.
Keep in mind that skin aging can also be influenced by external factors such as sun exposure and smoking history.
But for now, let’s focus on the effects of hypertension.
Hypertension exerts excessive force against arterial walls, leading to vascular damage and persistent elevated blood pressure. Over time, hypertension causes changes in blood vessel contractility and function, making the vessel walls stiff and calcified. Smaller capillaries may be damaged due to increased pressure, impeding blood flow. This reduced blood flow affects the delivery of nutrients and oxygen to surrounding tissues, including the skin. As people age, the microvascular effects of hypertension on the skin are compounded by decreased skin functions and structure, along with hormonal changes. The result includes thinning of the skin, changes in texture, reduced hydration, and expedited deterioration of collagen and elastin. The microvascular system becomes less effective and has reduced healing capacity, exaggerating the signs of aging skin. Hypertension also contributes to inflammation, which is already stimulated by the aging process, further worsening skin conditions and increasing the risk of chronic diseases.
Hypertension has been associated with skin conditions like petechiae (red spots), purpura (red patches), psoriasis, and even rosacea. It’s important to consider the potential side effects of medications used to treat high blood pressure, such as diuretics, which can lead to skin dehydration, and certain antihypertensives that may cause flushing in rosacea patients.
Hypertension is often linked with other conditions like obesity, high waist circumference, and high blood sugar levels, often collectively referred to as metabolic syndrome. While these connections can make discussions about skin health more complex, researchers are gaining a better understanding of how these conditions affect the skin. This cluster of diagnoses further fuels inflammation in the body, including the skin, leading to negative impacts on glucose regulation, oxidative stress, DNA damage, and the accumulation of “old cells.” These effects result in increased wrinkles and worsened clinical aging scores. Among skin conditions, rosacea, an inflammatory skin disorder, consistently shows an association with these combined conditions. Metabolic dysregulation also affects hair loss, as hair is considered part of the skin. Early onset of male pattern hair loss is linked to these conditions due to inflammation, oxidative stress, and reduced blood flow causing hair follicle miniaturization and hair loss.
What’s good for managing high blood pressure and reducing common risk factors also benefits the skin. Lifestyle choices play a significant role. This includes a healthy diet, regular exercise, reduced sodium and sugar intake, and hormone assessment and treatment. These lifestyle factors directly and indirectly affect the mechanisms described above, supporting skin health. Exercise, for instance, can lower both diastolic and systolic blood pressure, improve circulation and oxygenation, and help control diabetes or prediabetes, mitigating the adverse effects of high sugar levels, oxidative stress, and inflammation. Additionally, managing stress and sleep has been shown to be beneficial for stabilizing blood pressure.
In summary, as we age, hypertension becomes more common, and in turn, hypertension can contribute to the development of various diseases. While the relationship between hypertension and skin health is still not fully understood, it’s clear that this connection becomes more intricate when combined with the effects of aging and associated conditions, such as metabolic syndrome. Viewing the skin as a reflection of our internal health can aid in early assessment and diagnosis. Recognizing the relationship between risk factors and skin aging enables a more comprehensive approach to health management, promoting disease prevention and overall well-being.
Frances Krawiec
Nurse Practitioner