The blood pressure (BP) is defined as greater than or equal systolic blood pressure (SBP) to 140 mmHg or a diastolic blood pressure (DBP) greater than or equal to 90 mmHg , while SBP and DBP under 130/85 normal pressure values are considered. Between both categories is what is called normal-high blood pressure, with SBP greater than or equal to 135, but less than 140 mmHg and DBP greater than or equal to 85 and less than 90 mmHg.
“There are multiple clinical evidences that show that the higher the blood pressure, the greater the probability of suffering cardiovascular diseases . Likewise, all experts agree that keeping the pressure figures below the aforementioned values significantly reduces the risk of complications, “explains Enrique Rodilla Sala, professor of Medicine at the CEU Cardenal Herrera University and head of the Unit of Hypertension and Vascular Risk of the Internal Medicine Service of the Hospital de Sagunto (Valencia).
Risk of high blood pressure and why it needs to be lowered
Today, “high blood pressure is the most frequent chronic disease in Spain , and cardiovascular diseases are the leading cause of death in western countries,” says Rodilla. This group of pathologies includes ischemic heart disease underlying myocardial infarction , as well as cerebrovascular complications, such as stroke and transient ischemic attacks , not to mention kidney diseases such as kidney failure , as well as peripheral artery diseases such as intermittent claudication and, finally, pathologies of the retinal arteries .
If we specify about the prevalence, “ arterial hypertension in adults affects around 30 or 45 percent of the population . It is more common in advanced age (reaching more than 60 percent in people over 60 years old). The HTA was the global leader in contributing to sudden death with almost 10 million deaths in 2015 ”, points out Antonio Castro Fernández, head of the Cardiology Area of the Vithas Nisa Seville Hospital and president of the Andalusian Society of Cardiology (SAC) .
By way of summary, the head of Cardiology of the Vithas Nisa Seville Hospital tells that high blood pressure damages the arteries themselves and the organs that the blood reaches with high pressure:
- Arteries: aortic aneurysm and intermittent claudication .
- Heart: hypertrophy , heart failure and atrial fibrillation . Furthermore, it is a marker of preclinical or asymptomatic coronary disease.
- Brain: stroke , hemorrhage and dementia .
- Eyes: hypertensive retinopathy .
- Kidney: kidney failure .
“Some of these disorders are preventable and even reversible with early treatment of hypertension, ” says the president of the SAC.
What steps can be taken to reduce blood pressure?
Knee points out that, without a doubt, the cornerstone to prevent high blood pressure or reduce pressure figures – when hypertension has already been diagnosed – is to change to a healthy lifestyle , which includes restricting salt intake, moderating consumption of alcohol, reduce the content of saturated fats and cholesterol and increase the intake of vegetables, skimmed milk products, dietary and soluble fiber, whole grains and proteins of plant origin. In short, adopt the so-called Mediterranean diet .
This healthy lifestyle also includes weight reduction, strict smoking cessation, and regular physical exercise.
Schematically explained, Castro mentions that lifestyle modifications include:
- Restriction of salt in the diet, reaching less than 5 grams of sodium a day.
- Moderation of alcohol consumption. Consumed excessively has a strong hypertensive effect.
- Balanced diet, containing vegetables, legumes, fruit, cereals, low-fat dairy products, fish and olive oil. The Mediterranean diet showed in several studies a decrease in cardiovascular events and death, and at five years, a 29 percent reduction in cardiovascular risk compared to the low-fat diet, and a 39 percent reduction in stroke.
- Weight loss. Some studies have shown that losing 5 kg reduces systolic blood pressure by 4.4 mmHg. Overweight and obesity are related to increased blood pressure, diabetes , cardiovascular disease, and mortality. The healthy body mass index (BMI) is between 20 and 25 kg / m 2 in people younger than 60 years.
- Regular physical activity. Epidemiological studies suggest that physical activity is beneficial for the prevention and treatment of hypertension, and reduces cardiovascular risk factors and mortality. 30 minutes of moderate aerobic exercise is recommended, 5 to 7 days a week.
- Do not smoke. Tobacco is the highest risk factor for cardiovascular disease and cancer .
Of these steps, which ones cost the patients the most?
None of them is initially simple -knee admits-, especially when contrary habits have been exercised for many years. However, both reducing salt intake, getting used to the Mediterranean diet or starting physical exercise regularly are usually accessible goals that, to a greater or lesser degree, achieve a large number of patients. Much more difficult is weight reduction and quitting smoking .
From the start of a healthy diet until a significant loss of weight can be verified, the necessary time must pass so that the physiological mechanisms in the human body that regulate the maintenance of normal weight adapt to the new balance between intake and calorie consumption . “This process can last several weeks and requires a dose of patience and perseverance that patients do not usually have, if not adequately prevented,” explains CEU University professor Cardenal Herrera.
Healthy eating and physical exercise, two fundamental pillars
A healthy diet includes a consumption of common salt of approximately 5 or 6 grams a day, which can be easily achieved by eliminating the salt shaker from the table and paying attention to food labeling to avoid those that are rich in salt such as salted fish, canned in general, packaged vegetable juices and most cheeses. Thus , a drop in blood pressure of up to 5 mmHg can be obtained , according to Knee.
In turn, regular physical exercise has shown that it can reduce blood pressure by up to 7 mmHg . It is advisable to practice at least 30 minutes of moderate intensity dynamic aerobic physical exercise (walking, running, cycling or swimming) between five and seven days a week.
The two sides of the treatment
High blood pressure and its treatment have several obvious handicaps, says Castro. First, “ the absence of symptoms at the onset of the disease , which prevents its diagnosis and the perception by the patient. Secondly, adherence to pharmacological treatment , often with involuntary non-compliance , which must be endeavored to avoid. And finally, the also inadequate perception that changes in ‘my’ lifestyle are a loss of quality, which is precisely the opposite when it is carried out. ”
This cardiologist points out that the treatment is based on a large number of studies with hundreds of thousands of patients, which have shown that the reduction of 10 mmHg in systolic pressure (the “high”) and 5 mmHg in diastolic pressure (the “high”). low ”) reduces mortality by 10 to 15 percent; stroke, 35 percent; coronary events (heart attack and angina pectoris), 20 percent; and heart failure, 40 percent. All this regardless of other factors.
Castro concludes by saying that “treatment has two aspects: lifestyle modification and drugs. In most cases, both are necessary ”. And he stresses that lifestyle modification improves the effectiveness of the medication .
