High blood pressure : risk factors, prevention and treatments
High blood pressure is the most common cardiovascular disease. It is a chronic disease requiring lifetime treatment.
High blood pressure (HBP) or hypertension is where an increase in blood pressure in the walls of the arteries occurs when the heart beats. Normal adult blood pressure is 120 mmHg1 when the heart contracts (systolic pressure) and 80 mmHg when the heart expands (diastolic pressure). Thus, HBP results in an increase in the blood pressure figures greater than or equal to 140mmHg for the highest or systolic blood pressure and 90 mmHg for the lowest or diastolic blood pressure.
According to the World Health Organization, worldwide, the number of people affected has risen from 594 million in 1975 to 1,13 billion in 2015, 2/3 of whom live in low-income countries. Its prevalence in the WHO Africa region is 27% compared to 18% in America. In 2015, 1 man/4 and 1 woman/5 suffered from HBP, and only 1 patient/5 had normal blood pressure figures.
In general, high blood pressure does not have any noticeable symptoms that could alert the patient. Frequently it is discovered during a routine medical examination.
Sometimes, however, there are signs that point to possible high blood pressure:
- Morning headaches on the top or back of the head;
- Visual disturbances: floaters, blurred vision…
- Subconjunctival bleeding;
- Muscle cramps;
- Urinary frequency;
- Shortness of breath (dyspnoea)
The disease may only be discovered when complications arise, namely:
- Heart failure
- Myocardial infarction
- Heart attack
- Pulmonary oedema
- Ocular paralysis
- Retinal haemorrhages
- Kidney failure
- Erectile dysfunction
HBP risk factors are:
- Age (the older one becomes, the more rigid the arteries become, and the more blood pressure increases)
- Overweightness and obesity
- Alcohol and tobacco
- Excessive salt consumption
- Sedentary lifestyle
- Social isolation
- Social denial
- Some medicines: Oestrogen/progestin contraception, corticosteroids, anti-inflammatory drugs, antidepressants…
High blood pressure can, to a large extent, be avoided by adopting lifestyle changes as soon as possible:
- Have a healthy diet, based on fruits and vegetables, whole seeds and lean proteins;
- Limit sodium intake, by reducing the amount of salt added to food: the total daily intake of salt or sodium chloride, from all sources, must not exceed 5 grams (1 teaspoon).
- Limit the consumption of foods rich in saturated fats;
- Maintain a healthy weight: being overweight can increase blood pressure.
- Exercise: physical exercise can help lower blood pressure. Adults must engage in moderate physical activity of at least 30 minutes every day of the week or almost.
- Do not smoke: smoking damages blood vessels and accelerates hardening of the arteries.
- Limit alcohol consumption;
- Have your blood pressure checked regularly: it is important to monitor your blood pressure regularly because high blood pressure often has no symptoms.
- Have a social life and do not isolate yourself.
To this will be added, for people who already have high blood pressure:
- Monitor your blood pressure: it is possible to lower blood pressure through lifestyle changes and regular treatment.
- Prevent and manage other health problems, such as diabetes: nearly 60% of the population with diabetes also suffers from high blood pressure. The risk of diabetes can be reduced by having a healthy diet, maintaining a healthy weight and exercising regularly.
- Reduce and manage stress through meditation and other relaxation techniques.
High blood pressure treatments:
Taking a daily treatment for high blood pressure allows you to live longer without debilitating diseases. It is based on 8 drug “families”, which all work differently and may be complementary. In some cases, it is possible to combine 2 or even 3 therapeutic classes. HBP patients are different from each other. The caregiver may have to try several classes before finding those that are most suitable for the patient. The families are:
- ANGIOTENSIN RECEPTOR BLOCKERS (ARA II): They act against a very active substance to block contraction of the arteries and high blood pressure. They have very few side effects.
- ANGIOTENSIN-CONVERTING-ENZYME INHIBITORS (ACE): They act by having a favourable action on the arteries and the heart and are therefore also used to treat heart failure. They can cause a cough that disappears when this treatment is stopped.
- RENIN INHIBITORS (RI): They act by blocking a substance secreted by the kidney that favours the contraction of the arteries.
- BETA BLOCKERS: By decreasing the activity of the nervous system, they reduce the frequency and strength of heart beats.
- THIAZIDE AND RELATED DIURETICS: They act on the kidney and are usually combined with other medications, increasing their action on blood pressure.
- CALCIUM ANTAGONISTS: They soften the arteries and are active in angina. They can cause oedema of the ankles.
- CENTRAL ANTIHYPERTENSIVE DRUGS: They block brain signals to lower blood pressure. They are less used because they have more side effects than other medicines.
- ALPHA BLOCKERS: They act directly on the arteries but may cause falls in blood pressure when standing.
It should be noted that lifetime treatment does not mean the same treatment or dosage for life. The patient must be monitored regularly by their general practitioner. Each patient is an essential partner of their health in partnership with their doctor.
These ressources have been prepared by sister Yvette Ebolo, Central Africa Section