ALL YOU NEED TO KNOW ABOUT HEART HEALTH...

WHAT IS HYPERTENSION? E In some people, the force with which the blood circulates through the body (blood pressure) is increased chronically, we say that there is hypertension. Hypertension is a disease that no symptoms for many years and left to its evolution without treatment may be that the first sign that she has is a severe complication such as myocardial infarction or cerebral hemorrhage or thrombosis, and so on. thing that can be avoided if properly treated and controlled. The limit values are now accepted as normal to 140 mm Hg systolic and 90 mm Hg for diastolic pressure figures popularly known as 14 and 9

WHY IS DANGEROUS HIGH BLOOD PRESSURE? The damage on our body produces hypertension has been unknown for long. Until the sixties was not clearly demonstrated that maintaining the high pressure produced severe health complications (stroke, angina pectoris, myocardial infarction and congestive heart failure) and that a sustained reduction of blood pressure significantly increases the year life of the patient, as it reduces cardiovascular events characteristic in these patients.

The survival difference between a person with normal blood pressure and hypertension is that in the hypertensive arteries harden as they endure the high pressure continuously, grow thicker and tortuous and can be impeded the passage of blood through it. This is known as arteriosclerosis and is accelerated in hypertensive subjects. Therefore, the severity of essential hypertension is that it is an important risk factor for cardiovascular disease that presents as an asymptomatic.

WHAT IF I DO NOT CARE HIGH BLOOD PRESSURE? Hypertension then its evolution will inexorably. This occurs without symptoms, without you even noticing. It will be years later when the consequences of the disease insidiously introduced, appear and affect the kidneys, heart, eyes, brain and throughout the arterial tree. High blood pressure makes the workload of the heart, which increases in size and could fail, what we call heart failure. The first risk is myocardial infarction, untreated hypertension is, on average, 10 times greater risk of dying from heart attack than a person with normal tension. Continuous pressure within the main arteries of the brain can produce blood clots or arterial ruptures and may lead to bleeding, nerve cell damage, memory loss, paralysis, etc..

The kidney also suffers from high blood pressure among hypertensive patients and renal failure occurs more frequently than among normotensive patients. Small vessels in the back of the eye (which are viewed with the ophthalmoscope), are also threatened by hypertension, rupture causes bleeding up to and including loss of vision.

WHAT CAN BE DONE TO HIGH BLOOD PRESSURE? There are a number of measures with which your doctor can control their blood pressure numbers and avoid the serious consequences of hypertension. In case of moderate hypertension, a programmed plan of diet and exercise may be all you need. We have seen that there are a number of factors (dietary habits and lifestyle) that are associated with elevated BP levels. If this is not enough, a large arsenal of drugs to supplement these measures. Your doctor will decide which medication is right for you and the dose to take. However, remember that the failure to take "pills" for hypertension, does not mean you can stop dieting and exercise that you have recommended.

WHAT CAN I DO FOR MY BLOOD PRESSURE? The excesses of any kind are bad for everyone, not just for people who have high blood pressure numbers. MY BLOOD PRESSURE IS CONTROLLED? Whether hypertension is easily controlled. Simply measuring blood pressure with a device that can be called aneroid sphygmomanometer or mercury that is most used today by doctors or can also be done with an automatic measuring device. The World Health Organization (WHO) considers 140/90 mm Hg is the upper limit of normal for blood pressure. Therefore, if your doctor measures a blood pressure of 12 / 7 (120/70), or 13 ½ / 8 (135/80) your blood is normal. More lies that limit, you start a border area which requires monitoring more closely by their doctor. If you are under 40 years and also a diabetic hypertensive pressures should be below 130/85 mm Hg. If, by contrast, has over 65 years, depending on the circumstances of each patient, perhaps you can tolerate pressures slightly higher than reference, but never above 160/95 mm Hg.

How to measure blood pressure? There are three types of instruments to measure blood pressure: mercury sphygmomanometer is the most accurate and less prone to error, is required to use a stethoscope. Air Sphygmomanometer is the most widely used and is also specific equipment and also need a stethoscope for use. The electronic device, this type of device is widely used for self-control need not carry a stethoscope because of the pulse detector built, is easy to use. It is a device very sensitive to noise and movement, so that the values obtained are accurate, it is necessary that the arm does not move and is not discussed.

NOTE: It is important that the cuff is in good condition and is regularly reviewed. Besides the apparatus is in good condition, to measure blood pressure requires the subject to comply with a number of conditions must be relaxed. Sitting with his right arm on the table. Without the clothes you press the arm. With the bladder empty. Without having eaten, smoked, drunk alcohol or heavy physical exercise done in thirty minutes prior to measurement.

Blood pressure measurement: the sphygmomanometer cuff should be placed at heart level. The top edge of it must be at least 2 cm above the elbow flexure. Then the cuff is inflated to a pressure of 180 mm Hg, if you know that in previous determinations, the systolic pressure was higher than this figure is inflated to a pressure 20 mm Hg above the last known. Place the bell of the stethoscope where previously been localized in the blood throbbing elbow flexure and proceeds to slowly deflate the cuff. The first beat you hear is for the maximum systolic pressure or pulse and the disappearance of the diastolic pressure or minimal. In children and in some adults, the beats do not disappear, then diastolic pressure is considered that in amending the tone of the beats.

"Blood pressure is always the same? Regardless of the health you have, the blood pressure of any person is not constant but suffers many normal variations during the day, but always measured at rest. The figures follow a rhythm blood pressure over 24 hours, which is reproduced from one day to another and is called nictemeral rhythm of blood pressure, so pressure numbers are higher during the day and reduced during sleep. Circumstances tension values increase transiently
Moreover, taking blood pressure causes a reaction occurs which tends to raise alert, as are repeated shots of blood pressure, it tends to fall. So do not take more than two or three times the pressure and is considered the last or the average of all as real pressure.

WHAT IS A STRESS Decompensated? The term is used popularly when pressures are maximum and minimum values close (100/80). However, this situation is not abnormal and from the medical point of view there is no pressure "decompensated". The limits of 140/90 mm Hg for systolic and diastolic pressures respectively are the limits of normal difference whatever between them.

HOW OFTEN SHOULD BE TAKEN BLOOD PRESSURE? If you are normotensive should do every two years in order to early detect any elevation, because no symptoms. If you have hypertension and its pressure dropped to desired levels is sufficient to determine the pressure every three months unless there is some circumstance or new symptoms. If you are starting antihypertensive therapy or changed it, would normally allow a period of two weeks to give opportunity to the drug to exert its effect

IS IT have a means of stress on the patient's home to better control TREATMENT? Generally yes, although the patient should not make decisions about treatment based on blood pressures taken by him. Do not take the next dose of medication prescribed by doctors because the tension is controlled at the time action is quite common and with it all we are getting serious cause large swings in blood pressure that much damage the walls of blood vessels. The thing to do, therefore, is: note the pressures and time that it has been subsequently taken to provide this information to the doctor during each visit.

By taking the tension at home is called self-control and has a number of advantages such as: The pressures taken at the patient's home doctor provide valuable additional information to be very useful for the patient. The values listed are very reliable because it disappears alertness that occurs when the figures are determined in a medical office that we call "white coat phenomenon" and is a reaction which tends to raise blood pressures. Measurements can be made during the various activities throughout the day, which involves the doctor you better recognize and respond to certain situations or stimuli and can adjust better medication so that the tension you have it under control in any situation. It allows precise control of the effectiveness of treatment and may adjust the same, ie the daily number of tablets or doses throughout the day.

WHAT ARE THE CAUSES OF HYPERTENSION. The mechanism of hypertension most common, called "essential hypertension", "Primary" or "idiopathic". There are other types of hypertension, which can be clearly identified and its underlying cause are called secondary hypertension. Thus, some kidney diseases are associated with hypertension (renal hypertension), excessive function of some endocrine glands, cause elevation of blood pressure by increasing production of mineralocorticoids (hyperaldosteronism) or catecholamines (pheochromocytoma).

In essential hypertension have not been described yet, its specific causes, but has been linked with a number of factors that are usually present in most of these subjects. Should be separated from those related to heredity, sex, age and race and rarely modifiable, those that could be changed by varying habits, environment, and constumbres of people, such as obesity, sodium sensitivity, excessive alcohol consumption, oral contraceptive use and a very sedentary lifestyle. The following shall be developed each of these factors.

Inheritance from father to son transmitting a tendency or predisposition to develop high levels of blood pressure. Exact mechanism is unknown, but past experience shows that when a person has a parent (or both) hypertensive / s, the chances of developing hypertension are twice those of other people with both parents normotensive. If you find that in your family blood relatives who have suffered heart attacks (myocardial infarction) at an early age (under 50) or hypertension, you and your family must take the tension with some regularity.

As lack of time means to identify the gene or genes (in the case of the genes actually involved in this process). What we could do is insist on the desirability of the children and descendants of hypertensive blood pressure were taken once a year (in any case we all would have to take blood pressure with periodicity) and that these people are of particular attention to factors that raise blood pressure and have been called modifiable and therefore amenable to such as obesity, excessive salt intake, high alcohol consumption and sedentary lifestyles.

SEX Men are more prone to develop hypertension than women until they reach the age of menopause, after which the frequency in both sexes are equal. This is because nature has given to women while you are of childbearing age with a protective hormones are estrogen and therefore have less risk of cardiovascular disease. In this way nature protects women by ensuring procreation. However, in younger women there is a particular risk when they take birth control pills.

AGE AND RACE. Age is another factor, unfortunately coded, which will influence the blood pressure numbers, so that both systolic and diastolic pressures, or maximum or minimum increase with age and is logically a greater number of hypertensive in older age groups. In industrialized countries the prevalence of hypertension among the population over 65 years is almost 60% which is not to say that because frequent hypertension in the elderly, this is normal and to be hypersensitive to any age carries increased cardiovascular risk, ie the risk of complications such as myocardial infarction, cerebral hemorrhage or thrombosis, renal failure, and so on. As for the race, only to note that individuals of African descent are twice as likely to develop hypertension than whites as well as having a poorer prognosis.

OVERWEIGHT Regardless of the non-modifiable factors that influence hypertension other factors which we call environmental (lifestyle, diet, etc.) are able to highlight the disease is milder or more severe. In this sense, certainly, in most cases, the blood pressure level and even high blood pressure is the result of the lifestyle of a person. The realcionados between weight and blood pressures and between overweight and hypertension, has been known for many years, and reduction of overweight is used to treat the same too long.

Must start with the fact that an overweight individual is more likely to have higher blood pressure than normal-weight individual. As weight increases blood pressure rises and this is much more evident in those under age 40 and women. The frequency of hypertension among the obese, at any age under consideration, is two to three times higher than that of individuals of the same age who are at your ideal weight. It was unclear if obesity by itself the cause of hypertension or if there is an associated factor that increases pressure in overweight, although recent research suggests that obesity is associated with a number of other alterations that would partly responsible for increased blood pressure. It is also true that weight reduction causes these abnormalities disappear.


GENERAL INFORMATION Hypertension. Hypertension or high blood pressure (hypertension) is a term that refers to the fact that the blood travels through the arteries at a pressure higher than desirable for health. In some cases there may be dizziness, nosebleeds, and headaches, but not necessarily. Most affected have no symptoms. That does not mean that you can trust: Most of the deaths that occur each year are the direct consequence of hypertension or its complications on the cardiovascular system or kidney.
Hypertension. NORMAL STRESS. A typical normal BP is 120/80 mm Hg. This means that the heart exerts a maximum pressure of 120 mm Hg during systole or pumping phase, and the heart at rest in diastolic or filling phase, has a pressure of 80 mm Hg. (The pressure of the heart is the same as that of all the arteries of the body). The TA is determined by two main factors among many others: The amount of blood flowing, and the caliber of the arteries by circulating. In general, the circulating blood volume and the smaller the diameter by circulating this volume, the higher the blood pressure.

The kidneys control the volume of circulating water and salt contained in the body. These two facts have a direct impact on BP. The more salt in the body, more water is retained in the circulation, and more can increase BP, which in turn may increase the tendency for arteries to become narrower. Hypertension. Normal values and high blood pressure. (However, a person with a healthy kidney and without hypertension can tolerate a very wide range of salt intake without any effect on the TA). Moreover, if the vessels become smaller, the heart has to work harder to pump the same amount of blood, and increases the pressure at which blood is pumped. Other influences on BP are the nervous system, blood vessels themselves (particularly the smaller arteries, called arterioles) and a number of hormones.
Hypertension. CAUSES OF HYPERTENSION. Hypertension is the increase in BP to 140/90 mm Hg or more. This can occur without a previous known cause (essential hypertension) or as the result of another disease (secondary hypertension). The most common causes of secondary hypertension are: Endocrine (gland): Cushing's syndrome, adrenal gland tumors. Kidney Disease: Stenosis (narrowing) of the renal artery, glomerulonephritis, or renal failure. Pregnancy and oral contraceptive use may also cause high blood pressure in some women.
COMPLICATIONS OF HYPERTENSION. Hypertension DEFINITION excess pressure in the arteries maintained for a period of years and untreated can lead to many complications. It describes the most important. Hypertension ARTERIOSCLEROSIS When blood vessels are subject to increased pressure maintained, respond to thicken, making them less flexible. In these arteries stiff easily fixed with excess fats circulating in the blood. At the level of the kidney arteries, atherosclerosis causes less flow reaches the kidney and the kidneys respond by releasing renin, a hormone that in turn causes an increase in BP. This exaggerates high blood pressure and cause further damage to blood vessels.

Hypertension. HYPERTENSIVE HEART DISEASE. When atherosclerosis affects the vessels that feed the heart muscle or myocardium (so-called coronary vessels), the heart is forced to work harder to maintain blood flow in tissues. In some cases it does increase in size, with cardiac muscle hypertrophy, becoming more rigid and less effective. The end result can be congestive heart failure: The heart is pumping back into the circulating blood as needed, and fluids stagnate in the whole organism.
KIDNEY DISEASE Hypertension fifth of blood pumped by the heart goes to the kidneys. They filter waste products and help maintain proper chemical values. Also control the balance of acids, salts, and water. The kidneys are particularly sensitive to changes in blood flow resulting from hypertension and its complications. They can not function properly if the flow decreases, so the low flow makes more secrete the enzyme renin, which causes arteries to constrict all the body, raising BP in an attempt to restore this flow impairment. But ultimately, what occurs is a vicious cycle that ends more HYPERTENSION and worse renal function, until the renal failure.

Hypertension STROKE Latin term that encompasses all known stroke. When atherosclerosis affects the vessels of the brain may block blood occur somewhere in the brain by a narrowing, or a clot (cerebral thrombosis) or a rupture of a vessel (cerebral haemorrhage). This is much more common in hypertensives, and the risk decreases to treat high blood pressure. MEDICATION FOR HYPERTENSION. Changes in lifestyle, including dietary changes and exercise, are by far the most important in controlling BP, but often need a combination of therapies, including drugs. Regardless of the cause of hypertension, there is a wide range of drugs to treat it, usually used in stages to find the drug plan that works staff in every hypertensive patient.
Hypertension DIURETICS: Usually, the first drug of choice in hypertension is a diuretic. It increases urination and salt, which serves to lower the TA, both the fluid lost as well as lowering resistance to blood flow in the vessels of the body. [However, thiazides may increase blood cholesterol levels].
Thiazide diuretics were considered first choice, although it has long-term side effects non-negligible (increase in blood uric acid, decompensation of electrolytes (salts), etc.).. Thiazides are not effective in advanced renal insufficiency (serum creatinine> 2.5 mg / dl). In this case we usually use the metolazone, indapamide or high ceiling diuretics (furosemide). Not used for high blood pressure potassium-sparing diuretics.

With diuretics, we note that you urinate more frequently and more rapidly after ingestion of liquids. Apart from that, the side effects of diuretics are few, highlighting the loss of potassium or hypokalemia requiring follow the blood potassium levels through analysis and taking potassium supplements, it usually does not suffice with the intake of fruits rich potassium (orange, banana) to correct potassium deficits caused by diuretics. Taking little salt, will be more effective diuretic and potassium loss will be less.

Indications of diuretics: HYPERTENSION excess volume. HYPERTENSION Hypertension of the old diet-dependent obesity. In hypertension with heart failure. Classification of diuretics, dose and duration of action. Hypertension BETA-work by blocking many effects of adrenaline in the body, including stimulating effect on the heart. The result is that the heart beats more slowly and less forcefully. Effects of beta-blockers in hypertension cardíaco.Reducen Reduce spending stroke volume. They reduce the heart rate. Inhibit renin secretion. They have central antisimpático effect. Stimulate the production of kinins. Stimulate the release of atrial natriuretic peptide. They can produce a feeling of fatigue, reduced exercise capacity, impotence, cause asthma, tiredness and lethargy which severely limits their use. Some of them can reduce levels of "good" cholesterol or HDL. Be more appropriate in cases of hypertension with tachycardia, ischemic heart disease in that associated with migraine and glaucoma. Classification of beta-blockers.

CALCIUM - Antagonists: blockers calcium channel blockers prevent calcium entry into cells. This reduces the tendency of small arteries to narrow, decrease myocardial contractility and decreased peripheral vascular resistance. As side effects should describe pedal edema, facial flushing and headache, orthostatic hypotension, constipation, and bradycardia. Reminders of calcium antagonists. Hypertension with coronary ischemia with ventricular premature HYPERTENSION HYPERTENSION HYPERTENSION atrial fibrillation in paroxysmal supraventricular tachycardias. Classification of calcium antagonists, dose and duration of action.

Hypertension. INHIBITORS angiotensin CONVERTING ENZYME (ACE inhibitors) As above, decrease the tendency of small arteries to narrow, but by a different mechanism. Such as will generate a product of the body called angiotensin II, and without which it can produce renin (which raises BP and narrow vessels). Indications of ACE inhibitors are essential hypertension, hypertension with complications diabetes or hypercholesterolemia, hypertension with congestive heart failure or poor ventricular function, hypertension with impaired renal function or poor, most side effects are described, cough, hypotension, headache, edema, edema, skin rashes, and elevated urea. Rank dose and duration of action of ACE inhibitors.
OTHER ANTI-HYPERTENSION DRUGS. Vasodilators. (Hydralazine, minoxidil, diazoxide, sodium nitroprusside) produce dilation of the arterioles by direct action on smooth muscle (relaxed). This dilation causes reflex tachycardia and salt retention and therefore are often used associated with a diuretic and a beta blocker to counteract these effects. The hidrazalina used as third drug in hypertension. Care must be taken with dose. If it is greater than 200 mg there is a risk of a syndrome similar to lupus erythematosus. The minoxidil produces hypertrichosis (hair growth), but is effective in many cases refractory to other treatment.

Sodium nitroprusside and diazoxide are exclusively used in crisis hipertensas.Para severe high blood pressure have been used and Diazoxide Hydralazine. Nitroprusside is used in emergencies (hypertensive crisis), when an extremely high BP may endanger life. Alkaloids, Reserpine, Bietaserpina. Its effect is based on the depletion of catecholamine stores (mediators of self-involuntary nervous response) at central and peripheral. They are usually always associated with diuretic use, so often have gastrointestinal side effects and CNS (depression). They are used quite in the elderly (not lost its effect by too irregular and are taking one dose a day). Reserpine, Rauwolfia, guanethidine, and some alkaloids are other substances used. Each has situations that make it useful and others that limit their use. Concomitant diseases and indications to high blood pressure medicines.

TAKEN AS A BLOOD PRESSURE. Hypertension. DEFINITION. If you suffer HYPERTENSION, a necessary part of treatment is to monitor the TA, which can be done at home, through devices called sphygmomanometers. Sphygmomanometers There are many types, but they all include an inflatable rubber bladder covered by a fabric sleeve, and a pressure measurement system connected to the cuff, either in a column of mercury or a metal diaphragm system. Sphygmomanometers are complemented with a normal stethoscope, which can be included in the equipment or be a separate item. Hypertension for blood pressure, sit quietly 5 minutes, without having smoked or drank coffee, and with an empty bladder.

Put your left arm if right handed and vice versa at the height of the heart, resting on a table or chair arm. Put the cuff around the bare arm, between shoulder and elbow. Place the bell of the stethoscope in the flexure of the elbow, just below the cuff sphygmomanometer. Pump the bulb rapidly until the pressure reaches 30 mm Hg more than the maximum expected. Deflate the cuff slowly, causing the pressure to fall 2 to 3 mm Hg per second. Listen to the sound pulse as the pressure falls. When the heartbeat becomes audible, note the pressure, which is the maximum or systolic BP. Follow deflating. When you hear the heartbeat stops, note the pressure again, which is the minimum or diastolic BP. Repeat the process at least once more to check the readings.