Arterial hypertension is the most potent risk factor associated with the possibility of stroke, myocardial infarction or renal failure.
This situation is aggravated when it is associated with other risk factors in the patient, such as being diabetic, smoker, obese or having high blood lipid levels.
In recent years, consensus guidelines have been developed so that the entire medical community could agree on the blood pressure levels that should be reduced to minimize the risks.
The most recent review of studies has been published in the guidelines for the treatment of hypertensive patients of the European societies of arterial hypertension and cardiology, presented in Milan in May 2013.
This guideline reviews the most important studies published in recent years that have published results in hypertensive patients of different risks, ages, associated pathologies, etc.
The main novelty is that they unify the blood pressure target for all patients under 80 years of age at less than 140/90 mmHg. In previous guidelines, the target was set at less than 130/80 mmHg in patients at high cardiovascular risk and/or diabetics, and even lower if they had renal insufficiency with proteinuria. However, the current target is set at less than 140/90 mm Hg, leaving a margin of up to less than 85 mm Hg in the diastolic component for diabetics in good general condition.
In patients over 80 years of age, a blood pressure target less than 150/90 is reasonable.
On another subject, there is also a clear indication of which patients are candidates for the different blood pressure measurement techniques. In my opinion, this topic is essential if you are hypertensive.
There are at least 4 methods of blood pressure measurement that should be used in specialized hypertension units:
– The casual or consultation measurement. The classic oscillometric device.
– The AMPA. Self-measurement of blood pressure at home
– The ABPM or 24-hour blood pressure Holter.
– Central blood pressure. Indirect measurement of blood pressure in the aorta artery.
Only by means of an extensive and detailed clinical history and a thorough physical examination can we know which technique or set of techniques should be used in each patient and explain to him or her slowly and thoroughly which is the best way to measure blood pressure.