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25 Dec 2020

Arterial hypertension: symptoms, risk factors, complications, treatment and prevention

Arterial hypertension: symptoms, risk factors, complications, treatment and prevention Arterial hypertension: symptoms, risk factors, complications, treatment and prevention

Arterial hypertension is a common disease in people aged 50 and older. It can be present without any noticeable symptoms and be diagnosed with monitoring of blood pressure at home. If the disease is left untreated, it is fraught with myocardial infarction (heart attack) and other heart diseases that can cause sudden death.

Short information about hypertension

Symptoms None, headache, fatigability, general weakness, dizziness
Complications Coronary artery disease, stroke, heart failure, peripheral arterial disease, vision loss, chronic kidney disease, dementia
Causes Usually lifestyle and genetic factors
Risk factors Excess salt, excess body weight, smoking, regular alcohol consumption, sedentary lifestyle, diet rich in carbohydrates and fats
Diagnostic method Resting blood pressure measuring/monitoring
Treatment Lifestyle changes, medications
Frequency 16–37% globally
Deaths 9.4 million/18% (2010)

What do you need to know and most importantly do to feel good?

Know what hypertension is and how to control it.

Hypertension is usually understood as a persistent rise in blood tension up to 140/90 mm Hg and higher when not taking drugs that lower blood pressure. It should be recorded at least twice with an interval of two weeks. There are three degrees/severities of hypertension.

Systolic blood pressure, mm Hg
Diastolic blood pressure, mm Hg
< 130
< 85
Increased normal
Hypertension I degree II degree III degree
180 and higher
110 and higher
Isolated systolic hypertension
> 160
< 90

However, in addition to the degree/severity of hypertension, the doctor should also inform the patient and include in the medical record the degree of risk of cardiovascular complications development (myocardial infarction, cerebral stroke, etc.). There are four levels of risk: low, medium, high, and very high.

Low risk means that in the following ten years the likelihood of developing cardiovascular complications is less than 15%, and if very high, more than 30%. In other words, out of 100 hypertensive individuals with a low risk of heart diseases, no more than 15 within 10 years will be admitted to the hospital with these complications, and among people with a very high risk, more than a third of patients will suffer cardiovascular accidents. In order to correctly identify the risks associated with hypertension, it is crucial to undergo an examination that helps to clarify the disorders of carbohydrate and fat metabolism, damage to target organs (blood vessels, heart, kidneys, and brain).

blood pressure diagnosis and treatment

It is important to know that the awareness of each patient about their own risk factors is necessary not only to determine the prognosis and grief about their fate. Remember that by knowing the harm to the body of certain risk factors, they can be influenced. You yourself can change the prognosis of your illness and, consequently, life for the better. Many people know the sad epithet that hypertension has received - “the silent killer”. But it is better to remember another thesis - hypertension is a controllable risk factor for heart diseases. This means that any individual with elevated blood pressure, together with a doctor, is able to manage their illness.

Non-drug treatments, or, more precisely, lifestyle modification, is indicated for all individuals with hypertension, regardless of its degree and received treatment.

A healthy lifestyle can help diminish arterial pressure and reduce the amount of medication. But very often compliance with health recommendations requires the patient to reconsider and overcome the usual daily routine, to show willpower.

First, you need to force yourself to give up bad habits and a sedentary lifestyle. First of all, quit smoking. Why is smoking dangerous? Because even one cigarette raises the pressure for 15 minutes, with constant smoking, the vascular tone rises, and the effectiveness of medications decreases. If a person smokes 5 cigarettes a day, this is a 40% rise in the risk of death, if one pack a day - 400%, that is, the chances of dying of heart disease are 10 times higher!

blood pressure diet

A balanced diet is a balanced, regular (at least 4 times a day) nutrition with limited salt intake. Salt is harmful not only for hypertensive patients but also for patients with other cardiovascular diseases. Research has shown that limiting salt intake can reduce the risk of myocardial infarction and other heart catastrophes by 25%. No more than 5 grams of table salt (a teaspoon without top) - this is the daily dose of hypertensive patients. When choosing semi-finished products, keep in mind that they contain hidden salt. For  instance, a sausage contains 10 times more salt than natural meat. It is very useful to increase the consumption of foods containing potassium and magnesium (seaweed, raisins, beets, apricots, zucchini, pumpkin, buckwheat). And it is important to control your weight. To estimate your optimal weight, use a simple BMI formula (weight (kg)/height (m2) = body mass index). If the body mass index is more than 28 in women and 30 in men, obesity is diagnosed. It is with the obesity epidemic, which has hit many countries, that scientists associate a rise in the number of individuals with high blood pressure.

Regular exercise is very important for both fighting obesity and lowering blood pressure. Even moderate but regular exercise can help diminish arterial pressure by 10-15 mm Hg. Brisk walking in the fresh air, cycling, swimming for 30-40 minutes 6-7 times a week are the most physiological types of physical activity for individuals with elevated arterial tension. Isometric loads such as barbell exercises are not recommended.

Before doing physical training, you need to consult a doctor, and even better, start working with a physical therapy specialist.
Doctors today call non-drug methods of treating hypertension as lifestyle modification, because only a change in lifestyle, and not short-term dietary measures and occasional physical activity, will really help lower blood pressure. Remember also to include in healthy activities your kids and grand children, as a healthy lifestyle must be taught already in childhood and adolescence when the foundations of human behavior and lifestyle are laid. After all, it is no secret that the hereditary factor is of great importance in the onset of hypertension, and in children, a raise in blood pressure can begin 10-12 years earlier than in their parents, if you do not take measures for a healthy lifestyle.

To what level should blood pressure be lowered?

After large clinical studies, in which several tens of thousands of individuals were observed and received drugs, scientists have determined target blood pressure levels to be aimed at in the therapy of hypertension. Target blood tension levels are those blood pressure values at which the risk of complications, including fatal ones, will be minimal. The target blood pressure level greatly depends on the comorbidities. For patients with hypertension, the optimal pressure is below 140/90 mm Hg. If hypertension is combined with diabetes mellitus, it should be below 130/85 mm Hg. Of course, for the majority of hypertensive patients, it is necessary to constantly take antihypertensive drugs to achieve such levels of blood pressure.

The following medications are used for the management of arterial pressure:

blood pressure drugs

- Angiotensin-converting enzyme inhibitors (like Lotensin or its analogs based on Benazepril that is used for high blood pressure, heart failure, and diabetic kidney disease);
-  Diuretics (for instance, Indapamide),
- Calcium channel blockers (Amlodipine and others),
- Beta-receptor blockers (Metoprolol and others),
- Angiotensin II receptor blockers (Candesartan and others).

Worth noting that effective blood pressure management is rarely possible with just one medication. Most patients should receive 2-3 medications for optimal blood tension management. You can buy different blood pressure medications without a prescription at our online drugstore but make sure to consult your doctor first.

For the convenience of treatment, many combination medicines are now offered, which contain two substances with different principles of action. The optimal medication or medication combinations are those that act smoothly throughout the day, have a protective effect against target organs, do not worsen the carbohydrate and lipid profile, and also do not reduce the efficiency and quality of life of patients.  It is only necessary to remember that every individual with hypertension has their own optimal pill and only a doctor can correctly prescribe it. Therefore, dispensary observation of the patient is so important.

During the selection of the dose of the antihypertensive medication, at least monthly visits to the doctor are recommended. It is very good if the patient keeps a diary of self-monitoring of blood pressure, measuring it twice in the morning and twice in the evening. The average results of these measurements must be recorded in a diary and shown to the doctor at the visit. When the target arterial pressure level is reached, the doctor can be visited no more than once a quarter/six months. It is imperative to conduct a control examination of target organs once a year, because modern drugs can not only lower blood pressure, but also reduce the thickness of the walls of the left ventricle of the heart, increase the elasticity of blood vessels, and prevent the development of renal and heart failure.
And remember, when choosing a medicine, you and the doctor are allies, not opponents. The effectiveness of treatment largely depends on the patient, his or her adherence to the prescribed treatment, since it must be long-term, often lifelong.

Post by: John Avery, General Practitioner, Manchester, United Kingdom

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