The general strategy against hypertension
The goal of treatment
The goal of treatment is to prevent complications of hypertension (myocardial infarction, stroke, etc.)..
Several classes of antihypertensive drugs are effective in this case, but be aware that no treatment is able to completely eliminate the risk of heart attack or stroke. Prevention of complications depends largely on the ability of antihypertensive drugs to lower blood pressure.
These drugs are usually reducing the maximum pressure (systolic) of about 1 cmHg compared to a placebo (fake drug ). In other words, if the pressure is stable maximum of 1 7 cmHg, the drug will reduce the pressure to 16 cmHg.
It is often necessary to combine several types of drugs to normalize blood pressure.
In most cases, treatment lowers blood pressure, but it does not cure hypertension.
Blood pressure under treatment should ideally be less than 14 / 9 cmHg. However, in people who suffer from kidney insufficiency or diabetes,the goal to reach is more stringent .
In elderly and people who do not present high risk of cardiovascular complications (absence of diabetes, kidney insufficiency ), the value of blood pressure less than 16 / 9 cmHg is accepted.
The indications for surgery
Surgery can cure or at least improve hypertension when the disease is caused by certain specific causes.It is estimated that less than 2% of hypertensive individuals are concerned about it :
- In case of tumor of the adrenal gland (Conn’s syndrome, pheochromocytoma), surgical removal of the tumor is usually performed.
- In case of a renal artery stenosis, the surgery can perform a dilatation balloon through a catheter inserted in the arterial ptf groin or PWS rarely make a replacement of the renal artery.
The result of the surgery is more effective as hypertension is recent. Indeed, after several years of evolution, kidney lesions appear that keep blood pressure.
A comprehensive treatment
Treatment should be comprehensive,similar to the things we,ve been suggesting in our website to lower blood pressure you must follow :
- A diet low in salt
- Reduce or eliminate alcohol
- Losing weight if necessary
- Avoid tobacco
When should hypertension be treated?
Antihypertensive therapy should be prescribed in the following cases.
- If blood pressure exceeds 16 / 9.5 cmHg repeatedly.
- If blood pressure exceeds 14 / 9 cmHg repeatedly in patients who have other cardiovascular risk:
smoking, diabetes, renal failure, angina pectoris (angina), high cholesterol, history of myocardial infarction or stroke, among others.
Studies show that as the patient has risk factors for hypertension and her, the more treatment is beneficial and recommended.
Treatment after 65
Blood pressure normally rises with age, particularly because of the hardening of the arteries.
This age-related hypertension should be supported: 65 to 80 years, the benefit of antihypertensive therapy is clearly demonstrated for pressures greater than 16 / 9 cmHg (beyond that age, interest is likely, but the effects are not well studied).
With age, drugs are more sensitivity and increases the risk of side effects become more important drop in blood pressure during the transition to standing (orthostatic hypotension), leakage of potassium, kidney failure in dehydration the summer or during a diarrhea …
The goal of treatment
It’s because of side effects, in treating people over 65, generally sets a goal blood pressure to less than 16 / 9 cmHg and not 14 / 9 cmHg.
Monitoring should also be strengthened:
- Measures blood pressure frequently while lying and standing
- Regular blood tests to monitor the dosage of creatinine, potassium and sodium.
What to do if high blood pressure?
We talk about high blood pressure when the maximum pressure is greater than 20 cmHg.
- If the pressure of hypertension is associated with acute shortness of g, to speech, to paralysis of the face or a limb, a
chest pain, call the family doctor, an ambulance or fire department.
- If the pressure of hypertension is associated with acute vertigo, call and see very quickly the attending physician or, failing that, an ambulance or fire department.
- If the pressure of hypertension is associated with a nosebleed, take the advice of his doctor. For very heavy bleeding, a wicking must be done in a otorhin throat specialist or an emergency department. Rest is essential. If blood pressure does not drop sufficiently, the doctor will probably a new antihypertensive.
- If the minimum pressure is greater than or equal to 13 cmHg, consult a doctor or go directly to the emergency.
- If the maximum pressure is greater than 20 cmHg no other sign, and if the minimum pressure is below 13 cmHg, you have to stand for 15 minutes and repeat a measurement. If the pressure remains above 20 cmHg, call your doctor.
When measuring blood pressure themselves and that there is a surge of hypertension, the first thing to do is relax. If after a few hours the pressure remains high, we can take a medication if it has been prescribed or authorized by the medical (preventive or after a phone call).
It is dangerous to bring down blood pressure too fast. So do not take more than one tablet of antihypertensive if hypertensive.
When hospitalization is necessary?
In most cases, the treatment of high blood pressure do not require hospitalization. This is useful only if hypertension is severe or if the doctor has suggested it . It is essential when the hypertension is complicated, it is necessary when is associated with pulmonary edema, chest pain and other signs of severity.