on hypertension (HA) It is the main risk factor for cardiovascular disease, which is the leading cause of death. However, there is a large discrepancy in the number of people who know their hypertonic condition, those who are being treated and are not controlled, and those who receive treatment and are controlled.
High blood pressure is the main risk factor that suffers and dies from a cardiovascular event prematurely and is the second leading cause of disability in the world. It is also the major cause of ischemic heart disease and stroke. Other not less important complications resulting from poor blood pressure control are extensive heart disease, heart failure and arrhythmias.
According to the Pan American Health Organization (PAHO), between 20% and 35% of the adult population in Latin America and the Caribbean is hypertonic. The number of people with this condition has increased in recent years and many are unaware of their condition.
"Although it seems obvious, the first thing to say is that in order to know whether one is hypertonic, pressure should be put, I say that because half of the patients who are hypertensive do not know they have this state, "he said. Gabriel Weissman, a clinical doctor certified by a medical clinic and arterial hypertension from the Certification Council of Medical Professionals of the National Medical Academy.
According to a study in four countries in South America (Argentina, Chile, Colombia and Brazil), only 57.1% of the adult population, rated with high blood pressure, knows they have hypertension, which contributes to the low level of population control: , 8% of adults with hypertension in these four countries have controlled blood pressure.
Adequate control is a cost-effective measure to avoid premature death. According to PAHO, if you manage to cure half the population with uncontrolled hypertension, including those who are treated with sub-optimal blood pressure and those who are not treated, after 10 years can prevent 10 million deaths in the world due to events . cardiovascular.
"Hypertension is a sign, it's a number, it's a risk factor, and it's a disease, it's all together and it's very common in Argentina," Weisman said, who is also a former president of the Argentine Society for Arterial Hypertension. (SAHA). The latest study, released on April 15, "The Fourth National Risk Factors Study" revealed that hypertension remains one of the most common ailments. According to this study, about 36% of adults aged over 18 in our country have high blood pressure.
Figures, diagnostics and control
HA can not be cured, but it can be prevented, treated and controlled to keep figures safe. By considering the blood pressure values that allow the individual to be considered healthy or not, Waisman insists on distinguishing the diagnostic cases of control. For the first one, the patient needs to have more than 2 visits to a doctor with more than 140 maximum blood pressure and a minimum of 90, which is usually expressed as 14/9. Regarding the level of blood pressure control, the expert explained that this would depend on the pathology that accompanies the patient's hypertension and age.
"In older patients, it is not necessary to achieve such low blood pressure as it may be harmful to the cerebral circulation, while in younger or newer patients diagnosed and in patients with coronary heart disease, the pressure below 140/90 to avoid complications of high blood pressure because it is a disease that does not occur, says the expert.
Heart in South America
According to a study led by the current Minister of Health, Adolfo Rubinstein, in southern cone towns such as Bariloche, Marcos Pass, Temuco in Chile, Pando and Canelones in Uruguay, it is observed that Nearly 80% of the inhabitants of these settlements have 3 or more cardiovascular risk factors. According to Weissman, these data allow us to see that it is very common for hypertension to have diabetes, high cholesterol, not to eat properly with regular intake of fruits and vegetables, not to exercise, and to be smokers: the risk factors will affect of vascular diseases, mainly cerebral such as stroke, coronary and renal.
Much more than a state of mind
There are still many people who often say that their blood pressure increases only in a stressful situation like anger or nervousness during a conflict. However, the expert is not hypertensive who wants but who can: "If that were the case, there should be about 43 million hypertensives in Argentina, but we know it is not, and 36% of the population is affected by it disease. "
Just as a person with asthma may have an asthma attack, if he gets nervous, someone with irritable bowel syndrome may have diarrhea, and a diabetic patient may have high blood sugar and hyperglycemia. "The fact that you are nervous and you have a stress-crisis, especially psychosocial stress, make the hypertonic patient more hypertonic, it's a trigger, coquity that causes the problem to trigger," Weissman said.
"Those who had HA because they were once under stress should consult a professional and they should consult and control their pressure at home not only in the doctor's office but today we tend to empower the patient with treatment and control. There are also studies of outpatient blood pressure monitoring that performs day and night measurements, which allows us to determine if the patient is hypertonic or not, "says the specialist.
Some patients claim that their doctors recommend taking diuretics to better control their blood pressure levels, but what is the role of these medicines in this strategy? At present, according to the guidelines of the Argentine Consensus on Arterial Hypertension published by the Argentine Society of Cardiology in 2018, the Argentine Federation of Cardiology and the Argentine Society for Arterial Hypertension, four types of medicines like first line medications to treat this condition which are: diuretics, third generation beta-blockers, conversion enzyme inhibitors or angiotensin receptor antagonists and calcium blockers.
"Normally, the diuretic is not chosen as the first option unless the patient has symptoms of heart failure or volume overload." We usually use diuretics as a binding drug with angiotensin receptor blockers or conversion enzyme inhibitors. and / or calcium blockers, "Weissman explains.
As far as the pharmacological treatment of HA is concerned, the expert emphasizes the importance of the patient understanding that the drug once started will accompany him throughout his life and the intake can not be stopped. "You can add medications, lower medication, to change the medication if there are side effects or side effects, but that corresponds to the role of the treating physician and the patient's commitment not to stop the antihypertensive treatment," he said.
"It is necessary to take the medicine even if the pressure values are normal, because if the intake stops, the blood pressure can rise sharply and cause complications for the patient's health," he concludes.