Prevention of arterial hypertension

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Transcription Prevention of arterial hypertension

Arterial hypertension is the main cause of consultation to primary care medical services in all parts of the world, and it is estimated that about one third of the world's adult population suffers from it. It is both a disease in itself and a risk factor for a significant proportion of cardiovascular diseases, such as coronary heart disease, cerebrovascular disease, heart failure, renal failure, and peripheral vascular disease, among others.

The results of the "national health survey Spain 2017", from the ministry of health, consumption and social welfare, show the increase of arterial hypertension within the Spanish population between the years 1993 (when hypertensives were 11% of the total population) and the year 2017, when 19.8% of the total number of Spaniards were hypertensive, a considerably higher figure.

This increase in the number of sufferers is associated with changes in lifestyle, especially changes in eating habits and reduced levels of physical activity in the population.

Basic concepts

Blood pressure: blood pressure is the force exerted by the blood driven by the heart on the walls of the arteries. Blood pressure values are expressed in millimeters of mercury (mmhg). Blood pressure varies during the cardiac cycle, with two extreme values:

Systolic blood pressure (the high one): occurs when the maximum pressure value is reached in the arteries, during ventricular contraction (systole). In this phase the aorta and other large arteries distend with the surge of blood, dampening their pressure and storing the blood in their distended zone, to return it to circulation during ventricular relaxation.

Diastolic blood pressure (the low one): occurs during ventricular relaxation, when the minimum value of pressure in the arteries is reached. In this phase, although the heart does not expel blood, blood circulation is maintained, since the blood contained in the distended area of the aorta and other large arteries, when contracting, circulates towards the small arteries, vessels and capillaries carrying oxygen and nutrients to all tissues.

Normal variations in blood pressure

Blood pressure is a variable parameter, so the occurrence of the following variations, as long as they are moderate, are normal:

Variations throughout the day due to the influx of emotional stimuli or the performance of physical or mental exertion. Thus blood pressure is usually slightly higher during working hours, lower at rest and even lower during deep sleep.

Throughout life, systolic (high) blood pressure levels increase, but diastolic (low) blood pressure levels increase only up to the age of 55-60 years, after which they may even decrease.

Often in young healthy women, blood pressure levels are low and they may even feel tired; however, these values increase as the years go by and may equal or be higher than those of the male sex after menopause.

Measurements taken in front of a health professional in hospitals, doctors' offices or pharmacies are usually higher than those taken in the peace and quiet of the home, by the family or the person him/herself, a phenomenon known as the white coat effect.

Normal blood pressure and hypertension

Blood pressure readings are expressed as two numbers; the first or upper number expresses the systolic (high) blood pressure and the second or lower number expresses the diastolic (low) blood pressure. For example: 120/80 mmhg; 120 is read as 80 millimeters of mercury:

Optimal blood pressure: it is considered when figures below 120/80 mmhg are persistently obtained.

Normal blood pressure: it is considered when figures between 120/80 and 129/85 mmhg are persistently obtained.

Arterial hypertension (AHT): it is considered when figures equal to or higher than 140/90 mmhg are persistently obtained.

Risk factors for hypertension

Non-modifiable risk factors:

Age: the risks of arterial hypertension increase due to the effect of aging of organs and systems with the passage of time. It is estimated that the percentage of people over 60 years of age who suffer from arterial hypertension in the world is 60%.

Family heredity: individuals with one or both parents with hypertension are at a higher risk of suffering from arterial hypertension.

Sex: males have a higher risk of suffering arterial hypertension than females at younger ages. After 45 years of age, with the arrival of women in the postmenopausal phase, the risks are equalized.

People of African descent: a higher incidence of cases of arterial hypertension has been verified in black-skinned individuals.

Modifiable risk factors:

Overweight and obesity: people who suffer from obesity or are overweight are at a higher risk of arterial hypertension than thin people. It has been shown that in obese people with hypertension, weight loss is accompanied by a decrease in blood pressure levels.

Ingestion of alcoholic beverages: alcohol consumption raises blood pressure. Individuals who frequently drink large amounts of alcoholic beverages are at increased risk of hypertension; however, moderate consumption of wine during meals is associated with increased levels of high-density lipoproteins (good cholesterol) in the blood, which would reduce the risk of hypertension.

Smoking: smokers are at a higher risk of arterial hypertension; likewise, hypertensive patients who consume large quantities of cigarettes suffer more frequently from malignant hypertension, a disorder that causes very high blood pressure levels and serious cardiovascular complications.

Caffeine consumption: caffeine intake in the form of coffee, tea or cola can cause significant increases in blood pressure.

Diet: people who include the following foods in their diet, without due restrictions, are at greater risk of suffering arterial hypertension:

Foods made with a lot of salt and/or saturated fats, such as sauces or fried foods.

Sausages, smoked meats, salted meats, offal and red meat.

Precooked foods, such as broths and envelope soups.

Canned foods.

Fatty dairy products.

Margarines, pastries, sweets and carbonated soft drinks.

Salted dried fruits and nuts.

Alcoholic beverages.

Sedentary lifestyle: people with very low levels of physical activity are at greater risk of suffering arterial hypertension. Regular exercise increases the levels of high-density lipoproteins (good cholesterol) in the blood and reduces low-density lipoproteins (bad cholesterol), which favors the reduction of blood pressure levels. It is estimated that dynamic exercise, such as brisk walking, stair climbing, jogging, swimming or cycling, when performed regularly, can reduce blood pressure levels by 5 to 7 mmhg in hypertensives and by 2 to 3 mmhg in healthy people.

Personality: during the anger or tantrums that people with an aggressive, hostile or compulsive personality suffer, blood pressure levels increase; if the anger occurs frequently, the risk of suffering arterial hypertension increases.

Stress: Prolonged exposure of people to the effects of stress causes the same consequences as the aggressive personality, thus increasing the risk of high blood pressure.