Hypertension is one of the most important cardiovascular risk factors, in addition to being frequent in our population: it is estimated that in Spain there are more than 17 million hypertensive patients of varying degrees , and that 40% are unaware that they are. Due to the consequences that it can have on our body, it is key to prevent hypertension or, if it is already suffered, to detect and treat it.
But why does it occur? How does it manifest? What blood pressure measurements should we try to maintain? And how to achieve it? These and other questions were answered live by doctors José Luis Palma Gámiz, vice president of the Spanish Heart Foundation (FEC), and José Antonio García Donaire, nephrologist at the San Carlos Clinical Hospital in Madrid and president of the Spanish Society of Hypertension -Spanish League for the Fight against Arterial Hypertension (SEH-LEHLA). These are their responses:
What is hypertension?
As explained by Dr. Palma Gámiz, hypertension is an increase in blood pressure on the walls of the arteries exerted by the force of the blood that opposes the resistance offered by the arteries . Two values are obtained from this relationship between the volume of blood injected into the arteries and the resistance they offer, the systolic value or maximum pressure and the diastolic value or minimum pressure.
What are the values considered normal?
The ideal blood pressure is a random threshold chosen by experts, explained Dr. García Donaire, adding that it is set at a certain number because there is less morbidity and mortality there. However, that figure varies depending on the state of health and the age of each person.
For a healthy adult, the figures should not exceed 135/85 mmHg, although the optimal pressure is 120/75 mmHg while the ideal is below 110/70 mmHg. However, in patients who already have complications, such as having had a heart attack, kidney failure, or brain disorders, blood pressure should not exceed 120/75 mmHg. Finally, in those over 75 years of age, the pressure that is considered ideal would be around 140/80 mmHg.
What causes it?
Approximately 15% of the cases of hypertension have to do with the metabolic, hormonal or renal component or are related to the sympathetic nervous system, which is what makes us react when the body interprets potentially dangerous situations, explained García Donaire. “But in the other 85% of cases we don’t know why it happens, although we do know that style and quality of life play a role . We can prevent it if we follow the Mediterranean diet from childhood and do moderate physical exercise. Just as we also know that sleep quality and stress management are key , ”said the president of SEH-LEHLA.
Does it manifest itself in the form of symptoms?
One of the reasons that blood pressure should be taken at least once a year after age 40 is that, in many cases, hypertension is silent or unspoken. That is, it does not show any symptoms. However, sometimes it can send messages in the form of headaches that are different from the usual ones, visual alterations that are not those that we usually suffer from having myopia or astigmatism, non-specific dizziness, lightheadedness, memory deficits … “When these messages are put together, what they can occur both at rest and during exercise, we should go to a specialist in hypertension”, warned García Donaire.
What consequences does it have?
The first causal factor of myocardial infarction is hypertension. In people older than 70 years, increases of 20 mmHg for the maximum pressure and 10 mmHg for the minimum pressure double the risk of suffering a cardiovascular event. But it does not only affect the cardiac level, recalled Dr. José Luis Palma Gámiz. “The higher the blood pressure, the greater the risk and greater involvement of target organs such as the heart, brain, kidney, retinal arteries.… For this reason, among the possible consequences of high blood pressure are myocardial infarction, kidney disease, heart failure, stroke and blindness due to hypertensive retinopathy, as well as cognitive and psychological disorders,” explained the vice president of the FEC. Regarding the latter, García Donaire indicated that poorly controlled pressure can cause certain phenomena of dementia or cognitive impairment to appear earlier because the brain is hypervascularized, “and where there is a vessel that may have high blood pressure, we have to reduce it and get better. That’s why prevention is essential.”
How to prevent the appearance of hypertension?
– Adequate diet maintaining the ideal weight. It is a preventive measure, but once hypertension has been detected, it is also essential to follow the Mediterranean diet and reduce salt intake , one of the main allies of hypertension. “That does not mean that you have to eat without salt, but it does mean that it is a very moderate consumption,” recalled the president of SEH-LEHLA. According to the WHO, normotensive people should not consume more than five grams of salt per day., an amount that is reduced in hypertensive people. In order not to exceed that figure, it is a good idea that the pinch of salt that we add to the food “is already with the cooked dish, not during cooking. And consume ultra-processed and pre-cooked foods in moderation, which have a lot of salt”, advised García Donaire. Saturated fats are also directly related to high blood pressure, so they should also be consumed moderately.
– To do physical exercise. As the experts explained, going for a 30-minute walk in the morning and 30 minutes in the afternoon, avoiding very hot hours, is as important as any pill that can be prescribed. Regarding the intensity and type of exercise, the recommendation is to combine aerobic exercise and anaerobic exercise , knowing that the body has to adapt. “If I’m between 40 and 60 years old and I’ve never run, I can’t run a half marathon a month after I start training. You have to be progressive in terms of training”, recalled García Donaire.
– Drugs. “If it is possible, and in a very high percentage of cases it is, the modification of life habits should always come first. But if the blood pressure figures are very high, there are repeated hypertensive crises or the patient has an associated risk that does not allow us to wait, we will have to resort to pharmacological treatment”, indicated the president of SEH-LEHLA, recalling that there are 84 active ingredients different in Spain to treat hypertension . As for the best time to take the drugs, “the most effective pill is the one you take, no matter what time it is,” he recalled.
