Arterial hypertension: a patient’s guide

Arterial hypertension is one of the main reasons for medical consultation nowadays. We speak of arterial hypertension when the pressure is higher than 140/90 mm Hg. It is a very common disease that affects a large percentage of the adult population and, if not treated correctly, can lead to serious cardiovascular complications. Cardiology specialists affirm that the main burdens imposed by the pathology associated with hypertension do not prevent the relatively few cases of severe disease, but rather the large population with minimal elevations in blood pressure.

How to take blood pressure?

Blood pressure measurement should be performed very carefully to avoid mistakenly considering normal individuals as hypertensive and to ensure that hypertensive individuals receive appropriate treatment.

For two reasons it is important to avoid incorrect diagnosis of hypertension based on wrong measurement:

  1. If the diagnosis is established, treatment is likely to be indicated that involves a lifelong obligation and is often costly, tedious, and sometimes dangerous.
  2. Simply diagnosing hypertension can have counterproductive effects on patients’ mood and disposition.

When taking blood pressure, the patient’s posture is important. The patient should be seated quietly with the back supported for 5 minutes and the arm is held at the level of the heart (supported). In addition, it is advisable not to ingest caffeine during the previous hour and not to smoke during the previous 15 minutes.

Blood pressure variations

Blood pressure determinations are often variable; either due to patient-specific or procedure-related factors.

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The patient’s blood pressure variations may be rapid, influenced by respiration and the nervous system. During the day, they can be determined by mental stress and physical activity, as well as by daily and work activities.

They may also vary during sleep. Normally, blood pressure should decrease by 30% during sleep.

Elevated blood pressure usually occurs in the early morning hours and decreases during the day.

In summary, blood pressure varies permanently during 24 hours, both in normal people and in hypertensive patients; the variation is greater in the latter.

At present, there are methods of diagnosis and control such as the blood pressure Holter, which consists of a small portable device that automatically records, at programmed intervals, the patient’s blood pressure 24 hours a day. This makes it possible to prevent and/or detect arterial hypertension unknown to the patient.

Treatment for arterial hypertension

Arterial hypertension is a chronic disease that is not cured, but controlled. Therefore, it requires sustained treatment.

In addition to the appropriate pharmacological treatment, the patient should take into account certain aspects that can help to improve his or her arterial hypertension.

  • If the patient is overweight, weight reduction should be a fundamental objective.
  • Limit the dietary intake of sodium (salt) to 2g per day, taking care not to decrease the intake of calcium-rich foods.
  • It is not necessary to increase potassium intake.
  • Calcium and magnesium supplements should only be given when deficiencies are present.
  • Increased fiber and decreased saturated fat are beneficial for other reasons and may also contribute to lower blood pressure.