According to the World Health Organization (WHO), hypertension, known as high blood pressure, affects about one billion people worldwide. It is the major risk factor for cardiovascular diseases such as acute myocardial infarction and stroke.
In Brazil, about 35% of the population has the disease, according to data from the Ministry of Health, but half do not even know it. Of those with knowledge, 50% use drugs, and only 45% of them have controlled pressures.
What is High Blood Pressure?
This is a chronic and degenerative disease characterized by elevated blood pressure levels in the arteries.
"Blood, pumped by the heart, exerts force against the inner walls of the vessels, and they offer some resistance to this passage, determining the pressure." When something is not working well in this system, its rise occurs, "explains Celso Amodeo, a cardiologist and specialist. in arterial hypertension in HCor, in São Paulo.
According to WHO guidelines, one is considered hypertonic when their systolic (heart rate) pressure is greater than 140 millimeters of mercury (mmHg) and / or diastolic (relaxation between heart rhythm and the other) equal to or greater of 90 mmHg in the US this rating was changed in 2017 to 13×8.
However, the doctor explains that there are variables. "It will depend on the risk factors associated with it." There are patients who need to start treatment when the pressure exceeds 120 mmHg, "he says.
As well as being a disease, high blood pressure is a risk factor for other diseases such as kidney failure, kidney failure, dementia, and vision changes.
But the most important thing is for the cardiovascular, because they are the ones who kill the most in the world. To get an idea, in Brazil in 2017, more than 383,000 people died, according to data from the Brazilian Society of Cardiology (SBC).
"If we look at death certificates, we will see that high blood pressure has caused 80% of stroke and 60% of heart attacks," Amodeo reports.
It happens that the pathology causes narrowing of the vessels and causes the heart to pump the blood with increasing force to drive it throughout the body and then to get it back.
"This process expands the organ, damages the arteries and therefore favors the onset of heart attacks and strokes," said the HCor cardiologist.
Types of hypertension and risk factors
The primary type of high blood pressure is the main type, responsible for 95% of cases, according to Amodeo. "This is a picture that begins in adulthood and usually in people with a family history of the disease," he says.
But there are several factors that influence it. Number one is the excessive consumption of salt. Although a maximum of 4 g per day is recommended, Brazilians take 10 to 12 g, and this includes the quantities used in the preparation of food, as well as what is in the processed and industrialized products – some of them canned, inlaid and canned foods.
Others are: smoking, obesity, stress, high cholesterol, sedentary lifestyle, pollution and diabetes.
It is also known that the incidence of high blood pressure is higher among black people and that it increases progressively with age – it is estimated that 50% of people over 65 have a problem and 80% of those over 75 years old.
Another type of hypertension is a secondary type that causes 3 to 5% of the diagnoses. In this situation, pressure rise is due to some diseases such as hyperthyroidism, hypothyroidism, sleep apnea, adrenal tumor, and obstruction in the renal artery.
There is also a "white coat hypertension" that is characterized by abnormal blood pressure when measured in the office and normally when it is registered through outpatient and residential surveillance and masking, which is the opposite, low blood pressure. a doctor's office and outpatient and residential monitoring.
Finally, there is a specific hypertensive disease of pregnancy (DHEG). It occurs in the form of preeclampsia (increased blood pressure associated with urinary protein elimination) and eclampsia (a complication of preeclampsia, causes very high blood pressure and is associated with symptoms such as seizures, headaches and swelling).
Symptoms, diagnosis and treatment
Most of the time, the pathology has no symptoms. Eduardo Kosta Duarte Barbosa, a cardiologist and president of the Latin American hypertension, says signs such as headaches, shortness of breath, palpitations, ringing in the ears and dizziness only appear if a person has a hypertensive crisis.
"As it is an asymptomatic disease, it is very important to check the blood pressure once a year," says the doctor.
He also reports that in some cases the measurement performed in the office with manual or automatic devices is sufficient, but there are others where ambulatory blood pressure, known as ABPM, is needed for 24 hours.
Disease is not cured but can be treated and controlled primarily by adjusting unhealthy eating habits, fighting physical inactivity and controlling stress.
Many patients still have to use medicines, including vasodilators, diuretics, calcium channel blockers and beta-blockers. They can be used alone or in combination.
When it comes to DHEG, the Ministry of Health reports that "high-pressure treatment for pregnant women should focus on non-pharmacological measures, even in moderate and severe forms, the usual treatment recommended for any particular clinical condition" .
May: a month of consciousness of hypertension
The month is marked by the international mobilization of the consciousness of hypertension, as the 17th is World Day of Hypertension. At that time three years ago, the International Association of Hypertension (ISH), approved by the World League of Hypertension (WHL) and supported by Servier, promotes the Monthly Month of Measurement (MMM).
98 countries participated in last year's edition, total tracking of 1,504,963 people. Each of them checked blood pressure and completed a questionnaire on lifestyle and environmental factors.
According to the campaign, 502,079 (33.4%) had hypertension, of whom 298,940 (59.5%) knew about their diagnosis and 277,794 (55.3%) were on treatment.
In Brazil, the latest data is from MMM2017. In May of that year, information was collected about 7,260 people in the country. Of these, 3,396 (47.0%) have hypertension.
Other raised figures are that 924 (19.5%) have hypertension and those who receive 977 (40.0%) have no controlled pressure.
"The new diagnosed high rate and the identification of uncontrolled hypertension, despite pharmacological treatment, reinforce the importance of this action to raise awareness and improve the prevention of major cardiovascular events," concluded Barbosa, coordinator of MMM in Brazil.
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