The goal of any high blood pressure therapy is to reduce the risk of complications. Hypertensives should therefore reach values of less than 140/90 mmHg, the normal range (<130/80 mmHg) is aimed for. Values below 125/80 mmHg should be achieved in diabetics and values below 120/75 mmHg in patients with kidney disease. For adults with optimal blood pressure below 120/80 mmHg, 5-year blood pressure screening is recommended; adults with high normal levels (130-139 / 85-89 mmHg) are recommended at least annually.
Change of lifestyle for healthy blood pressure values
In patients with mild hypertension (140/90 mmHg), lifestyle changes alone are often sufficient to normalize blood pressure. If this fails, the doctor prescribes antihypertensive drugs. However, a healthy lifestyle always supports the effectiveness of a drug treatment.
Weight reduction as antihypertensive
A weight loss of around 10 kg reduces blood pressure by 5-20 mmHg.
dietary changes
A consistent change in diet can lower blood pressure levels by an average of 10 mmHg. Recommended - based on a Mediterranean diet - less animal fats, more fish instead of meat, vegetable oils and fresh fruits and vegetables.
Salt reduction when eating
The WHO recommends a salt intake of less than 5 grams per day. Less salt in the food has a positive effect on the blood pressure: cooking with low salt, do not salt and the absence of ready-made food reduces the blood pressure values by a few mmHg.
Regular endurance training
Regular physical training lowers the blood pressure and thus belongs to the therapy program of every patient with hypertension. Endurance sports such as cycling, running or swimming are particularly suitable for reducing blood pressure.
- Reduction of alcohol consumption
- smoking cessation
- stress reduction
Treatment of the underlying disease
In secondary hypertension, treatment of the underlying disease often results in normalization of blood pressure levels. Changing lifestyle is often recommended as well.
Medical therapy
In the medical treatment of hypertension so-called antihypertensive drugs are used. They are usually given as combined preparations (several active ingredients in just one tablet).
- ACE inhibitors
- Angiotensin receptor blockers
- diuretics
- calcium channel blockers
- beta blocker
The choice of the drug ultimately depends on the individual situation of the patient. Antihypertensive drugs must be taken regularly and always at the same time. As a rule, the therapy is life-long. By having a healthy lifestyle, the dosage of the active ingredients can be kept as low as possible.
New European guideline for hypertension
According to the US recommendation of autumn 2017, the European Society of Cardiology (ESC) and the European Society of Hypertension (ESH) have now for the first time on 9 June 2018 at the annual meeting in Barcelona, the new European guidelines for the Treatment of hypertension presented. The recommendation adheres to the definition of hypertension from values of 140/90 mm Hg, but intensifies the treatment goals to mostly 130/80 or lower, focuses more on prevention and early detection as well as on a simplified drug therapy by a drug combination in only one tablet.
"The definition of hypertension remains the same in Europe, that is, hypertension is still diagnosed only 140 to 90," said Thomas Weber, cardiologist at the Hospital Wels-Grieskirchen, president of the Austrian Society of Hypertensiology and initiator of the project "Know your vascular age ? ". "As in the United States, there is a stronger focus on 24-hour blood pressure and blood pressure measurements in Europe - which we have been recommending both here in Austria for many years."
The new guideline also stipulates that the majority of patients only need to initiate therapy from a blood pressure of 140 to 90. "Generally, however, high blood pressure is a complex disease and modern hypertension therapy must be personalized to the patient done - the guidelines set only a rough framework,"
"Whether a drug lowering blood pressure should be initiated depends on the individual risk for cardiovascular diseases: at very high risk, especially in the presence of coronary heart disease, possibly from values of 130 to 85, otherwise generally from 140/90 mm Hg , above 80 years of age, only from 160 mm Hg systolic. " said Priv-Doz. OA Dr. Thomas Weber, Department of Internal Medicine II, Cardiology and Intensive Care Medicine"Primary goal must be to bring all hypertensive patients into the normal range successfully. But currently half of all people with high blood pressure are not or not treated successfully, "says Weber. The reasons for this include, among other things, a lack of adherence to treatment of patients and a still existing underdeveloped disease. "It has been proven that compliance decreases as more and more different drugs are taken. Adherence to therapy should now be improved through the use of fixed-dose combinations: in the case of drug treatment, a combination of different active substances, but in only one tablet, is recommended for most patients right from the start. "
In addition to a drug therapy, hypertension can be positively influenced by various lifestyle measures. "Reduce, for example, the consumption of common salt-five grams a day is enough! Men should drink no more than seven-half beer or seven-quarters of wine a week, women even half! "Advises Weber. And: "Make sure you have plenty of fresh fruit, vegetables, nuts and olive oil! Eat low-fat dairy products, but little red meat! "To keep blood pressure at bay, the cardiologist also recommends regular exercise -" At least 30 minutes at least moderate exertion on five to seven days of the week! "- avoiding overweight and absolute smoking cessation.
1 komentar:
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