Hypertension, the silent disease: 4 million undiagnosed
The hypertension does not produce symptoms, hence there are up to 4 million hypertensive patients undiagnosed. In Spain, there are 14 million people with high blood pressure, which represents approximately 50% of those over 55 years.
"The main problem is that of the 14 million patients with the disease, 4 million does not know and another 9 million does not have it controlled", explains Dr. Antonio Álvarez-Viéitez, clinical cardiologist at the Hospital La Milagrosa.
It is established that a person has arterial hypertension when the elevation of blood pressure above 135/85 mm Hg. It is desirable that it be below 125/80 mm Hg. We must also forget the old concept of compensated and decompensated blood pressure because it has been seen that this does not mean an increase in risk.
Symptoms and causes of hypertension
Hypertension does not produce symptoms, the main fact of underdiagnosis. "When there are severe headaches and dizziness, sometimes the tension rises but it is not a symptom, but a cause." The same happens when there are spills in the eyes or nosebleeds (epistaxis), which is anxiety that causes the rise in tension ", explains the cardiologist at the Hospital La Milagrosa.
In 95% of cases, The cause of high blood pressure is unknown (called essential hypertension) where they can influence for example inheritance, obesity, sedentary lifestyle, the intake of drugs and some medications (anti-inflammatory), or sleep apnea.
Risks of high blood pressure
High blood pressure affects the heart causing the thickness of its walls to increase (left ventricle hypertrophy) causing decreased myocardial risk, heart failure and arrhythmias.
It can affect the blood vessels producing micro-trauma in the inner layer of the arteries (endothelium) and here attach cells (platelets) and begin to form plaque of atheroma and obstruction of the arteries. It can affect all the arteries: coronary (heart attacks), cerebral (strokes), those of the retina and those of the kidney (renal insufficiency).
Another risk is that when the pressure increases, bleeding occurs when an artery ruptures (hemorrhagic stroke).
How to make the diagnosis of hypertension?
It is advisable to perform taking blood pressure every 6 months after age 40 and more frequently if you have a tendency to hypertension. "In hypertensive patients, I recommend that they take the stress themselves, in order to avoid the anxiety component of going to the doctor (white coat hypertension)," explains Dr. Álvarez-Viéitez. Blood pressure should always be measured with a cuff placed on the arm, because wrist devices are much less reliable.
The definitive diagnosis is made with an ambulatory pressure monitoring for 24 hours (voltage Holter). With this device you can see the voltage peaks, the percentages of hypertension and the pressure during sleep.
What is the best treatment for high blood pressure?
It is recommended avoid the three eses: sedentary lifestyle, overweight and salt. A pharmacological treatment is almost always necessary if this is not achieved.
According to the cardiologist at La Milagrosa Hospital, "the treatments are based on decreasing the circulating fluid (diuretics), decreasing the strength and frequency of contraction of the heart (beta-blockers) and increasing the arterial continent (vasodilators)".
Marina Berrio
Advice:Dr. Antonio Álvarez-Viéitez, clinical cardiologist at the Hospital La Milagrosa.
