HIGH BLOOD PRESSURE: A VERY COMMON DISEASE

Arterial hypertension (HTA) is one of the main cardiovascular risk factors, i.e. it greatly increases the risk of developing cardiovascular complications (stroke, myocardial infarction, renal failure, arteriopathy of the lower limbs …). It is the leading risk factor for stroke and is responsible for 51% of strokes worldwide.

Nearly 11 million people are treated daily for high blood pressure, including more than 1 in 2 people over the age of 65. Moreover, 3 to 4 million hypertensives are unaware of their pathology; i.e. a total representing more than 20% of the French population.
However, arterial hypertension is also one of the major risk factors in the onset of type 2 diabetes, which is often detected late. 80% of people with diabetes are also hypertensive and 20% of hypertensive people also have diabetes. In addition, hypertension is the leading cause of death for people with diabetes, ahead of cancer.

What is high blood pressure?

The heart contracts, like a pump, to propel blood through all the arteries of the body. The circulating blood then exerts pressure or tension on the walls of the arteries. With age and other risk factors (smoking, overweight, etc.) the walls of the arteries become more rigid and thicken, which leads to an increase in blood pressure. When the blood pressure is too high and persistent on the walls of the arteries, it is called high blood pressure.
The normal value is 120/80 mmHg (mm of mercury. It is the unit of measurement of the pressure)
The measurement of two values ​​makes it possible to characterize arterial hypertension: the systolic arterial pressure (PAS) and the arterial pressure diastolic (PAD)
We speak of arterial hypertension when one and/or the other of these values, measured at rest, on several occasions, during 3 successive consultations over a period of 3 to 6 months, is greater than or equal to:
140 mmHg (millimeters of mercury) or 14 cmHg for systolic pressure
and/or 90mmHg or 9 cm Hg for diastolic pressure.

In diabetes, the threshold is lowered to 135 mmHg and 85 mmHg.

Eventually, this hypertension tires the heart and weakens the arteries.

Hypertension is therefore a chronic disease and a risk factor since it exposes to serious complications and pathologies. It is a major but avoidable cardiovascular risk factor, yet one in two people is not treated because it is often unrecognized. Very frequent and insidious, it requires regular screening and early treatment.

What symptoms should (you) alert?

Very often, hypertension has no symptoms, which is why it is called the “silent killer”.
The main symptoms that can alert you:
• visual disturbances (butterflies in front of the eyes)

• nose bleeds

• ringing in the ears

• headaches (especially when waking up), difficulty concentrating
• pain in the chest
• palpitations
• shortness of breath

What causes arterial hypertension ?

In 90% of cases, the origin of hypertension is unknown and does not have a single direct cause.
It is linked to multiple factors on which it is possible to act or not (modifiable and non-modifiable factors). We are talking about essential hypertension.
Some factors related to our lifestyle have negative effects on blood pressure.

 Among them:
• An unbalanced diet, particularly one that is too rich in salt. Excessive salt consumption promotes high blood pressure. In a hypertensive person, intakes of less than 6 g per day are recommended.

• Overweight and obesity: losing a few pounds can help bring blood pressure numbers down to normal levels

• Alcohol: excessive consumption (more than two glasses a day in women and three in men) increases blood pressure and can make certain anti-hypertensive medications ineffective.

• Lack of physical activity (or sedentary lifestyle): the time spent daily in front of the computer, television, video games, professional activity, can be harmful to health when it exceeds 7 to 8 hours a day.

• Tobacco: smoking increases blood pressure, prematurely wears out the heart and arteries

• Excess cholesterol: the harmful increase in bad cholesterol (LDL-cholesterol), and a low level of good cholesterol

• Poor quality sleep (disturbed sleep, not allowing sufficient recovery phases), impairs blood pressure control. In addition, a sleep apnea syndrome can induce and aggravate arterial hypertension.

It is possible to act on these factors to prevent and reduce hypertension by changing lifestyle habits and/or through appropriate drug treatments.
Diabetes, excess cholesterol, smoking, other cardiovascular risk factors often associated with high blood pressure, must also be sought and treated.

Test your risk of diabetes and hypertension

Other factors are involved in the appearance of arterial hypertension, on which we cannot act.
Among the non-modifiable factors are:

• age, the older you get the more exposed you are (40% of people aged 65 are hypertensive, 90% at 85)

• family history, having family members with hypertension increases the risk

• sex, because women are more exposed when taking the first contraceptive pill, during pregnancy and during menopause

• more rarely certain diseases or drug treatments (kidney or endocrine diseases, antidepressants, corticosteroids). This is called secondary hypertension.

What are the consequences of hypertension on health?

These consequences can be very serious, especially when they are associated with diabetes.
Fortunately, the treatment of hypertension is particularly effective in reducing or even avoiding the risk of the occurrence of the dreaded complications.
• The cerebral vascular accident (or CVA) can have two origins,
- ischemic: the obstruction of a cerebral artery by a plaque of atheroma can be fatal or leave serious sequelae, such as hemiplegia. Ischemic strokes are more common in people with diabetes.
- haemorrhagic: hypertension can also create haemorrhage and hematomas in the brain, or even rupture of the artery (aneurysm) with significant disabling sequelae. Arterial hypertension is directly responsible for 40% of strokes.

• Angina pectoris: the deterioration of the coronary arteries hinders the oxygenation of the heart, creating pain on exertion, even at rest.
• Myocardial infarction: if the coronary artery becomes clogged, it prevents the heart from working, and leads to myocardial infarction (or heart attack). Without rapid medical intervention, the patient risks death or serious sequelae.

• Heart failure: in the presence of hypertension, the heart works harder to send blood to all the arteries of the body. After a while, he becomes less efficient and gets tired. The heart's need for oxygen becomes greater. He exerts more effort, gets tired, which causes shortness of breath.

• Arteritis of the lower limbs: narrowing of the arteries in the legs limits walking distance. If they become blocked, the pain in the legs becomes permanent and there is a risk of amputation.

• Visual damage: damage to the small vessels of the eyes can lead to blindness.

• Kidney damage: damage to the small vessels of the kidneys in the first stage, located at the level of the renal filter. If the kidneys are affected, there is a risk of chronic kidney disease and kidney failure.

• Aortic dissection: too high blood pressure weakens the aorta, the envelope of which can tear suddenly, a very serious accident that can be fatal.