Arterial hypertension
What is high blood pressure?
A diagnosis of high blood pressure is medically referred to as a diagnosis of hypertension.
An individual is considered Stage 1 hypertensive if he or she has resting blood pressure values that are permanently above 130 mmHg (systolic pressure, i. e. blood pressure during the heart contraction phase) or permanently above 80 mmHg (diastolic pressure, i. e. blood pressure during the heart rest phase); that is, an individual has stage 1 hypertension if his or her resting blood pressure is above 130 or 80 mmHg.
An individual has stage 2 high blood pressure if he or she has resting blood pressure values permanently above 140 systolic or 90 diastolic.
Although one billion people worldwide are taking antihypertensive drugs, many others do not know they have them because hypertension is often asymptomatic. It is often diagnosed during a routine examination. However, headaches, ringing in the ears, dizziness or shortness of breath during exercise can be warning signs.
The different forms of arterial hypertension
In more than 90% of cases, it is essential hypertension, aka essential hypertension. This form is due to ageing, lifestyle and lifestyle factors (tobacco, excessively salty food) and heredity. In a minority of cases, there are secondary forms of high blood pressure due to excess hormones or kidney disease.
There are very specific forms of elevated blood pressure during pregnancy. This pregnancy toxemia affects women who were not hypertensive, and it can take very dangerous forms for both the child and the woman at the end of pregnancy (eclampsia). Most often, this occurs during the first pregnancy and justifies blood pressure monitoring of pregnant women.
Finally, high blood pressure is not always an essential hypertension but can also be secondary and result from a pathology that will have the effect of generating this hypertension.
Complications of hypertension
High blood pressure is not a disease in itself, but it causes cardiovascular diseases that can be serious: stroke, myocardial infarction, dementia... That is why it is important that pre-hypertensive individuals adopt a healthy diet and lifestyle - so they can work toward reducing their blood pressure.
Hypertension treatments
To limit the risks of high blood pressure, it is first necessary to make lifestyle and diet changes, as well as participate in physical activity adapted to one's condition. Supplemental medication treatments will additionally assist in reducing blood pressure.
The difficulty with high blood pressure treatment is that it is not possible to know in advance which medications will be effective and tolerated by the individual. As a result, doctors often struggle at the beginning of treatment, sometimes for several months, before finding the right "recipe," usually a combination of drugs (there are seven main families) to optimize the effectiveness and tolerance of the medication.
The objective of medical research is to simplify treatment with a fixed combinations of drugs, i.e. with at least two components in the same tablet. The first triple therapies (Triple Pill) for hypertension are appearing on the market. For the patient, this is a real simplification of medication, which undoubtedly promotes compliance with the treatment (compliance with the medication prescribed by the doctor). Today, this is the most complex goal to achieve: get a patient with few symptoms to take a medication every day.
Article written under the supervision of Professor Jean-Jacques MOURAD, Head of the Internal Medicine Unit at the Avicenna University Hospital of Bobigny (93), President of the French Committee for the Fight against Hypertension.
Published Dec 24, 2018
