What is hypertension? Ask your questions about the disease – 10/18/2023 – Balance and Health

Silent, generally asymptomatic, arterial hypertension — popularly known as high blood pressure — affects at least 1 in 4 Brazilian adults.

It is, therefore, one of the most prevalent chronic diseases in the country. It is also one of the main risk factors for cardiovascular diseases, such as heart attack and stroke.

Elderly people are the group with the highest prevalence rates of hypertension — over 65 years of age, it reaches 62.5%, according to data from the Covitel survey.

In recent years, however, the number of adults in younger age groups diagnosed with high blood pressure (and without a secondary cause) has also attracted the attention of experts, who attribute the situation to a worsening of risk factors, such as sedentary lifestyle and obesity.

Although it is simple to diagnose, increasing hypertension screening is still a challenge. Another impasse is low adherence to treatment, which increases the risk of complications.

See questions and answers about hypertension below.

What is hypertension?

Hypertension is a disease that increases the pressure at which blood circulates in arteries and veins. In practice, the heart needs to make a greater effort than normal for the blood to be distributed throughout the body.

“It’s like a hydraulic system. If there is a flow of blood circulating under high pressure, it will overload the organs where this blood is arriving under high pressure. And this overload ends up causing injuries and changes that can, over time, lead to evolution for a more serious event, such as a heart attack, CVA (cerebrovascular accident) and so on”, explains cardiologist Andréa Araújo Brandão, from the Brazilian Society of Cardiology, who remembers that adherence to the treatment indicated in each case helps to reduce the risk of complications.

How is the diagnosis made?

The diagnosis is made with two blood pressure measurements above 140 by 90 mmHG (or 14 by 9, as the measurement is called in everyday life) in two or more different consultations. The measurement is made using a suitable and calibrated device.

“In some situations, the doctor may need additional tests, when there is some doubt or when he suspects, for example, the so-called white coat hypertension, which is the case of the individual who is there hitting the goalpost, but who says that when measures blood pressure at home, which is lower. In these cases, he can use ambulatory blood pressure monitoring, which is Mapa, or home blood pressure monitoring, which is HBPM, which is an automatic blood pressure device with capacity to record these measurements”, explains cardiologist Erika Campana, assistant professor at Uerj (State University of Rio de Janeiro).

Should everyone have their blood pressure checked?

Experts recommend that blood pressure be checked at least once a year — or whenever there is an opportunity, in the case of healthcare services. The first measurement should be taken from the age of three.

What causes hypertension?

Hypertension is a multifactorial disease. Family history, sedentary lifestyle, obesity, smoking and excessive salt consumption — the amount of which should be less than five grams per day per person, or one teaspoon, according to the WHO (World Health Organization) — are some of the factors that risk.

“If I have a genetic predisposition, like a hypertensive father or a hypertensive mother, for example, I have a 25% greater chance of having hypertension. If I have a father and mother with hypertension, I have a 50% greater chance. What can I do about this? my healthier habits so that this genetics doesn’t manifest itself clearly or so that it, at least, manifests itself up front and not so soon”, says Campana.

What are the symptoms of high blood pressure? What does it feel like?

Hypertension is considered a silent disease because it is largely asymptomatic. According to experts, symptoms only appear in more advanced stages or when there is a very high rise in blood pressure. These include shortness of breath, chest pain, blurred vision, dizziness, severe headache and nosebleeds.

“These are signs that the pressure may be much higher than it should be”, says Luiz Bortolotto, from the Brazilian Society of Hypertension. “But the only way to know is to measure the pressure.”

What is the treatment for those already diagnosed with hypertension?

It depends on each case. In general, treatment involves lifestyle changes — such as improving diet and exercise — and the use of medications. According to Campana, the estimate is that around 70% of patients need medication to control their blood pressure.

The frequency of follow-up depends on each patient’s situation. “If the person doesn’t have a device at home and the pressure is very uncontrolled, the ideal is to go to the doctor at least every month at first”, says Bortolotto. In other cases, every three or four months.

It is worth remembering that there is no cure for hypertension. “What we have is blood pressure control through the use of medication”, says Andréa Brandão, who reinforces the importance of adhering to correct — and continuous — treatment. “Many patients sometimes understand that if you take the medicine and the pressure normalizes, then you can stop the medicine and the problem will be solved. But it isn’t.”

What are the main complications of hypertension? And how to avoid it?

According to experts, adherence to treatment is essential to avoid complications from hypertension. Among them are cardiovascular and kidney diseases. If left untreated, hypertension can also lead to death.

“Today it is accepted that in around 60% of heart attack cases, arterial hypertension is involved as part of the patient’s history, and, in stroke, it is estimated that this occurs in 80% of cases”, says Brandão.