Hypertension: careful measuring of pressure makes it easy to follow up

Hypertension is indirectly responsible for thousands of deaths per year. It is a cause and independent factor of sudden death, and at each elevation of 10 mmHg (millimeters of mercury) there is already a significant increase in the risk of death. Hypertension accounts for 54% of strokes and 47% of cases of acute myocardial infarction.

The normal blood pressure measurement should be less than 130 (maximum) per 85 (minimum). This is the measure in millimeters of mercury, the unit used to measure the pressure - in this case, blood pressure flowing through the arteries. Another way of talking is in centimeters, which fell in popular taste, getting 13 by 8.5. Blood pressure is an indirect measure of how much the heart is pumping of blood and how the resistance of the arteries prevents the passage of blood, increasing the pressure inside the blood vessel.

Electronic meters do not need the help of a professional. Images

People with high blood pressure should monitor it frequently, and significant changes should be reported to the physician. However, it is important to follow simple instructions to gauge the pressure correctly, avoiding the wrong results.

Today there are many electronic devices for measuring pressure. They allow the person to be self-sufficient in triggering the device, which is usually placed on the wrist or arm. In addition to electronics, we have the mercury column, increasingly rare in the market, and the analogues (the latter two are more reliable, but depend on a person capable of measuring the pressure).

The blood pressure measurement should be (ideally five minutes), in a sitting position and with an empty bladder (to prevent bladder distension causing discomfort and raising pressure). Give preference to times when you or the person measuring the pressure is without extreme pain or anxiety.

The arm should be positioned at the level of the heart, supported by some surface. Low arm can accumulate blood and create a small edema that distorts the measurement. After the positioning of the digital electronic device, we wait thirty seconds, with the cuff allowing a finger to enter without difficulty between the cuff and the skin (do not leave too tight or too loose).

is an extremely useful tool to guide treatment

Avoid talking during measurement. Preferably, repeat the measurement after five minutes on the digital device, to check the result. Analog and mercury devices do not require this.

No difference in left or right arm measurement, except in the case of aortic diseases or large vessels. For the first time, the pressure can be seen in both arms for future reference - but this must be done by the doctor in the office.

The devices must be calibrated every two to three months, and the mercury can be calibrated less often.

Residential blood pressure measurement (HBP) is an extremely useful tool for guiding treatment, and the patient can establish a diary, with two measures or more per week at different times, and show to his / her physician at the appointment.

Systemic arterial hypertension (SAH) has three stages: from 140/90 to 160/100 mmHg, from 160/100 to 180/110 mmHg and greater than 180/110 mmHg. The pressure of the person is constantly raised, not raised at times. This idea that pressure is not always high causes people to treat it only when they have symptoms (the most common headaches, tiredness, palpitations).When pressure is high but without symptoms, forced filtration through the kidney creates tiny holes and scars that will lead to kidney failure, small brain aneurysms that can rupture, and small bleeding into the retina that can lead to blindness. Hence the importance of not replacing doses or forgetting medicines.

Facing the disease

According to the Brazilian Society of SAH, the treatment is multidisciplinary and complementary. The recommended diets are DASH and the Mediterranean diet, and exclusive vegetarian diets are not an approach for treating SAH, because despite the low sodium and fat content, they are poor in vitamins and nutrients. Diets such as Dunkan and Atkins (protein diets), have no benefit because of the overload of sodium and fats, which leads to acute decompensation of lipids, cholesterol, triglycerides, uric acid and the pressure itself.

Aerobic exercises are preferred for treatment of hypertension, because they cause less changes in blood pressure than resistance exercises. For stress control, relaxation techniques such as yoga are stimulated, as long as they fit the patient's taste.

In women one of the causes of hypertension is related to the use of hormonal contraceptives. In women with SAH who are using contraceptives, we should, if possible, discontinue the contraceptive and assess the pressure over three months. If there is reduction, restart with minimal doses of estrogen and progesterone. If it persists, we should consider another form of contraception.

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