What is high blood pressure (HBP)?
Hypertension is a disease that is characterized mainly by the increase in blood pressure. It usually does not cause symptoms for a long time (until a vital organ is damaged) and increases its appearance in people with unhealthy lifestyle habits.
Research has revealed that approximately 30% of people suffering from this disease are unaware that they are hypertensive, and only about 50% receive adequate treatment.
When is high blood pressure?
It is defined that the blood pressure is high when it has a maintained level, equal to or greater than 140/90 mmHg (the highest value is the systolic pressure and the lowest is the diastolic), taken in adequate conditions at least three times in different days
BP is measured in millimeters of mercury (mmHg)
Here is a table where you can identify the range of hypertension and what your normal blood pressure level should be:
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What should you do if you have high blood pressure?
If you suffer from this disease, it is best to:
- Exercise often.
- Eat foods with low salt content.
- Eat a healthy diet that is low in saturated fat and trans-fat, and rich in fruits, vegetables, whole grains, and low-fat dairy products.
- Lose or maintain a healthy weight.
- Do not smoke.
- Drink alcohol in moderation.
- Check your blood pressure frequently.
- Consult your doctor regularly.
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Types and causes of hypertension:
– Primary hypertension:
In most people with high blood pressure, no cause can be determined, this is called primary hypertension. Approximately 95% of patients with hypertension have primary hypertension.
Although this type of blood pressure does not have a certain cause, certain factors have been found that may influence the condition of this disease:
- Genetics (Heredity): It has been found that people whose parents are hypertensive, have a much higher probability of getting to suffer from this disease than another person whose parents are not hypertensive.
- Age: As the age of a person increases, the risk of suffering it increases.
- Race: Black people are twice as likely to suffer from hypertension as white people, and the consequences of this disease are more serious in the black race.
- Overweight: People who are overweight are more likely to suffer from this disease than people with normal weight.
– Secondary hypertension:
This type of hypertension is characterized by being caused due to another disease or as a side effect of some medication. In these cases, HBP does not usually respond to treatment with the usual medications for hypertension or dietary treatments, managing to control it only when treating the disease that is causing it or withdraw the drug causing it.
There is a large number of diseases that can cause hypertension. Kidney diseases, in general terms, can lead to high blood pressure, both chronic infectious-inflammatory (pyelonephritis, glomerulonephritis) and tumor (polycystosis) or obstructive (hydronephrosis).
There are also many endocrine diseases capable of lead to hypertension, such as those that affect the adrenal glands due to hyperfunction (hyperaldosteronism, Cushing’s syndrome, pheochromocytoma) and those of the thyroid (hyperthyroidism). Among the neurological diseases, there is intracranial hypertension; and among the vascular ones, the coarctation of the aorta (narrowing of the aortic lumen).
On the other hand, some situations are prone to the appearance of hypertension; among them, pregnancy stands out for its importance due to the consequences that can have on the mother and the fetus.
Some commonly used drugs, such as anti-inflammatories, can trigger hypertensive episodes or decompensate hypertension already controlled with treatment. Therefore, when treatments are given with these drugs (contraceptives, oral corticosteroids, etc.) blood pressure should be checked frequently.
Certain toxins and drugs of frequent consumption in certain environments (discos, parties), such as cocaine, “night club pills” or alcohol, can also lead to episodes of hypertension.
HBP contributes 12.7% of total mortality and 4.4% of disability in the world.
Primary hypertension, in the first years, usually does not give any symptoms. Because most people do not notice any symptoms, they may have heart disease and kidney problems without knowing they have high blood pressure.
Also on certain occasions in young people, there may be palpitations and some degree of fatigue or shortness of breath. Sometimes headaches associated with hypertension, usually morning and occipital, lasting two or three hours, usually occur. However, if you have any of these symptoms, it is best to have the blood pressure measured correctly or the exams necessary to verify if you suffer from hypertension or not.
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The measurement of blood pressure is very important, because with the values obtained a person is diagnosed or not as hypertensive, that is why it is so important to correctly measure blood pressure and requires knowing the technique used, the device and the method to measure it.
Diagnosing hypertension is much more than obtaining blood pressure values, since it is necessary to determine whether it is primary or secondary; if it is mild, moderate or severe; and the grade, according to the possible injuries caused. Then you have to follow an appropriate treatment, for who the indicated will be the doctor.
Although the majority of hypertensive patients suffer from primary hypertension, it must be borne in mind that, on some occasions, there may be a curable cause of HBP (for secondary hypertension).
Once the correct measurements are obtained, if they are elevated and the patient is diagnosed with hypertension, a series of tests must be done to see the degree of repercussion in the most sensitive and most important organs due to the rise in blood pressure. These are the so-called “target organs”, which are: the heart, the brain, the kidneys, and the eyes (also the arteries).
Most of these tests can be done in a health center, such as a blood and urine test, which inform us of renal function, parathyroid thyroid, the existence or not of other risk factors, such as diabetes, hypercholesterolemia and hepatic involvement due to alcohol.
The treatment is fundamentally based on changes in lifestyle, diet, physical exercise, and pharmacological treatment.
– Change your diet:
- The restriction in the salt intake reduces the blood pressure, however, it can be reduced more in some people than in others.
- The Mediterranean diet is rich in fruits, vegetables, legumes and skimmed milk and low in saturated fats, which makes it highly recommended.
- Reduce alcohol consumption, since it is shown that BP increases; Consumption should be limited to no more than 30 grams of alcohol per day in men and 15 grams per day in women (approximately 1 drink per day for women and 2 for men).
- Weight reduction: the reduction of 10 Kg lowers the BP approximately 10 mm Hg. A normal weight should be maintained, that is, a BMI (body mass index) between 18.5 – 24.9.
- Tobacco is an important cardiovascular risk factor and should be abandoned. If necessary with substitution treatment with Nicotine (patches, gum) or even with medicines.
- Drink a lot of water
- The DASH diet (Dietary Apaches to Stop Hypertension) is a diet rich in fruits, vegetables and skimmed milk products, with a low content of saturated and total fats. This diet is very similar to the Mediterranean diet, rich in fruits, vegetables and legumes, more fish than meat and eating foods rich in polyunsaturated fats such as olive oil.
– Reduce stress
- Try to avoid factors that cause you stress and try medication or yoga to release it.
– Do exercise:
Physical exercise is cardio-healthy. Regular aerobic activity, such as fast walking at least 30 minutes a day, most days of the week, can reduce BP by 4-9 mmHg.
Isometric exercise, such as lifting weights, can have negative effects.
It is recommended to control the blood pressure before exercising and make sure you do not have any heart disease.
If after three to twelve months the BP is not normalized, pharmacological treatment would be given.
Usually you start with only one drug. In case of severe HBP, target organ damage or the existence of other risk factors that lead to a high risk, it would start with two or more drugs from the beginning.
The doctor will determine the most effective medication according to the case, considering factors such as age, the existence of other pathologies, cardiovascular risks, possible side effects of the medication, etc.
Some of the most commonly used drugs are diuretics, beta-blockers, ACE inhibitors, calcium channel blockers and ARA II, and other second-line drugs, which are direct vasodilators and centrally acting sympatholytics.