High blood pressure (or hypertension) is defined by the elevation of the pressure exerted by the blood on the walls of arteries. This blood pressure is characterized by two numbers (eg 130/70), the first (maximum) corresponding to contemporary pressure of cardiac contraction (systolic) and the second (minimum) is the heart relaxation in pressure between beats 2 ( diastolic). The unit of measurement is millimeters of mercury (mmHg) (or sometimes mercury cm: 140/70 mmHg = 14/7 cm Hg).
Hypertension is defined by numbers of higher blood pressure 140/90 mmHg or equal measured lying after several minutes of rest repeatedly by a cuff placed around the arm and connected to a mechanical or electronic manometer.
Risks and Complications of Hypertension
In the short term, sudden high blood pressure may be responsible for acute pain organs such as the brain (Stroke, hypertensive encephalitis), kidney (acute renal failure) or the heart (heart failure, acute coronary insufficiency ).
However most of the consequences of high blood pressure are long-term, linked to changes for several years at low noise of hypertension unsupported. The blood pressure will be liable for damages on all the arteries of the body by stiffening and onset or worsening of atherosclerosis.
This is particularly true for brain arteries (responsible stroke brain stroke), heart (responsible for myocardial infarction and heart failure), and kidney (causing chronic renal failure), but all arteries are affected including the legs (peripheral arterial disease). The achievement of all of the arteries and the heart is called cardiovascular disease is the second cause of death with 150 000 deaths per year (2011) after cancer.
The consequences of high blood pressure are all the more rapid and severe that it is significant (higher numbers) and that it is associated with other cardiovascular risk factors such as diabetes, high cholesterol ( LDL), smoking, obesity and lack of physical exercise. Age, male gender and personal and family history of cardiovascular disease are also risk factors.
The causes of high blood pressure
In the vast majority of cases, high blood pressure is called "essential" that is to say that no cause is found. However, several risk factors for arterial hypertension are known as overweight, lack of physical activity or diet, particularly excess salt and diabetes mellitus.
In about 10% of cases, hypertension may be secondary to another disease. It may be a kidney disease and / renal artery (stenosis), adrenal or hormonal diseases.
Exceptionally high blood pressure may be linked to a single genetic mutation family.
Symptoms of high blood pressure
Hypertension is often "silent" that is to say, it is not accompanied by any symptoms. Thus more than half of adults with hypertension do not know. This is a serious factor because during the time that high blood pressure develops, it continues its deleterious effects on the arteries and heart.
When hypertension is severe and / or sudden, it may be accompanied by headache, nausea with or without vomiting, nosebleed. Black spots or white flashes can occur in vision.
The reference method for measuring blood pressure is taken after several minutes of rest, lying down, taking the armband, the 2 arms. Currently the electronic measurement is favored at home and in the office, preferably with an arm device validated rather than wrist (SFHTA 2011). Several successive measurements of blood pressure are necessary for diagnosis of hypertension.
Blood pressure varies throughout the day, it may be useful to obtain a measure covering a wider time so as to better reflect the stresses exerted on the arteries. For this, it is possible to achieve a measure of blood pressure over 24 hours (Holter blood pressure) or standardized way several times a day (MAPA: Automated Measurement of Blood Pressure).
With what does he not be confused with high blood pressure?
Blood pressure may exceed the limit of 140/90 mm of mercury from time to time, for example because of the emotion that causes the consultation (high blood pressure so-called "white coat"). To make sense of things, the doctor may ask the patient to take his blood pressure at home, thanks to a self-measurement electronic device.
In hypertension "white coat", blood pressure falls below 135/85 mmHg at home. A home is recommended, sitting, three measurements in the morning at breakfast, three measurements in the evening before bedtime, three days in a row (rule 3). The measurements are spaced a few minutes (2011 recommendations of the Society of Hypertension).
It may overestimate blood pressure in obese people. We must then verify with a suitable cuff.
Finally, the equipment check (blood pressure) is necessary because calibration is rarely regularly from the manufacturer. With possibly resulting in a breach of hypertension or an unfounded alert.
Are there possible prevention of hypertension?
Yes. It is to act on the factors that can be modified, that is to say, the healthy lifestyle: eat more balanced, limit salt intake, fat and alcohol, engage in an activity regular physical, weight control, stop smoking.
These good habits are essential for those who have a genetic predisposition to hypertension, that is to say, those whose father and / or mother have high blood pressure, especially if she appeared before the age of 50 years
When to consult?
Given the usual lack of symptoms of hypertension, it should be systematically search each medical and regularly after 50 years.
In the presence of the symptoms mentioned above, it is necessary to consult promptly their physician to develop a rapid and appropriate treatment.
What is the doctor?
The first "treatment" of arterial hypertension is that of the management of hypertension risk factors. This includes moderate in salt consumption, no smoking, a diet low in fat, regular physical activity and diabetes control if necessary.
The application of these rules before the onset of high blood pressure can prevent or delay the HTA.
If these lifestyle and dietary rules are insufficient, it is necessary to use antihypertensive therapy. Several classes of antihypertensive medications exist. These classes should be mentioned diuretics that help eliminate salt by action on the kidneys, beta blockers that slow heart rate, calcium channel blockers that increase the caliber of the arteries, and IEC ARA2 blocking a system increasing blood pressure and finally the central antihypertensives playing on the dilation of blood vessels.
These classes can be combined to get a better blood pressure control.
- Chronic disease very common and frequency increases with age
- Purveyor of serious cardiovascular disease complications: stroke, heart attack, heart and kidney failure, ...
- Cardiovascular disease = 2nd cause of death (150,000 / year)
- Silent disease, often goes unnoticed: the importance of routine screening
- Risk factors and progression of hypertension: Smoking, diabetes mellitus, excessive salt intake, high cholesterol, lack of exercise, overweight
- No cause found in most cases: essential hypertension.
- Treatment: involves correcting +++ risk factors and if insufficient antihypertensive treatment.
- The importance of prevention of hypertension: management of risk factors prior to the onset of hypertension
- Antihypertensive: several classes of drugs that can be combined to achieve proper blood pressure control.
- Voltage Monitoring is essential: in the office and at home with a self-measurement.