Cardiovascular disorders and therapeutic methods

Hypertensive disorder

High blood pressure is global health problem. In the western world, including our country, a quarter of the adult population is affected.

Calling hypertensive disorder “the silent killer” wasn’t by accident. It occurs without any symptoms, it is typically detected by some kind of a routine or aptitude examination. For the very same reason, patients already diagnosed with high blood pressure often discontinue their medication administration, claiming that they don’t feel sick after discontinuation. This however, is a serious mistake. The persistently high blood pressure damages the wall of blood vessels without causing pain or sickness, thus only a sudden – even life threatening – incident manifestation will draw attention to the severity of the situation - unfortunately much too late.

What is defined as high blood pressure?

If pressure above the value of 140/90 mmHg is measured on several separate occasions, on both upper arms, in a sitting position

What causes vulnerability to high blood pressure?

• genetic factors (heritance)
• age
• overweight
• smoking
• excessive salt consumption
• stress
• lack of exercise
• excessive alcohol consumption

What complications may be associated with high blood pressure?

As a result of elevated pressure in blood vessels, as well as other consequences of the lifestyle factors listed above (for example high cholesterol levels, etc.) elasticity of blood vessels will be impaired, small “heaps” form on their walls, which become solid, calcified over time (plaque).

This leads to the formation of two risk factors:

• On one hand, the plaque may enlarge almost occluding the vessel- if this occurs in coronary vessels, so called angina symptoms evolve including a tightening across the chest, later even completely occluding that certain vessel, resulting in cell death of the area supplemented by the blood vessel due to complete anoxia. That is defined as an infarct.
• The same incident occurs if a small segment of the original plaque breaks down and gets carried away by the blood stream, blocking the blood flow where it gets stuck, also resulting in an infarct.

An infarct not only occurs in the heart with this mechanism, but also in the kidneys, in the brain and in the eye.

Consequences of a cardiac infarct may be:

• sudden death
• sustained loss of working capacity
• cardiac failure

An infarct in the brain results on any of the following based on the area affected:

• death
• paralysis
• urinary incontinence
• facial nerve paralysis

High blood pressure therapy

It needs to be noted, that treatment of high blood pressure isn’t primarily pharmaceutical, but requires radical lifestyle changes.

• Make efforts to reduce your overweight. Pharmaceutical therapy may not even be needed after a radical weight loss.
• Exercise regularly (at least half an hour at least three times per week),

TIPP: use the stairs instead of the elevator, or get off the bus one stop earlier

• make efforts to quit smoking. Passive smoking also damages the blood vessel walls, and the health impairing effect of smoking is more prominent in women
• reduce alcohol consumption
• the daily salt intake should not exceed 6 grams

Mediterranean diet

Research shows, that the diet typical for Mediterranean countries has a protective effect against cardiovascular diseases. What are the characteristics of this diet?

• the high amount of vegetal fibers (seedy bread, durum pasta, salad, etc.)
• olive oil
• consume about half kg of fruit and vegetable per day
• moderate, but regular red wine consumption
• Fish (especially fish rich in omega-3-fatty acids: mackerel, herring)

Pharmaceutical treatment

Establishment of a pharmaceutical treatment is always a doctor’s assignment, since it depends on other co-morbidities of the patient.

Antihypertensive medications belong to several groups, depending on where their chemical effect is exerted. It is not rare, but even common, that the agents with different mechanisms of action have to be administered in combination in order to reach the opted blood pressure decrease (aimed value).

What can you do to support pharmaceutical treatment:

• take your medicine every day, even if you feel completely free of symptoms. High blood pressure doesn’t hurt
• take your medicine even if you measure normal values. If dosages are taken as prescribed, your blood pressure won’t be too low, however, if you skip a dose, the well-adjusted value may raise up again
• if you get the chance, check your blood pressure regularly, and note the value in a log-book
• Visit your treating physician once a month, take the log-book with you
• If you have any complaints, or you feel like experiencing any side effect, contact your treating physician, don’t discontinue treatment arbitrarily.
• Occasionally you’ll be required to attend a laboratory and ophthalmological examination, the frequency will be established by your doctor based on your co-morbidities.

The risk of organ impairment may be decreased by an adequate pharmaceutical therapy, thus getting the chance, though under the condition of a disciplined medication intake, to live a qualitative and long life.