Browse categories

Hypertension The Silent Killer

Hypertension: the silent killer!

What is blood pressure?

It is the force with which blood circulates within artery walls. So-called normal blood pressure is necessary for blood to reach its destination in the body. The blood pressure value varies throughout the day.

What values ​​of hypertension are considered good?

Blood pressure categories:

  • Low risk: 120/80 mm Hg
  • Medium risk: 121-139 / 80 - 89 mm Hg (Normotension)
  • High risk: 140 + / 90 mm Hg

There are some exceptions to these categories: for example, for people with diabetes, high risk values ​​are considered when blood pressure is above 130/80. For those over 80 years of age, systolic blood pressure should generally be less than 150.

To assess blood pressure, a sphygmomanometer is used

What are the “maximum” and “minimum”?

The two measured values ​​refer to: 
systolic pressure (usually called “maximum”): it appears first and measures the force with which the heart contracts and “expels” the blood from inside.
Diastolic pressure (usually called “minimal”): it is the second value and refers to the measurement of pressure when the heart relaxes between each beat.

When does high blood pressure occur?

Arterial hypertension occurs when the heart tries harder to pump blood, thus exceeding normal blood pressure values.

One way to understand what happens is to imagine that our body's arteries are flexible hoses. In a healthy state: blood circulates in them easily, finding no obstacle along the path that goes to the cells. In an unhealthy state what happens? If due to various factors, such as atherosclerosis, the blood flowing in the “hoses” is under pressure, the heart has to do more to circulate the blood. In these cases, the effort can cause the muscle mass of the heart to increase, causing the volume of the heart to become larger - the so-called hypertrophy.
In the first phase, the cardiac muscle increase is not a problem. However, over time, this hypertrophy can lead to heart failure, angina pectoris or arrhythmia.

Today, hypertension is the leading cause of death in the world, as it can favor a number of other diseases

How and when to measure blood pressure at home, correctly?

In order to provide your doctor with correct information and to make sure that the values ​​obtained by you are correct and reliable, you should pay attention to the following aspects, before and during blood pressure measurement (

The measurement should be done in the morning and at night.

  • 3 readings should be taken with an interval of 1 minute between them.
  • The weekly average of all readings corresponds to the person's blood pressure at home.
  • If you consider the result to be too high, repeat the assessment at least two more times, on separate days and check that it remains.
  • Prepare your measurement 5 minutes before: sit quietly with your feet flat on the floor and your back against a firm surface.
  • Always use the same arm, stripping tight or thick clothing.
  • Place the cuff 3 cm above the elbow on the skin (two fingers should fit between it and the arm).
  • Place your arm on a firm surface, such as a table, keeping the cuff at heart level.
  • Do not smoke or consume caffeine (coffee, tea, cola and some sports drinks) in the previous 30 minutes.
  • Do not take the measurement when you are upset or in pain.
  • The values ​​can be changed if you talk or watch TV during the measurement.
  • Record the values ​​in an organized way.
  • Take the records for appointments to show the doctor.

Prehypertension: what does it mean?

Blood pressure values ​​slightly above normal are an alert to the increased risk of hypertension. Blood pressure between 120/80 and 139/89 mmHg is considered to be prehypertension, a concept generally associated with the evolution of blood pressure with age. This is a term adopted in the United States (Joint National Commitee) and Europe (Sociedad Europea de Hipertensión), but which, as Mário Espiga Macedo warns, “is in disuse”.

Is your blood pressure above normal for the first time? And now?
A single measurement is not enough to diagnose high blood pressure, reinforces the specialist at Hospital Lusíadas Porto. After a first analysis, your blood pressure should be checked over the next few weeks. If hypertension is confirmed, follow your doctor's instructions and implement changes in your lifestyle.

What factors favor high blood pressure?

  • heredity
  • sedentary lifestyle
  • overwork
  • obesity
  • smoking
  • diabetes 
  • hypercholesterolemia (high cholesterol)

Treatment for hypertension / prevention

  • A more hygienic life that includes greater physical activity and smoking cessation.
  • Excess weight loss.
  • The decrease in salt consumption.
  • Avoid excessive alcohol consumption.
  • Maintain normal body mass index.
  • These earlier lifestyle changes are often sufficient. Otherwise, several families of antihypertensive drugs are available. In the pharmaceutical world, there are 7 main classes of antihypertensive drugs and several drugs in each class, several combinations of drugs are possible to manage the treatment of hypertension.

What consequences can uncontrolled high blood pressure have?

Hypertension is recognized as one of the situations that rarely manifest itself by symptoms and whose sequels can take years, or even decades to be recognized. in the very long term, in certain cases, it may arise:

  • heart
  • failure kidney failure
  • retinal injury
  • brain hemorrhage (stroke). It contributes to a person's Global Cardiovascular Risk, a concept that reflects the risk of suffering a stroke throughout life, as a consequence of the presence of several risk factors.

Non-adherence to treatment for hypertension. Why?

Another reason for non-adherence is the fact that patients think they do not need treatment because hypotension is rarely symptomatic. In addition, patients may think that the medication they take will have no effect because they have no symptoms when they start it. Solution? Monitoring blood pressure at home ( or self-monitoring of blood pressure is one of the tools to improve adherence, possibly because it allows the immediate return of information to patients on how the blood pressure blood pressure is being controlled.

Why do blood pressure values ​​measured by healthcare professionals sometimes change?

Sometimes, the values ​​that your doctor obtains do not fully reflect the reality of your daily life.
Patients who take blood pressure measurements at home can avoid many difficulties in monitoring blood pressure at the doctor's appointment, including poor measurement techniques and masked hypertension. Patients can also avoid reverse white coat hypertension, which happens very often when measured in the office or in front of a professional, although it is high outside the office.

In which people is blood pressure higher?

Arterial hypertension and target organ damage caused by hypertension are more prevalent and more severe in certain minority populations, namely in African-Americans. These studies carried out in the United States can be generalized to the black population in general. The prevalence of hypertension in African Americans is among the highest in the world. Compared with Caucasians, African-Americans develop hypertension earlier, have higher mean arterial pressure and have higher rates of grade 3 arterial hypertension (Severe arterial hypertension: with systolic pressure> 180 and diastolic pressure> 110 mmHg) .

As a result of this earlier onset, the higher prevalence of arterial hypertension and the rate of grade 3 hypertension, African-Americans have a higher burden of complications and higher mortality rates, than in the general population, due to stroke (80 higher%) and for heart disease (50% higher). In addition, rates of end-stage renal disease due to hypertension are up to 320% higher.

This higher incidence of hypertension-related morbidity and mortality is due to the fact that there is not only a genetic predisposition, but also because African Americans often only start treatment when blood pressure is already very high, and even when it is already high. there is damage to the target organ.

Thus, diagnosis and treatment among African Americans should begin earlier, if possible as early as 12 years of age. In fact, a study by John Hopkins University found that black children are more likely than those of any other race to have high blood pressure and left ventricular hypertrophy (a dangerous thickening of the heart muscle). In addition, black adolescents not only have higher blood pressure, but also tend to keep it in the dangerously hypertensive range for longer periods.

In spite of this, the evidence indicates that if African-Americans receive adequate treatment and comply with it correctly and persistently, they will be able to achieve and maintain global reductions in blood pressure similar to those of Caucasians.

Based in: Postgraduate Medicine, April 2013