What is high blood pressure?
An individual is considered hypertensive if he or she has resting blood pressure values that are permanently between 140 mmHg (systolic pressure, i. e. blood pressure during the heart contraction phase) and 90 mmHg (diastolic pressure, i. e. blood pressure during the heart rest phase); that is, above 140/90 mmHg.
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. This is due to ageing, lifestyle and life 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 is pregnancy toxemia, which affects women who were not hypertensive and 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 monitoring the blood pressure 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 for pre-hypertensive people to adopt healthy dietary rules and a lifestyle that help reduce this blood pressure.
To limit the risks of high blood pressure, it is first necessary to respect the necessary lifestyle and dietary rules and to carry out physical activity adapted to one's condition. Medication treatments can also reduce this blood pressure and allow you to live normally.
The difficulty of hypertensive treatment is that it is not possible to know in advance which molecules will be effective and well tolerated by the subject. As a result, the doctor will often fumble at the beginning of treatment, sometimes for several months, before finding the right "recipe" combining several drugs (there are seven main families) to optimise the effectiveness and tolerance of the medication.
The objective of medical research is to simplify treatment with fixed combinations of drugs, i.e. with at least two components in the same tablet. The first triple therapies in hypertension are coming on the market. For the patient, this is a real simplification of medication, which undoubtedly promotes compliance with treatment (compliance with the medication prescribed by the doctor). Today, this is the most complex goal to achieve: to 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 29 May 2017