High blood pressure
In April 1945, U.S. President Franklin Delano Roosevelt said, "I feel a terrible pain in the back of my head..." and then, he collapsed to the floor. His blood pressure was 300/190 mm Hg, and as a result, he suffered a cerebral hemorrhage.
In those days, health specialists did not give hypertension its due importance. However, the sudden death of the American president favored the approval of a study - carried out in the city of Framingham, located in northern Massachusetts - designed to understand the "epidemiology" of cardiovascular diseases. The Framingham Study was a milestone in medical history, and the concept of "risk factor" was born.
High blood pressure (arterial hypertension) is one of the most relevant health problems nowadays. It is both a disease and a risk factor for other conditions, mainly cardiovascular, by exerting its effect on the so-called "target organs": the heart, the brain, and the kidney. Arterial hypertension is the most prevalent cardiovascular risk factor today, easily identifiable. It has been related, among others, to the development of myocardial infarction, heart failure, stroke, aortic dissection, atrial fibrillation, and peripheral artery disease.
How can I know if I am hypertensive?
The most widespread definition of arterial hypertension uses blood pressure values equal to or higher than 140/90 mmHg in the office measurement. Your physician may also use other classifications according to different criteria, either by blood pressure numbers, etiology (primary or secondary), or specific subtypes (white coat, masked).
Can I measure my blood pressure at home or the pharmacy?
Yes, but you must remember that blood pressure may vary throughout the day and between different days.
There are three scenarios or ways to measure blood pressure:
● The in-office measurement by health care personnel.
● Self-determination by the patient at home.
● Ambulatory blood pressure monitoring (ABPM) over 24 hours.
To correctly measure your blood pressure at home, follow a few simple steps:
-
Choose a quiet place that is not too hot or too cold.
-
Wear comfortable clothing that does not constrict the arm.
-
If you have arrived from the street, rest for at least 5 minutes.
-
You should not have taken stimulants such as coffee or alcohol before.
-
You should rest your arm at the level of your heart
-
Remain still and do not talk while you are taking the test.
-
If you can choose the device, avoid wrist devices and preferably use arm devices.
-
Take your blood pressure three times. Allow a 3 minutes window between each measurement. The second and third measurements are valid, as the first one is always higher.
-
The best times to measure your blood pressure are when you get up in the morning or before dinner.
.png)
What are the causes of high blood pressure?
Sometimes high blood pressure is linked to problems in the kidneys' arteries, endocrine disorders, or sleep apnea. This type of arterial hypertension is called "secondary."
In most patients, there isn't a single cause. Instead, several factors may contribute to its appearance, which we call "essential" or "primary" arterial hypertension. Many of these risk factors depend on you and your lifestyle. Here are some of them:
Sedentary lifestyle
Obesity
Alcohol consumption
Age
Smoking
Being stressed or anxious
Eating poorly and with too much salt
Family history
How do I know if I am hypertensive? What symptoms does it cause?
Most patients with high blood pressure are asymptomatic, which is the most significant risk. Doctors usually meet the patients when there are already lesions in the target organs (heart, brain, and kidney). That is why it is so important to take your blood pressure regularly.
How is it treated?
The objective of the treatment of arterial hypertension is to maintain blood pressure levels below 140/90. But you should know that these levels may vary depending on the pathology or characteristics of the patient. For example, in elderly patients, excessively lowering blood pressure sometimes cause symptoms such as dizziness. Also, in diabetic patients with ischemic heart disease, lower figures are desirable.
There are two pillars in high blood pressure treatment: pharmacological treatment (pills to stabilize the pressure) and non-pharmacological treatment. The latter is just as important, if not more so, as it can even prevent medication initiation. Here are some examples:
-
Quit smoking: although there are no conclusive studies on the effects of smoking on blood pressure, patients are encouraged to give up smoking, as it is a very potent concomitant cardiovascular risk factor.
-
Moderate alcohol consumption: excessive alcohol consumption is linked to high blood pressure and cardiovascular and liver disease.
-
Restrict sodium ingestion: the recommendation is that dietary sodium intake should be less than 5 g/day of sodium chloride.
-
Lose weight: there is a clear relationship between overweight and obesity and the presence of arterial hypertension.
-
Reduce stress' triggers: avoid situations that provoke tension and try to practice relaxation techniques.
-
Physical activity: aerobic activity is recommended for at least 30 minutes a day, five days a week. It can be walking, climbing stairs, actively doing household chores, shopping, cycling ...