In the opinion of Dr. Luis Vara , coordinator of the Hypertension semFYC, “This data is particularly worrying, especially in the case of hypertensive patients, as one of the mainstays of treatment is to follow a diet low in salt . Also people at risk of developing hypertension may recommend they avoid excessive consumption of salt to prevent its onset. In both situations, therapeutic and preventive education is the key role it can play the family doctor. “

The aim of the survey was to know the degree of awareness among the population through the health center on the salt with food. He also asked about the seasonings to replace it and the risks to health may have a binge. In general, according to women are more familiar with that other seasoning to replace salt, but there were no differences with those who were hypertensive. “This is probably due to the fact that women remain the most often in charge of preparing meals in the home and because, in general, are more interested in issues related to health,” said Dr. Rod. Another point striking is that only 3% are aware of the risks of taking salt in hypertension, being also aware women. We also analyzed the consumption of packaged foods and reading labels, resulting in arterial hypertension patients consume less of these foods. According to this expert, “certainly the advice given to patients about reducing consumption of processed foods, have influenced this result. In this sense, it is recommended that the diet is based on the preferential consumption of vegetables, fruit, milk and dairy products low in fat, and limit intake of saturated fat, cholesterol and salt. This plan also includes cereals, pulses, fish, poultry and nuts, and recommends limiting consumption of red meat, sweets and sugary drinks. “

Adherence to treatment in hypertensive

Another study, also in Aragon with 125 hypertensive patients with a mean age of 71 years, has determined the level of adherence to treatment in these patients and the monitoring of blood pressure. The paper concludes that although there is good adherence (75%), only 57% good treatment compliance (adherence and blood pressure control) and 42% poorly enforced or are poorly controlled despite taking the treatment. “These data,” said Dr. Rod, “consistent with those described in studies in Spain and in other countries suggest that lack of adherence to treatment of hypertensive patients is one of the biggest challenges with which face in the office of family doctors. “

64% have good control of hypertension, which could be related to the comprehensive monitoring is done by the nurses and the implementation of quality control programs. “This demonstrates the degree of control found in recent years there has been significant improvement in this aspect, which has also been detected in other national studies like the 2010 or the study PRESCAP ENRICA. Undoubtedly, the role of primary care professionals has been a decisive influence on these results, although there is still much room for improvement, “said the expert.

Controlled hypertensive patients more frequently associated with other pathologies such as diabetes and hyperlipidemia. Another fact is that adherence is improved by knowledge about medicines. In the study, 75% knew when to take and has no difficulty, 20% do not recognize problems, but making bad and 5% take them well, but admits to having some difficulty. These results confirm the importance of health education as a means of improving control of hypertension, “especially if we consider that in many cases the patient does not notice any symptoms related to high levels of blood pressure and, nevertheless, you are encouraged to take pills every day, even on occasion, can cause unwanted discomfort, “concluded Dr. Vara.

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However, the treatment requires 80 percent of the patients is the same, regardless of whether they are controlled or not. The drug combination is the best way to improve disease control. The combination of verapamil and trandolapril increases the possibility of control by 42 percent compared to monotherapy, although increasing the dose or change of drug.

As suggested by Dr. Antonia Sans, Manresa General Hospital in Barcelona, ​​”has shown that controlling blood pressure below the limits of 140 and 90 mmHg resulting in a greater benefit to patients, although in the case of diabetics this therapeutic goal should be below 130 and 85 mmHg and in hypertensive patients with proteinuria exceeding 1 g / day below 175 and 75 mmHg. In addition, consideration should be also considered as risk markers to now not taken into account, how are urinary albumin excretion (UAE) and pulse pressure (PP) and heart rate.”

Until now, little has been linked to control of hypertensive patients with treatment failure. However, new arguments are beginning to bloom. For example, it has been shown that, although the relative risk may be similar in young and old, in terms of absolute risk reduction benefits are greater in hypertensive patients senile to present these high-risk profile.
Despite the obvious benefits of reduced blood pressure, morbidity and mortality in hypertensive patients remains high. It has also shown that the only way to reduce this mortality is to reduce the tension, already present in a mild or severe case.

It should be noted that recent studies determined that to achieve optimal reduction will be necessary in most cases to use a combination of drugs. Thus, only if you have well-designed drug combinations will facilitate the control of blood pressure to yield a better prognosis of hypertensive patients.

According to Dr. Sans, “you should look for synergies, reducing adverse effects and enhancing effects, beyond simply reducing blood pressure. It is also important to control other cardiovascular risk factors.”

The consideration of isolated systolic hypertension, isolated diastolic hypertension and pulse pressure as independent cardiovascular risk factors suggests that there is a proportion of people at high risk increasing with age. The drug combination trandolapil varapamilo and helps to control these cardiovascular risk factors by reducing both systolic hypertension and pulse pressure.

About three million are hypertensive Spanish. In the case of men, 38 percent of Spanish between 35 and 64 years have higher blood pressure levels 140/90. For women, the percentage drops to 36 percent, but in both cases only half know they have high blood pressure, and therefore becomes even more difficult to control.

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This disturbing reality is due to many factors. First and foremost the fact that hypertension does not cause problems: if that happens then the pressure is not measured regularly, many hypertensive patients do not know to be such. Moreover, a large proportion of people not taking hypertensive drugs that are prescribed to lower blood pressure. Moreover, only half of hypertensive patients treated pharmacologically are unable to maintain pressure within the normal range. To change this situation and ensure that all hypertensive patients are aware of the importance and benefits that can be obtained from a blood pressure control requires a better understanding of hypertension and its consequences. This was the belief that dictated the writing of the booklet

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What is the most antihypertensive therapy protects the cardiovascular and cerebrovascular system? Have talked about names in cardiology authoritative speakers at the symposium “Optimizing to hypertensive therapy reduces cardiovascular and cerebrovascular risks” of the ESC Congress 2005 which was held in Stockholm.

The antihypertensive reduces vascular risk?

Once again in this authoritative occasion was highlighted as the main goal of treatment of hypertensive disease should not be considered the sole reduction of blood pressure to reach the target values recommended by recent guidelines, but a significant decrease risk of vascular disease of the heart, brain and related systems.

Although the last major international trials have however shown a significant reduction of vascular risk in correlation to a reduction in blood pressure in hypertensive patients, Bryan Williams, professor at the University of Leicester, in the first speech of the symposium, it was initially asked whether all types of medication available today are just as effective, not only in reducing blood pressure, but also in the entity of the reduction in cardiovascular and cerebrovascular risk.

Is it possible that some groups of drugs are able to reduce the risk more significantly than others, despite equally effective in controlling blood pressure, thanks to ancillary benefits that accompany the principal action of certain substances (eg , activity on endothelial function, renal protection, control of values and anti-inflammatory efficacy of lipemia). But this is currently only a hypothesis can not yet proven. More plausible is instead the possibility that some antihypertensive drugs (such as blockers of the renin-angiotensin system), or some combination of therapeutic classes, are able to delay the onset of diabetes mellitus or to obtain more evidence of harm reduction ’s body linked to high blood pressure or prevent it from developing as it has been demonstrated on left ventricular hypertrophy

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Today we have many drugs to treat hypertensive patients. The ideal treatment should be effective, safe, easy to perform, without adverse economic effects. Unfortunately, all these features are hard to find in a single drug, but every day makes more progress in achieving the objective. Modern treatments have demonstrated efficacy of 50 to 70%, and by combining two or more drugs are able to control blood pressure over 90% of cases.

The objective of the consultation is whether the pressure is controlled with treatment, and if you did not take medication is impossible to know. The drugs exert their action during a given time; past it are metabolized and eliminated from the body.

A drug taken for so many years in a row, can cause some damage in the body?

This, as above, is also very common. For fear of buying something to stop serving, the patient prefers not to acquire You can go to the office with high blood pressure. If for some reason, your doctor decides to change the drug, it can serve for later or to be combined with another. It’s rarely happen because the drugs demonstrated use us today have even harm their safety without causing long-term treatment.

What we do is proven, is that uncontrolled hypertension leads to serious complications.

Does treatment can cause impotence?

It is a very common concern among our patients. Some drugs to employ, but practically this is avoided when used in low doses. Moreover, there are now new drugs that affect sexual function.

Is it for life?
Hypertension is a disease that is not cured, but controlled, therefore requires lifelong treatment. An example: if you are over 45 years and has to wear glasses to see up close, knows that when evil is not used (hypertension) and when you put them, you see everything clearer (treatment) and must use Lifetime (treatment must be sustained).

Why if I take a drug, I lower the pressure?

While the cause of hypertension is mostly unknown, we know that there are several mechanisms by which a person may have hypertension. Different drugs work by blocking a mechanism generally therefore often have to take two or more drugs to “block all the mechanisms” and thus able to control their hypertension

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