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Hypertension
¿Qué es la hipertensión?
First, let us consider blood pressure
The heart plays the role of a pump that moves blood throughout the body, which ensures that oxygen and nutrients are delivered to every tissue and organ. To do so, the heart generates a force to make blood run through the arteries, which is called BLOOD PRESSURE.1Two main factors contribute to the variations of blood pressure:The more blood the heart pumps and the narrower the arteries are, the higher the blood pressure is.2
The amount of blood pumped by the heart
The amount of resistance to blood flow in the arteries.
Definition of hypertension
Blood pressure can be low, normal or high, but over time and with age, blood pressure rises. Why? The walls of large arteries become more rigid and the small blood vessels become narrower. Because of these changes, the heart has to generate a greater force to keep blood flowing around the body. This leads to an increase in blood pressure. Hypertension3 is defined as blood pressure that is consistently higher than 140/90 mm Hg.
SYSTOLIC blood pressure (mm Hg) :
The highest level of blood pressure, when blood is pumped from the heart to the entire body.
DIASTOLIC blood pressure (mm Hg) :
The lowest level of blood pressure, when your heart is relaxed before it contracts again.
Optimal:
- Systolic <120
- Diastolic <80
Normal:
- Systolic <120-129
- Diastolic 80-84
High normal:
- Systolic 130-139
- Diastolic 85-89
Let us check how to interpret your blood pressure values.4
Sys <120 & Dia < 80 | Sys 120-129 &/or Dia 80-84 | Sys 130-139 &/or Dia 85-89 | Sys 140-159 &/or Dia 90-99 | Sys 160-179 &/or Dia 100-109 | Sys ≥ 180 &/or Dia ≥ 10 | Sys ≥ 140 &/or Dia < 90 | |
|---|---|---|---|---|---|---|---|
| OPTIMAL | NORMAL | HIGH NORMAL | GRADE 1 HYPERTENSION | GRADE 2 HYPERTENSION | GRADE 3 HYPERTENSION | ISOLATED SYSTOLIC HYPERTENSION* | |
| “Good, keep going!” | “Your blood pressure should be recorded at least annually, and you should be offered lifestyle advice. You may receive a medical treatment if your cardiovascular risk is very high because of an established cardiovascular disease, especially coronary artery disease. | “In case of low-to moderate risk grade 1 hypertension, with no link to any organ damage, a medical treatment is recommended if a period of lifestyle intervention does not lower blood pressure to acceptable levels. In any other case, your blood pressure needs to be reduced with a medical treatment, and you should as well follow lifestyle advice.” | “Medical treatment is recommended if a period of lifestyle intervention does not lower blood pressure to acceptable levels.” | ||||
*Isolated systolic hypertension is also graded on a scale from 1 to 3, depending on the systolic blood pressure value, with the same cut-off values as “standard” hypertension. 2018 ESH/ESC Guidelines for the management of arterial hypertension.4 | |||||||
Hypertension : a worldwide problem5
1.27 billion
Around the world, hypertension affects about 1.27 billion people.5
34%
Men’s prevalence5
32%
Women’s prevalence5
60%
Patients over 60 years old prevalence6
Age-standardized prevalence of hypertension among adults aged 30–79 years, and among those with hypertension, diagnosis, treatment, and effective treatment coverage in 2019, by WHO region.1
What are the causes of Hypertension?
There are two types of hypertension: primary (or essential hypertension) and secondary hypertension.Primary hypertension
Primary hypertension describes high blood pressure that has no obvious cause. There are number of factors that increase the risk of developing high blood pressure :
Lack of physical activity
Stress
Excessive weight
Excessive alcohol intake
Excessive salt intake or too little potassium6
Chronic heavy smoking
Caffeine
Sugar
FAMILY HISTORY :
Genetic factors likely play some role in high blood pressure, and sharing a common environment and other potential factors may also increase the risk.7
RACE OR ETHNICITY :
Black people develop hypertension more often than other ethnicities, and at a younger age.
Secondary hypertension
is high blood pressure produced by identifiable causes (for example, an abnormal production of hormones from the adrenal glands). Only a small number of patients suffer from this kind of hypertension. Once the cause is found and treated correctly, blood pressure should return to normal.With whom should I discuss this if I want to find out more?
Your general practitioner is the right person to ask about blood pressure.8
References
1
WHO. Avoiding Heart Attacks and Strokes.
2
Mayet J, Hughes A. Cardiac and vascular pathophysiology in hypertension. Heart.
3
Pollock JD, Makaryus AN. Physiology, Cardiovascular Hemodynamics. StatPearls Publishing; 2019.
4
Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J.
5
Williams B et al. Eur Heart J. 2018;39(33):3021-3104.World Health Organisation. A global brief on hypertension Silent killer, public health crisis.. Published April 2013. Accessed
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Last modified date: 1/30/2023
