Hypertension Article Competition Winner (English)

HIGH BLOOD PRESSURE: THE SILENT ENEMY Lifestyles and their relationship to blood pressure levels

By Kevin Josue Mejías Palma

Keywords: HTN, risk factor, ACE inhibitor, treatment, diagnosis.

INTRODUCTION Objective:

To

demonstrate

the

importance

of

publicizing the benefits of good lifestyle habits to

Blood pressure is the pressure with which blood

prevent diseases such as high blood pressure that are

circulates inside the arteries and is expressed through

the cause of a high number of deaths despite their easy

different measurement techniques such as systolic

control.

tension and diastolic tension.

Methodology: It is necessary to determine the influence

High blood pressure is a major risk factor for

of good lifestyle habits in order to carry out a good

cerebrovascular disease, coronary heart disease, heart

prevention program that reduces the risk of suffering

failure, renal failure and peripheral vascular diseases. It

from hypertension and with it morbidity and mortality.

is estimated that, under optimal conditions of treatment and control of hypertension in a population,

Results: High blood pressure is still a disease that is hyper diagnosed and that therefore the morbidity and mortality rate has increased considerably over the years. As a preventive measure mustn develop new

it would be possible to reduce

the associated

cardiovascular diseases by up to 70%.

EPIDEMIOLOGY

research that address aspects that interfere with

High blood pressure is considered to be the leading

adherence to pharmacological treatment of arterial

cause of death and disability worldwide.

hypertension.

In Costa Rica the prevalence of the disease is not well

Conclusion: Hypertension is one of the lethal diseases

defined and few studies have been published. In a study

whose mortality rate has grown the most in recent

conducted by Arguedas in 1979 (Epidemiology of

years (32%) and causes, directly or indirectly, a high

hypertension in Costa Rica. Cooperative study 1976-

morbidity and mortality in the world population. The

1979; unpublished manuscript) established

biggest problem with hypertension treatment is the low

prevalence was 9.0%, which meant that there were a

level of therapeutic compliance.

total of 86,070 hypertensive Costa Ricans at that date.

In addition to age and sex, overweight, tobacco, alcohol,

Although the prevalence figures of hypertension

and lack of physical activity directly contribute to raising

increase over the years, the truth is that this disease is

BP, so the recommendation to maintain healthy habits

not exclusive to any particular group or gender.

has

become

treatment.

the

cornerstone

of

that the

hypertension

PHYSIOPATHOLOGY Genetic bases of high blood pressure they are still unclear. Nevertheless, there are some theorys that they

try to explain the high blood pressure; between the mas

However, sometimes the cause is not determined, so a

featured we can mention sympathetic hyperactivity,

large number of environmental and genetic factors

and genetic defect in the excretion renal sodium.

come into play. 90% of cases of high blood pressure are of idiopathic origin, and only 10% are of secondary origin

According to the Costa Rican Social Security Fund (CCSS, 2002) [To diagnose a person as hypertensive requires at

Table 2. Main causes of secondary hypertension.

least two assessments on different occasions spaced apart for a reasonable time of at least one month].

Because high blood pressure is virtually asymptomatic, it is referred to by some people as "the silent enemy."

Treatment of high blood pressure aims to reduce morbidity and mortality with as little intervention as

Indeed, hypertension is defined as the elevation of

possible.

blood pressure equal to or greater than 140/90 mmHg. Classification Table 1 shows the classification for blood pressure according to the Guide for the Detection, Diagnosis and Treatment of Arterial Hypertension in the First Level of Care of the Costa Rican Social Security Fund (CCSS).

TREATMENT

Table 1. Blood pressure rating (mmHg)

ETIOLOGY In people under 13 years of age, secondary and potentially curable forms of hypertension, such as renal

Non-pharmacological treatment It consists of dietary measures, decreased alcohol intake, stopping smoking, decreasing body weight, physical activity and stress management.

It has been shown that a diet rich in fruits, vegetables,low-fat dairy products, and a reduced total fat content, can produce a reduction between 8 and 14 mmHg in systolic blood pressure (SBP).

artery stenosis, are the most common and occur in 90% of cases.

Table 3. Non-pharmacologicaltreatment

High blood pressure is an important risk factor for the development of a large number of other conditions, including

myocardial

infarction,

heart

failure,

cerebrovascular events and kidney disease.

BIBLIOGRAPHY

Source: Costa Rican Social Security Fund

Pharmacological treatment It aims to achieve the maximum reduction of cardiovascular morbidity and mortality, through the sustainable normalization of the patient's blood pressure figures.

It is given to all patients who are in stageI who do not respond to non-pharmacological treatment for a period of 2 to 3 weeks, also to all those who are in stage II. The list of antihypertensive drugs includes thiazide diuretics, β-Blockers, calcium antagonists, angiotensinconverting enzyme (ACE) inhibitors, angiotensin II receptor antagonists (ARBs-II), direct vasodilators, among others.

Diuretics and beta-blockers have proven effective in reducing cardiovascular mortality and morbidity, which is why they are considered the first choice in the treatment of uncomplicated high blood pressure.

SUMMARY Hypertension (hypertension) is the most common chronic disorder, with the global prevalence currently estimated at around 1 billion individuals. Casi 7 100 million deaths per year are directly or as a close consequence of this disease.

1. Costa Rican Social Security Fund. Guidelines for the Diagnostic Detection and Treatment of Arterial Hypertension in the First Level of Care. 2002.

2. Costa Rican Social Security Fund. People's Health Care Plan. 2001.

3. Banejas, R. R. (2017). Epidemiology of arterial hypertension. Hypertension and Vascular Risk, 34, 2-4. https://www.elsevier.es/es-revistahipertension-riesgo-vascular-67-articuloepidemiologia-hipertension-arterialX1889183717611257 4. Fiedler-Velasquez, E., & Gour zong-Taylor, C. (2005).

Epidemiology and pathogenesis of essential arterial hypertension, role of angiotensin II, nitric oxide and endothelin. Acta Médica Costarricense, 47(3), 109117. https://www.scielo.sa.cr/scielo.php? script=sci_arttext&pid=S0001-60022005000300003 5. Ministry of Health of Costa Rica. Dietary guidelines for nutrition education in Costa Rica. Ministry of Health; 1997.

6. Morice. A. (1998) Analysis of the situation of chronic noncommunicable diseases in Costa Rica.