High blood pressure is one of the most common conditions in Germany. The risk increases with age, and men are affected slightly more often than women. Obesity, an unhealthy diet, lack of exercise and other factors favour an abnormal rise in blood pressure. A genetic predisposition can also play a role, especially if several members of a family are affected or if none of the typical triggers apply.
Whatever the cause, high blood pressure should be treated, because it usually causes no symptoms for years while damaging the heart, blood vessels, kidneys and brain. Treatment combines a healthier lifestyle with medication where needed. Many people take one or more blood pressure drugs every day for the rest of their lives. This article explains how hypertension develops, how it is diagnosed and treated, and what to consider when obtaining medication, including from mail-order pharmacies.
This is how high blood pressure develops
Doctors distinguish between primary and secondary hypertension. Secondary hypertension is the result of another condition, such as kidney disease, narrowed blood vessels or hormonal disorders. Metabolic diseases such as diabetes or lipid disorders are closely linked to high blood pressure and increase the risk of complications.
Primary or essential hypertension is far more common. There is no single cause; usually a genetic predisposition combines with one or more of the following factors:
- Obesity
- Sedentary lifestyle
- Regular alcohol consumption
- Too much salt
- Chronic stress
- Smoking
- Side effects of certain drugs, for example some painkillers or hormonal contraceptives
With high blood pressure, the pressure in the arteries is permanently too high. The heart has to pump against this resistance and is constantly overloaded, which over time can lead to heart failure, heart attacks and strokes. The vessel walls also suffer: high pressure promotes deposits of fat and calcium (arteriosclerosis), which narrow the arteries and increase the resistance even further.
That is why it is important to bring blood pressure into the target range agreed with your doctor. Lifestyle changes help in every case; medication is added when they are not enough or when the risk is high. Do not stop or change your medication on your own, and only obtain prescription drugs from legitimate pharmacies.
This is how the diagnosis of hypertension is made
Most people with high blood pressure feel nothing at all, which is why it is often called a silent condition. It is frequently discovered by chance during a routine check-up. In Germany, people with statutory health insurance are entitled to a health check-up, which includes a blood pressure measurement.
Regular measurement is the only reliable way to detect high blood pressure. Some people notice unspecific signs, but these are not a reliable warning. Possible signs include:
- Headaches, especially in the morning
- Dizziness or ringing in the ears
- Fatigue, poor sleep and poor concentration
- Nosebleeds
- Shortness of breath during exertion
This is how hypertension treatment works
If your blood pressure is elevated, your doctor will usually confirm it with repeated measurements, a 24-hour measurement or home measurements with your own monitor. Severe chest pain, shortness of breath, sudden severe headache, visual disturbances or signs of paralysis together with very high blood pressure are an emergency: call 112 immediately. Depending on your values and risk factors, the doctor will recommend lifestyle changes and, where needed, medication. A combination of two drugs, often in a single tablet, is common.
Common blood pressure medication in Germany
Frequently prescribed groups are ACE inhibitors such as ramipril or lisinopril, sartans (angiotensin receptor blockers) such as candesartan, calcium channel blockers such as amlodipine and thiazide-type diuretics. Which drug or combination is right for you depends on your values, other illnesses and side effects, and is decided by your doctor.
Anyone who takes these medicines every day needs a reliable supply. Since 1 January 2024, prescriptions in Germany have been issued as electronic prescriptions (e-Rezept). Repeat prescriptions can often be requested from your practice without an extra visit. You can redeem the e-prescription with your health insurance card at a local pharmacy, or via app or printout at a mail-order pharmacy. If a medicine is not in stock, local pharmacies can usually order it within a day.
Some patients prefer to order their regular medication online. Mail-order pharmacies based in other EU or EEA countries, such as the Netherlands, may supply prescription medicines to customers in Germany if they are licensed and meet comparable safety standards (§ 73 of the German Medicines Act, AMG). Since Brexit on 1 January 2021, the United Kingdom is no longer part of the EU or EEA, so ordering prescription drugs from English mail-order pharmacies is no longer covered by this rule.
There is little money to be saved for most patients: people with statutory health insurance pay only the statutory co-payment for prescription drugs, which until 31 December 2026 is 10 percent of the price, at least 5 euros and at most 10 euros per pack. From 1 January 2027, it rises to at least 7.50 euros and at most 15 euros. Always use a valid prescription, check that an online pharmacy is officially registered, and be wary of websites that offer prescription drugs without a prescription, as counterfeit medicines are a real risk.
Lifestyle in hypertension
Medication works best together with a healthy lifestyle, and in mild cases lifestyle changes alone can be enough. A balanced diet with plenty of vegetables, fruit and whole grains and little salt, sugar and processed food lowers blood pressure. Regular exercise helps too: swimming, cycling or walking are well suited, especially for people who are overweight. Losing excess weight, quitting smoking and drinking little or no alcohol make a measurable difference. With the right treatment and a healthy lifestyle, most people can bring their blood pressure under control. Check your values regularly and attend follow-up appointments with your doctor.
As of October 2026. This article is for general information only and does not replace medical advice.
