in this article:
We often hear about ‘hypertension’ in everyday conversations, but in reality there are many clichés and prejudices that can divert attention from what is today an extremely widespread health problem, and that must be tackled with knowledge of cause.
Why hypertension occurs?
In simple terms, the circulatory system consists of a central pump, the heart, and a system of tubes, inside which blood flows, proceeding because it is driven by a pressure difference between the heart and the ducts, progressively thinner, which are termed arterial vessels, up to the extreme periphery in the capillaries, and then be returned to the heart by the venous vessels. This involves work for the heart pump, as well as a stress on the walls of the arterial vessels.
Moreover, the pump activity performed by the heart is not continuous, but cyclic: the heart muscle contracts (systole), and immediately afterwards it releases (diastole) between one beat and the other, and this is repeated continuously, cycle after cycle. It follows that within the arteries there is a pressure that is not always constant, but oscillates between maximum (systolic) and minimum (diastolic) values. Normal resting blood pressure is between 140 and 100 mm of mercury (mm Hg) of systolic and between 90 and 60 mmHg of diastolic: this occurs under normal conditions.
Transient increases in blood pressure can occur when the body is subjected to particular situations (stress, fatigue, acts of force, anger and even sexual intercourse), but once the contingent situation has ceased, the blood pressure returns to normal values. However, there are conditions in which the pressure of the blood inside the arteries increases, more or less stable and continuous, and in this case we can speak of ‘arterial hypertension’. By convention, hypertension occurs if the measured values are frequently equal to or greater than 140/90 mmHg.
In these conditions the work done by the heart pump is greater, and so do the stress on the walls of the arterial vessels, causing a series of harmful consequences for the organism. Arterial hypertension is not a single pathological condition, but there are two main variants. The overwhelming majority of cases (over 90%) of cases are classified as ‘essential hypertension’ or ‘primary’, since high blood pressure by itself is not attributable to other obvious pathologies, and blood pressure increases without apparent cause.
There is also a percentage (less than 10%) of so-called ‘secondary’ forms of hypertension, when increases in blood pressure are found in other known diseases: diseases affecting the kidneys, arteries, the heart or the system hormone; in such cases it is more correct to speak of ‘hypertension in the course of another disease’.
The first aspect that should be considered in describing the phenomenon ‘arterial hypertension’ is that arterial hypertension can determine over time an important impairment of the state of health of those affected.
Epidemiological studies have shown that hypertension is a risk factor for serious and disabling diseases: cerebral stroke, myocardial infarction, heart failure, arterial aneurysms and other arteriopathies, chronic renal failure, are more frequent in individuals suffering from arterial hypertension. It should be emphasized that although this is more true for severe hypertension, conditions with a moderate increase in blood pressure are also associated with a reduction in life expectancy.
In most cases it is therefore essential to resort to the treatment of arterial hypertension using drugs, which are quite effective in reducing blood pressure, while it has also been seen that changes in diet and lifestyle are able to improve control of blood pressure, both to reduce the risk of complications harmful to health.
The arterial hypertension as a clinical entity in the common practice was verified at the end of the 800 with the introduction of the instrument to measure it, the mercury sphygmomanometer: being a pressure, it requires a pressure gauge to be measured; but since the arterial pressure has an oscillating trend, determined by the alternation of systole and diastole in the heart, it is necessary that the pressure gauge takes into account these variations, just as occurs in the procedure developed by Riva-Rocci and perfected by Koroktoff, which currently remains valid and applicable.
It should in any case be borne in mind that the measurement of arterial pressure, which today can also be performed using automatic electronic devices, is always an indirect measurement, and therefore subject to a certain error with respect to the actual one, with deviations that can be attested around the 5-10 mm of Hg.
The second aspect that should be considered in describing the phenomenon ‘arterial hypertension’ is its diffusion in the population. Nearly one billion people in the world, around 26% of the adult population, currently have arterial hypertension. The geographical distribution highlights the presence of arterial hypertension both in industrialized and in the so-called developing countries.
However, rates of affection may vary widely (from 3.4% in men and 6.8% in women in rural areas of India, up to 68.9% in men and 72.5% in women in Poland. Moreover, as regards youth, it was found that the prevalence (i.e. new cases) of essential arterial hypertension is continuously increasing. However, cases of arterial hypertension in children are more frequently related to kidney disease or other underlying conditions, and are therefore secondary hypertension.
As already mentioned, essential hypertension is the most common form of hypertension, accounting for over 90% of all cases. It has been seen that in almost all population groups blood pressure increases with age, and therefore the risk of becoming hypertensive is higher in old age.
Essential arterial hypertension does not seem to be a pathology linked to a single causal factor, but rather to result from a complex interaction between genetic and hereditary factors on the one hand, and environmental factors and lifestyles on the other. Several genetic variants have been identified, which have effects on blood pressure, but to date the genetic basis of hypertension is still little known.
Also different are the environmental and lifestyle factors, which can influence blood pressure; we have seen that a reduced intake of salt in the diet and an increase in consumption of fruit and foods with a low lipid content can reduce blood pressure, and even with controlled exercise and weight loss the same effect is obtained. Other factors may be involved, but studies to try to understand other possible causes of hypertension are numerous and it will still take time to draw meaningful conclusions.
Secondary hypertension is instead due to a known and identifiable cause. In order of frequency, arterial hypertension is secondary to kidney disease (nephroparenchymal hypertension) or renal artery (nephrovascular hypertension), to endocrine conditions such as hypercortisolism (Cushing’s syndrome) and hyperaldosteronism (Conn’s syndrome), hyperthyroidism, excess growth hormone (acromegaly) or adrenal medullary hormones (pheochromocytoma). Other causes of secondary hypertension include obesity, nocturnal apnea syndrome, aortic coarctation, excess intake of licorice and some prescription medicines, as well as the use of illegal substances (cocaine and others).
As already mentioned, hypertensive disease is responsible for the decrease in life expectancy, as the effects of long-term hypertension cause impairment of vital organs: brain, heart, kidney and arterial vessels.
How hypertension affects the body
The harmfulness of arterial hypertension must be expressed through the concept of risk: the damage has a certain probability of occurring, but it is not a priori to know who in the population will be affected, nor when and how it will be; one can only say that those with normal blood pressure values are less likely to be affected by a complication of hypertension.
No less important are the possible damages on the vascular system of the brain: vascular sclerosis, microaneurysms with possible rupture and intracranial hemorrhage, vascular thrombosis and cerebral stroke. Also the visual apparatus can be involved, at the retina level, in case of long lasting hypertensive condition: it determines narrowing and diffuse sclerosis of the small arterioles, with ischemic areas, microaneurysms and capillary dilatation. Clinically this can result in a reduction in visual ability.
The effects on the kidneys can also be serious: from the progressive sclerosis of the vessels in the renal tissue, with a decrease in the typical function of the kidney (glomerular filtration), up to the actual chronic renal failure, which in turn determines hypertension triggering a vicious circle that determines irreversible damage.
Infrequently the primary arterial hypertension of early onset is associated with pathognomonic symptoms; more often its recognition occurs during medical checkups, often due to another problem not related to hypertensive disease.
However, it is noticeable that most hypertension sufferers report a sensation of headache, especially in the morning and with occipital localization. Other disorders reported by hypertension include sensation of dizziness, vertigo, buzzing or hissing auricular, visual disturbances similar to flying flies, and sometimes episodes of loss of consciousness. Measurement of arterial pressure, carried out under conditions of rest and several times, is the main element to arrive at the clinical diagnosis.
Other clinical elements that the medical examination can detect during the physical examination in a hypertensive subject include, for example, the relief of hypertensive retinopathy on the examination of the ocular fundus with the ophthalmoscope (the retinal vessels can in fact be visible by directing a light through the hole pupillary).
In the case of secondary hypertension, further signs and symptoms are detectable as a function of the identifiable cause of hypertension. For example, an obesity associated with glucose intolerance and purple stretch marks on the abdomen orient towards Cushing’s syndrome; the characteristic signs of thyroid disease or acromegaly address a form of secondary hypertension due to these diseases; the presence of an abdominal breath, audible by listening through the phonendoscope, can indicate a renal artery stenosis (a narrowing of the arteries that carry blood to the kidneys), while the reduction of arterial pressure of the lower limbs may be a sign of an aortic coarctation (a narrowing of the main artery near the heart); still, the data of a hypertension that occurs suddenly and just as suddenly returns to normal, associated with severe headaches, palpitations and sweating, may be evidence of a pheochromocytoma (neoplasm of the adrenal medulla).
High arterial hypertension (with a systolic value equal to or greater than 180 and a diastolic value equal or greater than 110) represents a so-called ‘hypertensive crisis’, with a considerable risk of short-term complications. In this case it is frequent that there are severe headaches and dizziness, visual disturbances and breathlessness.
On the other hand, ‘hypertensive emergence’ is considered the condition in which damage to one or more organs occurs due to high blood pressure: brain (hypertensive encephalopathy, headache associated with neurological disorders), heart (angina pectoris, with increasing chest pain, up to myocardial infarction or tearing, said dissection, of the part of the aorta), respiratory system (severe dyspnoea due to acute pulmonary edema due to heart failure), kidney (acute renal failure). In these situations, a rapid reduction in blood pressure is necessary to stop the organ damage in progress, otherwise irreversible.
Arterial hypertension occurs in about 10% of pregnancies. Most cases of hypertension in pregnancy occur in women with pre-existing primary hypertension. However, hypertension during gestation may represent the first sign of preeclampsia, a serious complication that can occur in the last months of pregnancy and also in the puerperium, where the increase in blood pressure is associated with the presence of proteins in the urine , indicating renal damage.
Preeclampsia may in some cases evolve into a life-threatening condition called eclampsia characterized by further serious complications. In infants and young children growth retardation, the occurrence of non-febrile convulsions, irritability, fatigue or difficulty breathing may indicate a condition of arterial hypertension. Hypertension can cause headaches, frequent fatigue, blurred vision and frequent bleeding from the nose during childhood.
Arterial hypertension is diagnosed based on evidence of persistently elevated blood pressure. By convention, at least three significant measurements are required, interspersed, over the period of one month, in which a clear increase in pressure values is highlighted. The initial assessment of the hypertensive patient must include a complete and accurate medical history, as well as an accurate medical examination, with detailed objective examination of the main organs and systems. After the diagnosis of hypertension, we try to identify the possible cause, looking for a possible association with the pathologies that cause secondary hypertension, and on the other symptoms, if present.
Children in pre-puberty period are especially prone to developing secondary hypertension. Most commonly, kidney failure is the cause of elevated blood pressure. Essential hypertension, at the same time, is more frequent in young people and adults, and presents the association with certain risk factors, including obesity and the family history of hypertension.
Laboratory tests should be taken, first and foremost to determine if hypertension has caused damaged to other organs of the body, including kidneys and eyes. The most frequently requested laboratory tests in the diagnostic course of arterial hypertension are: blood count, urinalysis, proteinuria, azotemia, creatinine and creatinine clearance, plasma electrolytes (sodium, potassium, calcium), uricemia, thyroid hormones (T3, T4, TSH). Further specific tests concern the possible association with diabetes and hypercholesterolemia, since these conditions are other risk factors for the development of heart disease and may require a simultaneous treatment: glycemic framework (fasting glucose, glycemic load curve), lipid picture (total cholesterol and HDL, LDL, triglycerides).
How to diagnose hypertension
The most frequently requested instrumental examinations in the diagnostic procedure of arterial hypertension are: the chest X-ray, the electrocardiogram (ECG) and the echocardiogram. The ECG is performed to check for evidence that the heart is under high blood pressure. Chest radiographs and echocardiograms can be performed to look for signs of enlarged heart or any organ damage.
Severe hypertension increases the risk of complications, especially against the background of relative general health, or with mild or moderate hypertension if there are three or more cardiovascular risk factors. Finally, a very high risk of complications occurs in all other associations (severe hypertension with other cardiovascular risk factors, or hypertension of any degree if complications involving associated clinical conditions are already present.
There are other classifications, but the concepts that are developed are substantially overlapping. If all the investigations to investigate the causes of a possible ‘secondary hypertension’ are negative, we can proceed to diagnose a form of ‘essential hypertension’.
How to tell the time to start hypertension therapy
When the blood pressure values are greater than 140 for the systolic pressure and 90 for the diastolic pressure it is time to start therapy. For normal-high pressure (values 130-139 for systolic and 85-89 for diastolic) we recommend only a change in lifestyle (diet, physical activity, etc.) and periodic checks over time. Even for high-risk patients (diabetic, previous cardiovascular events) the results of aggressive treatment on blood pressure when the values are normal-high (values 130-139 for systolic and 85-89 for diastolic) are controversial in various studies.
In the elderly patient (over 75 years) the pressure values that require treatment are slightly higher: 160 mmHg of systolic pressure. The targets of arterial pressure to be achieved or the objectives are represented by values below 140 for systolic pressure and below 90 for diastolic. In elderly subjects, the targets are a systolic pressure of less than 160 mmHg.
How to lower blood pressure: systematic approach from doctors
After clinically framing the subject with arterial hypertension, the problem arises of establishing which type of treatment is most appropriate for attempting to bring back the values of arterial pressure within the normal limits.
The therapy of secondary arterial hypertension is simple: basic disease therapy must be implemented, possibly in association with antihypertensive drug therapy, at least until the pathological condition that supports hypertension is resolved; and if this is not resolvable, it will be necessary to continue sine die (i.e. indefinitely) antihypertensive drug therapy. In the treatment of essential arterial hypertension, it is essential to distinguish two types of interventions: lifestyle changes and pharmacological treatment.
First-line treatment for arterial hypertension includes interventions to modify the lifestyle of the subject affected by hypertension: dietary changes, habitual exercise, weight loss, moderation in alcohol intake. These interventions, if implemented with care, have shown that they can significantly reduce blood pressure in essential hypertensives, even when hypertension is so high as to justify the immediate use of drugs, in which case the lifestyle changes are however recommended in combination with drugs. All patients with arterial hypertension should therefore be encouraged to change their lifestyle regardless of the need for drug therapy.
An effective lifestyle modification can lower blood pressure as much as taking a single antihypertensive medication; and combinations of two or more lifestyle changes can yield even better results. Adoption of a diet with little salt (ipoxy, low sodium content) are always a winning strategy. In Caucasian subjects, such a hypodynamic diet lasting more than 4 weeks alone is capable of reducing blood pressure, both in essential hypertensives and in individuals with normal blood pressure.
In addition, in the United States the evidence suggests that ‘DASH diet’ (a system of nutrition with an increased content of fatty amino acids) also leads to a reduction in blood pressure. While limiting the intake of sodium, the diet can still be rich in other minerals (calcium, potassium and magnesium).
The practice of physical exercise also gives good results: for essential hypertensives it is advisable to carry out regular aerobic physical activity, such as brisk walking (≥ 30 minutes a day, for most days of the week). Still, it is important for adults to maintain a normal body weight (for example, keeping the so-called ‘body mass index’ within the range of 20 to 25 kg per square meter of body surface area)
Finally, it is advisable in hypertensive to limit the intake of alcohol, keeping the consumption of ethanol to no more than 3 units / day for men and no more than 2 units / day for women. Instead, tobacco smoke seems to have a transient effect only on blood pressure, as it increases the blood pressure and heart rate in the period immediately following the consumption of a cigarette, but does not seem to result in a significant increase in baseline values over time.
Epidemiological studies have in fact highlighted overlapping arterial pressure values between smokers and non-smokers, although clinical studies that took into account dynamic monitoring of blood pressure over the 24 hours showed higher daytime blood pressure values in smokers, and a trend in time to have a higher systolic blood pressure than non-smokers.
For those cases of essential hypertension that do not respond to changes in lifestyle, or that have high blood pressure values, it is necessary to establish a drug therapy, with the aim of gradually and permanently bring back the values of arterial pressure within the defined limits normal. There are many classes of drugs to treat hypertension, which are called antihypertensive drugs, which are able to reduce blood pressure by various mechanisms.
Antihypertensive drugs can be used alone (monotherapy) or in combination; for some associations synergistic effect is described (i.e. the association allows to obtain an effect superior to the sum of the effects of the single drugs administered as monotherapy).
Some combinations, such as ACE inhibitor + diuretic, or ARB + diuretic, or ACE inhibitor + calcium antagonist, are marketed with a single tablet combination to improve patient compliance.
The prognosis of arterial hypertension can be described in a simple and effective way, referring to the damage in the target organs (brain, heart, kidneys, eye, arterial vessels) and to the complications in the same target organs: the lower the damage of organ, and minor complications, the prognosis of hypertensive disease will be better.
Even if the condition ‘uncomplicated arterial hypertension’ is not a tabulated illness for the purposes of recognition of civil invalidity, the onset of cardio-vascular (angina pectoris, myocardial infarction, heart failure), cerebro-vascular (cerebral stroke, cerebral haemorrhage), vascular (aneurysm, desecation, arteriosclerosis), ocular (hypertensive retinopathy) or renal (hypertensive nephropathy, chronic renal failure) complications configures clinical conditions that are ascribable to a percentage degree of permanent disability and to this connected.
The same lifestyle changes described above are recommended to prevent essential arterial hypertension: correct dietary regimen, possibly low sodium, regular aerobic exercise, body weight control, restriction of alcohol intake.
In order to obtain adherence to these regimes, which can undoubtedly involve a certain degree of sacrifice on the part of those concerned and at the same time a resistance to their implementation, it would be advisable for people to be informed about the social and economic impact of the hypertensive disease, severity of complications and their probability of occurrence, as well as what is the real cost to the population, which must endure morbidity and morbidity, disability and death due to hypertensive disease.
How to definitively get rid of high blood pressure
To lower the pressure, it is necessary to intervene on several fronts. First of all, if possible, it is essential to remove the primary triggering agent; otherwise, it is necessary to resort to drug therapy under medical supervision. In both situations, it is always advisable to reduce the overall cardiovascular risk index by also intervening on possible collateral risk factors, such as diet and lifestyle.
Ultimately, if high blood pressure is due exclusively to a physical, dietary and lifestyle condition, the priority interventions are:
- Hypocaloric diet and increase in overall energy expenditure (in the event of overweight and obesity)
- A diet rich in potassium, magnesium and omega-3, low in saturated / hydrogenated fatty acids (possibly supported by some supplements such as arginine and herbal products)
- Begin a protocol of motor / sport activity mainly aerobics, perhaps associated with muscular toning exercises
- Eliminate all alcohol (and possibly also beverages containing stimulating nerviness - such as coffee)
- Eliminate smoking
- Minimize mental stress, also considering the intervention of a professional in the psychological sphere or the use of anxiolytic drugs.
Generally, this type of high blood pressure arises with advancing age and proportionally to the increase in body fat; however, in the West, we are witnessing more and more the manifestation of early hypertension (at puberty).
On the contrary, if a hereditary base is so strong that it is independent from any other risk factor, the pharmacological intervention is almost inevitable. Among the various molecules are used (alone or in association): diuretics, adrenergic inhibitors, calcium antagonists, inhibitors of the renin-angiotensin system, direct acting vasodilators.
Natural ways to lower the pressure
As anticipated, high blood pressure is the result of profound metabolic decompensation. Sometimes it is sufficient to intervene exclusively in a ‘natural’ and without the use of drugs that, generally, once taken cannot be interrupted but only decreased! However, this approach requires two essential requirements: a weak genetic base and total compliance with the strategy without exception.
In the previous paragraph we mentioned the priority actions to be carried out to lower the pressure; they are almost all natural except for drugs and, for the more ‘severe’, supplements. Let’s analyze them one by one:
Elimination of cigarette smoking, alcohol consumption and abuse of stimulant to the nerves cannot be stressed enough.
Low-calorie diet and increase in overall energy expenditure: overweight is one of the factors that most affect the increase in blood pressure. It goes without saying that reducing the excess of fat up to the normal weight can also be enjoyed by a clear moderation of blood pressure; however, even the simple loss of a few pounds in excess is useful, so that in general for every kg lost you can expect the reduction of 1mmHg of the pressure values.
Follow the nutritional balance and pay attention to the needs of hypertension: in addition to being hypocaloric, the diet for hypertension must possess some precise requirements.
1. Total elimination of added sodium chloride (cooking salt) and sometimes sodium naturally present in foods. Sodium is a mineral that, if in excess, appears to be involved in the mechanisms of onset and aggravation of high blood pressure.
Sodium is naturally present in foods but, through the intake of raw foods (unprocessed), it is never possible to create a nutritional excess. The only exception is constituted by certain bivalve molluscs which, being alive and sealed, release sea water from the inside when cooked. On the other hand, the main food sources of sodium in the human diet are related to sodium chloride added in food during industrial processing or at the time of consumption, and sodium content in certain food additives. To promote the reduction of pressure, certain measures such as: prohibition of the addition of sodium chloride on food at the time of consumption, prohibition of consumption of stock cube and prohibition of consumption of preserved meat, preserved fish, aged cheeses and vegetables in a jar.
2. Increase of potassium and magnesium with food: if sodium is a mineral responsible for increased pressure, potassium and magnesium (some also hypothesize calcium) act with a diametrically opposed mechanism. Among other things, in the healthy subject, potassium and magnesium ‘in excess’ are easily excreted by the kidneys, which facilitates much nutritional intervention: the more it is consumed with food, the better!
Obviously, this indication must subordinate to other nutritional considerations. Being minerals typically contained in vegetables, fruit, whole grains and legumes, their massive intake could result in some imbalances such as: excess of dietary fiber and excess of fructose.
3. Increase of omega 3 essential fatty acids and reduction of saturated / hydrogenated ones: in addition to contributing significantly to the production of endogenous cholesterol (increasing cardio-vascular risk) saturated / hydrogenated fats are in some way related to the increase in blood pressure; it does not matter if it is a direct or indirect relationship, the important thing is to drastically reduce them avoiding the following: fatty meats (the conserved ones mentioned in point A are again involved), butter and fat cheeses (almost all aged ones).
On the other hand, omega 3 play a very important role and intervene on the reduction of cardiovascular risk through the reduction of triglycerides in the blood, the improvement of cholesterolemia, the anti-inflammatory function and the protection from compromises linked to an eventual diabetic type 2. These nutrients are quite difficult to find and are mainly found in algae, krill, fish liver, flaxseed, hemp seed, kiwi seed, wheat germ, soy and (at lower concentrations) in all foods from which these seasoning fats are extracted.
4. Begin a protocol of motor / sport activity: as mentioned, this must be predominantly aerobic, better if associated with muscle toning exercises. As for aerobics, it is advisable to practice at least 3-4 weekly sessions lasting 50-60 minutes, with intensity oscillating between the aerobic band and just above the anaerobic threshold.
Toning by overloading takes a secondary role and can be performed after aerobics or in independent sessions twice a week, avoiding excessive loads and working at high repetitions.
5. Use of herbal products and supplements: they are not all natural products. For example, arginine is a synthetic amino acid (responsible for endogenous nitric oxide production at the cellular level). Its actual hypotensive efficacy is still the subject of controversy. The same applies to potassium, magnesium and omega 3, although in this case the beneficial effect is evident.
On the other hand, there are herbal extracts and products, in raw or dried form, which can promote the fight against high blood pressure; among these we remember the specifically hypotensive plants, such as: garlic, onion, rauwolfia, birch, hawthorn, cardiac, ginkgo biloba, blueberry, orthosiphon, mistletoe, red vine, olive tree, periwinkle, uncaria, lily, ligusticis, carcadè (hibiscus), evodia and Iranian achillea. Eventually, they can be associated foods / extracts with diuretic functions such as: pineapple, birch, artichoke, cucumber, walnut leaves, onion, horsetail, fennel, apple, nettle, elder flowers, corn and dandelion stalks.
This is how you get rid of hypertension with auto training
Most cases of hypertension have unknown origins (essential or idiopathic hypertension) and do not depend on other diseases, but can be influenced by environmental factors such as stress and psychological disorders such as anxiety disorders. It is therefore possible to combine the hypertension’s medical treatment with a psychological intervention and the use of relaxation techniques such as Autogenic Training, which allow modifying some physiological parameters linked to the pressure rise.
Autogenic training is a relaxation technique that acts on the musculature not only ‘dissolving’ the contractures of the skeletal muscles (e.g. neck, shoulders and back), but also producing the distension of smooth vascular muscles and the consequent drop in internal pressure blood vessels. Thanks to this action, the values of blood pressure tend to go down to normalize, because the muscles that line the walls of the blood vessels relax and relax (vasodilatation).
Autogenic training therefore acts in two ways that integrate with each other:
- from the psychological point of view, allows the person to reduce the levels of anxiety and stress
- from the physiological point of view, it induces the relaxation of the arteries and the consequent decrease of the pressure values.
The medical treatment of hypertension can therefore be supplemented by the use of Autogenic Training, which can effectively combine the use of medicines and compliance with the usual prescribed food standards. In conclusion, hypertensive subjects can learn to take better care of themselves, subjecting themselves to the necessary controls and seriously following the indications of their doctor, but they can also learn to counteract the stress and tensions that determine and / or negatively affect hypertension by the use of a relaxation technique.
How to prevent hypertension in pregnancy with… chocolate!
Preeclampsia is a pathology of the second half of pregnancy characterized by arterial hypertension, edema and proteinuria, caused by endothelial dysfunction, which involves vascular alterations at the placental level. This pathology exposes women and their fetuses to serious risks during gestation (delayed intrauterine fetal growth, greater risk of prematurity and natality, placental detachment, endangered parts, kidney, liver and brain damage, etc.).
Dark chocolate is preferred, because less calories is richer in substances useful for the body. The dark chocolate in fact, in moderate quantities, about one square a day, contains flavonoids, antioxidant substances that stimulate the enzyme NO-synthase and therefore increase the production of nitric oxide, a powerful vasodilator. Flavonoids also lower LDL cholesterol, have antiplatelet and anti-inflammatory properties, reduce insulin resistance.
Theobromine is another beneficial substance contained in dark chocolate also has vasodilating effect, stimulates diuresis, myocardial contractility and fights the production of free radicals. Finally, the chocolate contains magnesium, which among its various beneficial functions, helps to maintain adequate pressure levels. Therefore, as long as the permitted dose is respected, dark chocolate can be a useful and pleasant food to be included in the diet of pregnant women.
Recently, for the same reasons it has been shown that the consumption of dark chocolate is recommended for both men and women, as it lowers the risk of atherosclerosis and type 2 diabetes.
Conclusions: how to fight and keep off hypertension for good
To conclude, what are the recommendations based on current knowledge?
Check the blood pressure regularly
Essential hypertension is one of the main causes for heart disease, which, in its turn, ranks highest on the lists of diseases and death causes among adults the U.S. It is therefore important to keep the arterial pressure monitored with controls whose frequency depends on the individual conditions to early highlight a possible increase in blood pressure.
Adhere to an adequate lifestyle
In patients with normal-high pressure and in patients with hypertension, the adoption of an adequate lifestyle allows to keep the blood pressure under control, as well as to reduce the consumption of antihypertensive drugs in hypertensive patients already in pharmacological therapy.
- Dietary control.
- Physical activity
- Reduce body weight
- Limit alcohol intake
Follow drug therapy regularly
Pharmacological therapy of the patient with arterial hypertension can have a wide choice of drugs, belonging to different classes, which can be administered as monotherapy or in combination. It is appropriate that the drug therapy of high blood pressure is individualized for the individual patient, taking into account the clinical conditions, the presence of risk factors, possible concomitant diseases and organ damage.