High blood pressure (arterial hypertension)

Arterial hypertension (high blood pressure) is a persistent elevation of blood pressure that often goes unnoticed for a long time and significantly increases the risk of heart attack, stroke and kidney damage. If your therapy is already well controlled, your home readings can be discussed in a video consultation; following a doctor's assessment, a follow-up private prescription for your existing medication can be issued.

Medically reviewed by Adi Zoabi, Approbation als Arzt.
Last reviewed on August 31, 2026. Updated as clinical guidelines change.

Overview

High blood pressure (arterial hypertension) is one of the most common chronic conditions in Germany. It usually causes no symptoms for a long time, but if left untreated it increases the risk of heart attack, stroke, heart failure and kidney damage. Consistently good blood pressure control is therefore essential – it is based on lifestyle measures and, where necessary, blood-pressure-lowering medication. For patients whose blood pressure is already well controlled with medication, the video consultation is particularly suitable: your home readings are discussed together with the doctor, and following the doctor's assessment a follow-up private prescription for your existing medication can be issued in accordance with the German medical fee schedule (GOÄ). This helps avoid interruptions in therapy without requiring a practice visit for every repeat prescription. Initial diagnosis, initial titration of medication and regular physical check-ups remain the responsibility of a local practice – telemedicine complements this care but does not replace it.

Common causes

In roughly nine out of ten cases, the condition is so-called primary (essential) hypertension, for which no single cause is responsible. The most important contributing factors include hereditary predisposition, increasing age, excess weight, high salt intake, lack of exercise, regular alcohol consumption, smoking and persistent stress. Sleep disorders such as obstructive sleep apnoea can also raise blood pressure. Secondary hypertension, in which another condition is the underlying cause – such as kidney disease, hormonal disorders or vascular changes – is considerably less common. Certain medications, for example corticosteroid preparations, some painkillers or hormonal contraceptives, can also increase blood pressure. If hypertension starts at a young age, readings are very high or the response to therapy is inadequate, a secondary cause should be investigated by a doctor; this requires in-person examinations.

When to see a doctor

Arrange a doctor's appointment promptly if your home readings are repeatedly above your agreed target range despite regular medication, if you repeatedly measure values above 160/100 mmHg, or if new complaints occur – such as possible side effects of your medication, dizziness when standing up or increasing fluid retention. Call the emergency number 112 immediately if very high readings (around 180/120 mmHg or above) occur together with warning signs: severe chest pain or tightness, shortness of breath, sudden paralysis, vision or speech problems, very severe headache, a nosebleed that cannot be stopped, confusion or impaired consciousness. Such signs may indicate a hypertensive emergency, a heart attack or a stroke and cannot be treated via video. You should also seek medical attention without delay if blood pressure readings are newly elevated during pregnancy.

Symptoms & Indications

Often no symptoms for a long time Headaches, especially in the morning Dizziness or light-headedness Ringing in the ears Palpitations or irregular heartbeat Shortness of breath on exertion Nosebleeds Visual disturbances with severely elevated readings

Treatment Options

Regular blood pressure self-monitoring at home with a validated upper-arm device and a measurement log
Lifestyle measures: low-salt diet, regular exercise, weight reduction
Reducing alcohol, stopping smoking and managing stress
ACE inhibitors or angiotensin receptor blockers (sartans) – as a follow-up prescription for established therapy, following a doctor's assessment
Calcium channel blockers as an established drug class for long-term therapy
Diuretics, often combined with other drug classes
Beta blockers for certain accompanying conditions, e.g. coronary heart disease

Important Notes

The video consultation is suitable for follow-up care and repeat prescriptions for already controlled hypertension – not for initial diagnosis, initial titration of medication or emergencies.
If readings are around 180/120 mmHg or higher together with symptoms such as chest pain, shortness of breath, paralysis, speech or vision problems, call the emergency number 112 immediately.
Do not change the dose of your blood pressure medication on your own and do not stop it without consulting a doctor.
Regular physical check-ups, such as blood tests, kidney function and ECG, remain necessary at a local practice.

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Medical notice: Not a substitute for an in-person medical examination. The information on this page is intended for general guidance only. In an emergency, please call 112.

Frequently Asked Questions

Can I get a follow-up prescription for my blood pressure medication via video consultation?

If your blood pressure is already well controlled and you know your current medication, a video consultation is well suited for this. The doctor will discuss your home readings and how well you tolerate your medication. Following the doctor's assessment, a private prescription for your existing medication can then be issued. There is no entitlement to a specific prescription – the decision always rests with the treating doctor.

How do I measure my blood pressure correctly at home?

Measure after about five minutes of rest while seated, with your arm supported at heart level and a properly fitting cuff. Measurements in the morning and evening over at least three to seven days before the appointment are recommended; record all values with date and time. If possible, use a validated upper-arm device and have your measurement log ready during the video consultation.

What does a video consultation for high blood pressure cost?

Billing is a private medical service based on the German medical fee schedule (GOÄ). Privately insured patients can usually submit the invoice to their private health insurer; reimbursement depends on the individual tariff. Self-paying patients receive a transparent GOÄ invoice. You can see the expected costs before booking.

Can blood pressure therapy be started for the first time via video?

Initial diagnosis and initial titration of medication generally require in-person examinations, such as 24-hour blood pressure monitoring, blood and urine tests and an ECG. The video consultation is primarily suited to follow-up care and repeat prescriptions for therapy that is already established. If elevated readings appear for the first time, the doctor can advise you and refer you to a suitable local practice.

What should I do if my blood pressure readings are suddenly very high?

Repeat the measurement after a few minutes of rest while seated. If the readings remain very high (around 180/120 mmHg or above) and are accompanied by symptoms such as chest pain, shortness of breath, paralysis, speech or vision problems, call the emergency number 112 immediately. Without symptoms, seek medical advice the same day rather than changing your medication dose on your own.