High blood pressure, known as hypertension, affects a large part of Brazilians, about 38.1 million people aged 18 or over, which is equivalent to 23.9% of the population in that age group, according to the National Health Survey (PNS) of the IBGE.
What is Blood Pressure
The term “blood pressure” (BP), sometimes referred to as “blood pressure,” refers to the pressure exerted by circulating blood on the walls of the arteries. This pressure is produced in part by the heart, which is the muscular organ that contracts and pushes blood into the arteries. In systole, it injects about 70 ml of blood into the arterial system, in each “beat”, increasing this pressure. As it expands (diastole), the pressure drops. Thus, there are two values for blood pressure: (1) the “maximum” pressure or systolic pressure and (2) the “minimum” pressure or diastolic pressure.
In the same way, and with the same consequences, the arteries are also organs that contract slightly and when they contract or dilate they help determine high or low blood pressure. In addition, blood pressure can also be affected by the loss of elasticity of the arteries, which occurs, for example, in atherosclerosis. These mechanisms, in turn, depend on the nervous, cardiovascular and renal systems. Alterations in these structures can alter blood pressure and cause blood pressure problems.
What is High BP ?
According to the Department of Health, it occurs when our pressure values are equal to or greater than 140 x 90 mmHg (millimeters of mercury), which most people know as “14 x 9”. However, since 2020, the Brazilian Society of Cardiology (SBC) considers a figure of 130 x 80 mm Hg (13 x 8) as a condition of prehypertension.
The first number is related to the force that the heart uses to expel the blood from its interior and transport it to all the organs. The second, instead, is the pressure of “relaxation”. If it is too high, the device is overloaded.
Signs and symptoms of high blood pressure
High blood pressure isn’t called the “silent killer” for nothing. Yes, most people with high blood pressure don’t know they have it. But if left untreated, it can cause hardening of the arteries, stroke, kidney damage, and even cognitive decline and dementia.
However, the main symptoms when they occur are:
- The Illness.
- Headache.
- Neck Pain.
- Drowsiness.
- Tinnitus.
- Dizziness.
- Double or blurred vision.
- Labored Breathing.
- Heart palpitations.
Almost Risk Factor’s
The disease is inherited from parents in 30 to 50% of cases. But there are several factors that affect blood pressure levels, including:
- Smoking
- Consumption of alcoholic beverages.
- Obesity
- pressure
- High salt intake
- Sedentary lifestyle.
Reasons
The causes of high blood pressure are various, some normal and others related to habits and lifestyle.
- Heredity: 30 to 50% of high blood pressure cases are hereditary, meaning it is a hereditary condition. If one parent has high blood pressure, about 20% of children have the same diagnosis. If both parents have high blood pressure, the chances of developing it increase to 60%.
- Food: The consumption of foods that contain excess salt, such as ultra-processed foods, as well as excessive alcohol consumption are factors that can cause high blood pressure.
- Permanent Residence: Lack of physical activity is also a factor that can lead to high blood pressure. Yes, exercise helps the heart work properly and also helps control weight and avoid obesity.
High Blood Pressure x Stress
Excessive stress increases the levels of hormones such as adrenaline, norepinephrine, dopamine, and cortisol. As a result, the risk of cardiovascular disease and hypertension arises even in adults with normal blood pressure. So says research published in Hypertension, a journal of the American Heart Association.
The study, which was conducted at Carolina University in Los Angeles in the United States, indicated that when the levels of these four hormones are doubled, there is a 21% to 31% increase in the risk of developing high blood pressure. Thus, the result was obtained after observing the study participants for approximately six years.
Additionally, the likelihood of developing cardiovascular disease increased by 90% as cortisol levels doubled.
And the researchers claimed, in a press release, that levels of these hormones rise in response to stressful events in daily life, whether in personal life or at work. According to the scientists, the analysis shows how mental state can positively or negatively affect cardiovascular health.
Diagnosis of high blood pressure
But how do we diagnose high blood pressure? You will have already had a sphygmomanometer test at least once in your life, that device that presses your arm, at the same time that the doctor touches the artery with a stethoscope, a sphygmomanometer. However, cardiologist Juliana Pérez says that he alone cannot diagnose high blood pressure.
This is because several factors can alter our pressure, and it is considered completely normal. “Having a full bladder, eating just before taking a measurement, and talking during the procedure are a few examples,” she says. Therefore, it is necessary to take at least two blood pressure measurements at intervals of days to weeks or perform the measurement outside the office, for example by ABPM (ambulatory blood pressure monitoring). It is a device that you wear for 24 hours. During this time, check your blood pressure from time to time. The average results will tell you if you have this condition or not.
Finally, frequent follow-up with a general practitioner or cardiologist is also essential.
Complications Behind
Although there are no symptoms, organs such as the heart, brain and kidneys, as well as blood vessels, are affected by the condition, which is considered a risk factor for heart attack, stroke, chronic kidney disease and premature death.
Although medications are part of the treatment, other measures are necessary to combat the disease, such as reducing sodium intake in food, adopting healthy lifestyle habits, with regular physical exercise and a balanced diet. Finally, frequent follow-up with a cardiologist is also essential.
Is high blood pressure curable?
There is no cure for high blood pressure, but it can be controlled. Thus, once controlled, the patient will be able to live very well and with quality of life.
Treatment
As stated, there is no cure for high blood pressure, but it does exist and it can be controlled. Only a doctor can determine the best method for each patient.
The SUS offers free medicines in the Basic Health Units (UBS) and through its popular pharmacy program. To get the medicine, you just need to present a photo ID, CPF and a prescription within the validity period, which is 120 days. The prescription can be issued by an SUS specialist or by a doctor working in hospitals or private clinics.
Treatments for high blood pressure
Around 10 million people die every year in the world due to complications of high blood pressure. In Brazil, 30% of the population has high blood pressure, according to data from the Brazilian Society of Cardiology. Because it is a problem that affects so many people, the number of drugs available to control the condition is high: in the country alone, there are more than 40 options, listed by the Ministry of Health. Although many of the options are newer high blood pressure medications, medications that have been on the market for years are still used. In this sense, it is common to ask the question: which is better?
Both, according to Fabio Pita, a cardiologist at the Israelta Albert Einstein Hospital, since the effects vary a lot. “These are not new classes of substances, that is, they have an action similar to old drugs,” explains the expert on the effect of new drugs.
The main difference lies in the dose or posology. “It is possible to reduce the number of times a patient needs to take medication from three times to once a day, for example,” explains Pitta.
Medications against high blood pressure
Among the most used medications to control high blood pressure are:
- Diuretics – increase the excretion of sodium in the urine, reduce fluid retention in the body and help lower blood pressure. There are more than seven classes of this type of medication, but all of them should be taken only under medical supervision;
- Adrenergic blockers: They act in the central nervous system by relaxing the blood vessels and allowing blood to circulate more easily. They are divided into two types: alpha-1 blockers and beta blockers.
- Direct vasodilators: promote the dilation of blood vessels, facilitate blood circulation and prevent excessive cardiac stress.
- Calcium channel antagonists: These prevent calcium from entering the cells of the heart and arteries, allowing the vessels to remain relaxed and open for blood flow. Some types can slow the heart rate, protecting the heart from the risks caused by overexertion of the organ.
- Angiotensin-converting enzyme (ACE) inhibitors: These block the production of a hormone called angiotensin, which is responsible for the narrowing of blood vessels.
- Angiotensin II receptor blockers: These are similar to ACE inhibitors, except that they act on angiotensin II receptors, preventing them from working in the body.
Diet for High blood pressure
Bad eating habits can exacerbate the problem. Therefore, it is very important to change them ”, emphasizes the nutritionist. That is, you have to reduce sodium consumption (it is recommended to eat only 5 grams a day) and processed, combined and processed foods. “Crusted meats, salami and mortadella, for example, are considered bad.”
On the other hand, you should increase your intake of elements rich in fiber, potassium, calcium and magnesium, which are found mainly in fruits and vegetables. “Milk derivatives, if they are skimmed, are a great option,” she adds. In short, she is committed to:
- Consume less sodium
- Limit the intake of processed foods;
- Reduce or significantly reduce alcoholic beverages on the menu;
- Eat a well-balanced diet (and be referred by a nutritionist) that respects your routine and food preferences;
- Eat more fruits and vegetables (ie less packaging, more peels!);
- Give up smoking
- Finally, do physical activities under supervision.
Dash Diet – Cardio diet
The DASH diet (Dietary Approaches to Stop Hypertension) or, in a free translation, Diet to Stop Hypertension, proposes a low consumption of sodium, sugars and saturated fats found in fried foods, red meats and processed foods. Thus, the list arose from a study carried out at universities in the United States that evaluated the effect of food restriction on blood pressure.
But in addition to stopping high blood pressure, one variation suggested cutting calories to aid weight loss and improve metabolism. With this, the consumption of fruits, vegetables, low-fat dairy products, fish, oilseeds and whole grains, such as oats and flaxseed, is released.
Thus, total fat should account for 27% of the total food for the day, with up to 6% coming from saturated fat and up to 150 milligrams of cholesterol. In addition, carbohydrates represent 55% of calories and proteins 18%.
What can you Eat
- Lean meats: skinless chicken and fish, which are low in saturated fat, cholesterol, and total fat.
- Nuts: The dash diet recommends four to five servings of nuts per week (one serving equals ⅓ cup or 40 grams).
- Fruits, vegetables and greens: 4 to 5 servings of fruit per day are allowed, juice counts. But the ideal measure of vegetables per day is 1 cup if they are raw and 1/2 cup if they are cooked.
- Milk and its fat-free derivatives, cheese, yogurt and other milk derivatives are effective for losing weight.
- Whole Grains: Whole grain breads, cereals, pasta, or whole wheat are allowed. Well, whole foods are more nutritious than refined foods, because they contain more fiber, vitamins, and minerals, which are kept in the structures that were removed by refining.
- Oil
Does rosemary tea help improve high blood pressure?
Consuming tea in general helps to improve high blood pressure, since it is diuretic. Diuretic tea results in the removal of salt and water from the body, thus lowering blood pressure when urinating.
Rosemary has medicinal properties that improve blood circulation and therefore help lower blood pressure. However, medical treatment should not replace drinking.
Exercises for high blood pressure
Physical exercise can help lower blood pressure. Plus, it also gives you more energy and is a great way to relieve stress and feel better.
A review of studies published in the British Journal of Sports Medicine, a specialized magazine, suggests that physical exertion may have the same potential as medication in controlling this disease.
- Cardiovascular or aerobic exercise: These can help lower blood pressure and strengthen the heart. Examples include walking, running, jumping rope, bicycling (stationary or outdoor), skiing, rowing, high or low impact aerobics, swimming, and water aerobics.
- Strength Training – Build strong muscles that help you burn more calories throughout the day. It is also good for joints and bones. Also, strength training is important to protect the body from injury in aerobic exercise.
- Stretching: makes the body more flexible, helps you move better and prevents injuries.
Moderate activity, such as brisk walking, is recommended for 30 minutes, at least 5 days a week. However, if you’re short on time, vigorous activities like running will give you the same benefit in 20 minutes, 3-4 days a week.
High Blood Pressure During Pregnancy
Gestational hypertension (DHEG), or high blood pressure, is the most common health problem among pregnant women. High blood pressure can affect both mother and fetus, and you don’t need to have a history of the condition to develop complications. The causes of high blood pressure during pregnancy may be related to an unbalanced diet or a placental abnormality.
Thus, soon the body begins to present changes. That is, the indicators exceed 140/90 mm Hg, and the woman begins to feel pain in the neck, headache, blurred vision, abdominal pain and swelling among the main symptoms.
When the picture appears only after the 20th week of pregnancy, it is called gestational hypertension. The situation is maintained throughout the pregnancy. But they tend to disappear up to 3 months after delivery.
The disease can be serious and can lead to preeclampsia, which is a serious complication that leads to miscarriage if not properly treated.
In Brazil
Data from the Epidemiological Bulletin published by the Ministry of Health show that gestational hypertension was the main direct cause of maternal death among deaths that occurred between 1996 and 2018, followed by hemorrhage, puerperal infection, and spontaneous abortion.
Maternal death is the death of a woman during pregnancy or within 42 days of its termination, regardless of the duration or location of the pregnancy.
The same survey points to high levels registered in Brazil. In 2018, the country registered 59.1 deaths of pregnant women for every 100,000 live births. Well above the target set with the United Nations, which was 35 deaths in 2015.
High blood pressure during pregnancy is associated with serious complications for both the mother and the fetus. Yes, when the pressure is high, it makes the heart work harder so that the blood is distributed correctly throughout the body. Therefore, it is extremely important that a pregnant woman have her blood pressure levels measured at every medical appointment.
Symptoms
- Widespread swelling
- Blood pressure greater than 140/90 mmHg.
- Continuous headache
- Severe abdominal pain;
- Blurry vision
- Neck Pain
- Photosensitivity
Risk Factor’s
Pregnant women with hypertension are at increased risk of preterm labor, placental abruption, changes in placental blood flow, and fetal growth restriction. Thus, complications are more common in women with a severe condition, characterized by blood pressure levels above 160/110 mmHg.
- Under 18 years of age or over 35 years of age
- First pregnancy
- Over weight
- Aries twins
- Having a family history of preeclampsia
Consequences of gestational hypertension
As a result, DHEG poses serious risks to the life of the pregnant woman and the fetus. In the mother, it can cause seizures, kidney failure, stroke, anemia, heart failure, and bleeding. With this, the danger extends to the baby, who begins to receive less blood from a poorly inserted placenta, and may die from lack of these nutrients.
In rare cases, the placenta separates, leading to the consumption of large amounts of platelets and clotting factors, as well as preventing oxygen from reaching the fetus. Therefore, delivery must be immediate. The infant mortality rate exceeds 50%, warns Negrini, as well as the risk of severe bleeding for the mother, with prematurity being another consequence.
To delay delivery and avoid the effects of prematurity, it is possible to maintain the pregnancy until later stages using antihypertensive drugs. However, control must be maintained until 42 days after calving. Well, the substances that are released in the placenta that raise blood pressure take a long time to metabolize.
Types of high blood pressure during pregnancy
Pre-existing: Women who had high blood pressure before pregnancy will continue to have it throughout their pregnancy. But if it was recognized before the 20th week of pregnancy, then the woman already has high blood pressure, and she does not know it.
Arterial hypertension during pregnancy: it appears only after the 20th week and does not present loss of protein in the urine or signs of severity, which returns to normal in the postpartum period.
Preeclampsia: When high blood pressure appears after the 20th week of pregnancy and is associated with loss of protein in the urine, or proteinuria. It may also be associated with other signs of risk: problems with the kidneys, liver, central nervous system, or a low platelet count.
Risk of Preeclampsia
When left untreated, it can progress to eclampsia, causing seizures, coma, and even death for both mother and baby. Yes, it is a more serious form of high blood pressure. Therefore, all pregnant women should be carefully monitored and have their urine tested frequently. But in cases where blood pressure cannot be lowered, even with medications prescribed by an obstetrician, labor must be stimulated to avoid the risk of death for both.
Treatment of high blood pressure during pregnancy
A diet to help lower high blood pressure during pregnancy should be low in salt and high in folic acid, which is a way to prevent fluid buildup and lower blood pressure.
Thus, most of the drugs used in the treatment are contraindicated during pregnancy, which makes it difficult to control blood pressure. Well, unless it’s a serious condition, doctors prefer not to treat it with medication. But although a pregnant woman can have her blood pressure measured at home, counseling is follow-up to prevent the situation from getting worse. This means that in the case of non-severe gestational hypertension, the pregnant woman does not need bed rest, but a reduction in daily activities is indicated. Finally, women who develop severe gestational hypertension have complication rates similar to those of preeclampsia. Therefore, they should receive the same treatment.
Arterial hypertension in children and adolescents.
Although it is more common among adults, arterial hypertension – also known as high blood pressure – has reached more and more young adults and adolescents. According to the World Health Organization (WHO), pediatric hypertension affects about 17% of Brazilian children.
Therefore, early diagnosis and intervention are very important to prevent further damage during adult life.
“Arterial hypertension has doubled in children and adolescents, and this can have serious consequences for life. Therefore, this pathology, especially in young people, requires correct knowledge and diagnosis for adequate treatment. Most of the Sometimes, identification can be done by taking blood pressure. that are taken by a health professional”, explains Dr. Pedro Jr., HCSG cardiologist.
According to the specialist, childhood hypertension can occur for various reasons. It is “generally associated with childhood obesity and a sedentary lifestyle,” he cautions.
High Blood Pressure can be Prevented
It is very important to follow healthy lifestyle habits and follow the treatment recommended by the doctor, since “high blood pressure can be associated with 80% of strokes and 60% of heart attacks, and we already know that people with high blood pressure High blood pressure are more likely to develop complications from Covid-19”, says cardiologist Rica Buchler, from São Paulo.
Since it is a multifactorial disease, it helps to eat a healthy diet (high in vegetables and low in salt) and control your weight and blood sugar levels. In addition, physical activity and an annual visit to the doctor are always recommended. If a father has high blood pressure, he should start measuring blood pressure at age 20 ”;
Prehypertension: what it is and how to prevent it
Prehypertension occurs when blood pressure is high, but has not yet reached the values required for a diagnosis of hypertension, that is, greater than 140/90 mm Hg. The disease usually has no symptoms.
Therefore, it is necessary to make a diagnosis to initiate prevention and treatment measures according to the needs of each individual, thus avoiding cardiac, renal and neurological complications. If not properly treated, prehypertension can develop into high blood pressure, a condition that carries serious health risks.
According to the scientific journal The Lancet, the number of hypertensive patients in the world has doubled in the last 30 years. The analysis was conducted on 100 million adults, ages 30 to 79, in 184 countries.
What is High Blood Pressure?
Prehypertension indicates high blood pressure, but it is not enough to diagnose hypertension. See below how disease classifications are defined.
- Less than 90 x 60: low pressure
- Between 90 x 60 to 120 x 80: normal compression
- From 121 x 81 to 139 x 89: arterial hypertension
- Above 140 x 90: high blood pressure
Consequences of uncontrolled hypertension
People with high blood pressure should also be extra vigilant about stroke (stroke), as the disease also affects the arteries in the head, which become more fragile and therefore more prone to narrowing and breaking. .
There are also other risks for these patients with high blood pressure, such as:
- Small blockages and bleeds in the brain that can kill neurons, cause dementia and even memory loss;
- Kidney failure: High blood pressure affects the values that supply the retina (tissue under the eye). In this scenario, the patient may experience blurred vision and vision loss.
Why is it important to measure blood pressure regularly?
Pressure monitoring helps to more quickly identify prehypertension and high blood pressure. Therefore, the sooner the diagnosis is made, the better the treatment.
In this way, the pressure can be monitored in pharmacies, health centers or even in your place of residence. For those patients who prefer the third option, it is essential to have blood pressure monitors approved by Anvisa, since they guarantee diagnoses with higher quality and precision.
The Brazilian Society of Hypertension has created a list of most appropriate monitors. It is important to know the characteristics of each one to understand which alternatives best fit your profile. In addition, the SBH indicates that the pressure should be measured after the patient has been at rest for five minutes.
Different Medical specialties involved in the care of hypertension
Because it has a treatment that includes both lifestyle changes and medications, monitoring of conditions such as high blood pressure is most effective when performed by a multidisciplinary team, made up of professionals from different areas working together.
See below some of the disciplines in which this attention can consist, its function and the frequency of consultations proposed:
- General practitioner, geriatrician, family doctor, and cardiologist: The person who diagnoses, prescribes treatment and medications (if necessary), identifies risk factors, assesses associated health conditions, and gives advice on how to prevent potential complications. It is recommended that you have an appointment twice a year or as needed;
- Dietitian: Person who personalizes the recommendations for a healthy diet according to the needs, tastes and routine of each person. This professional will create an eating plan that is adapted to your condition and the objectives set with the doctor, will indicate what, how and when to eat, and will encourage an increase in the consumption of fruits and vegetables and a decrease in sodium in the diet. The recommendation is to consult at least once a year;
- Psychologist: concerned with emotions, thoughts and behaviors, helping mental health, hence the physical. It is not always easy to deal with a diagnosis or the challenges that life presents, so getting psychological support can make a difference in your physical and emotional health. Consultations according to the needs of each person.
Other specialties involved in the care of hypertension
- Physical Educator: Prepare a physical activity plan according to the needs and capacities of the person served, in addition to monitoring and directing the execution of the exercises. consultations as needed;
- Pharmacist: They can help with information on how to properly take a medication, as well as provide guidance on potential drug interactions, and are often prescribed to treat various conditions. He is also able to teach the correct way to use the equipment to measure pressure;
- Ophthalmologist: Routine eye health exams are recommended for everyone. However, since diabetes can lead to possible vision complications, as a form of prevention, it is recommended to consult this specialist at least once a year;
- Dentist: Ideally, everyone should have regular dental appointments, not just people with diabetes. But those with this condition who can’t control their blood sugar well may be at higher risk of oral problems like bad breath, cavities, infections, and gum disease. A preventive follow-up for six months (at least) can avoid these complications and prevent them from getting worse if they occur.
- The nurse: has the role of observing, answering questions, promoting healthy habits and adhering to the treatment suggested by the doctor and other specialists of the health team. Consultations with this professional can be made at least once a year;
