These are the guidelines for hypertension
Last year hypertension guidelines were adjusted to the United States. The therapy is now much more differentiated and adapted to the patient in Europe. For example, the values in older patients of 140/90 are more susceptible to being tolerated and in other cases the pharmacological treatment begins at very normal levels of 130-85. The article explains the specific guidelines.
The limits in Europe remain different in the United States, where 130-80 are applied, basically 140/90 mmHg. This corresponds to the previous recommendations. However, elderly patients sometimes accept higher thresholds of up to 160 mmHg, "to avoid unwanted side effects of intensive drug therapy," said Andrea Podczeck-Schweighofer, president of the Austrian cardiology society ( ÖKG).
In certain cases, medications must already be given at a normal upper blood pressure interval (130-139 / 85-89 mmHg). "That is, if there is a particularly high cardiovascular risk due to a cardiovascular disease," said Podczeck-Schweighofer.
The objective of treating a therapy is still a reduction below 140/90 mmHg. In the case of well-tolerated therapy, it is necessary to seek 130 mmHg as a systolic value and in patients under 65, up to 120 to 129 mmHg. Objective values below 120 mmHg are counterproductive for all patient groups, as the risks outweigh the potential benefits.
Europe vs. USA
130/80 mmHg hypertension has been registered in the US since last year. However, it is considered that patients requiring blood pressure beyond 130/80 mmHg in the new US guidelines only need medication if they have other risk factors. Other patients should be treated with general measures. "But, according to the new US guidelines only in the US, about four million people need medication treatment, which would not be a 140/90 mmHg threshold," says Podczeck-Schweighofer.
New to the European published guidelines on blood pressure is a recommendation of treatment at the beginning of therapy. As a result, most patients with high blood pressure in the future should conduct a treatment with two different substances that act from the beginning. So far, it was recommended to first start with a medication and only if it is necessary to use a second or third-party medication. "In this context, the new directive indicates that combined preparations containing substances in a tablet should increase adherence," said the president of the ECOC.
Less salt and more exercise
If hypertension can not be adequately controlled with a combination of three antihypertensive agents, you must also add a diuretic, as recommended. "It is also recommended to change the lifestyle of the new ESC directive for all high blood pressure patients," adds Podczeck-Schweighofer. These include a reduction in salt intake, a healthy diet, a regular exercise, the abstinence of nicotine and the fight for normal weight. In the recent recommendation to consume moderately alcohol, now comes the explicit indication that the so-called intense coma or drink is an absolute taboo.
Regarding hypertension and cancer, it is noted that a temporary interruption of cancer treatment can be considered when very high blood pressure levels are not controllable only with the combination of therapy.
Hypertension and physical effort are also recommended in the high mountains. You should advise patients with high blood pressure to make trips up to 4,000 meters above sea level. without
Last but not least, attention is paid to the risks to the health of hypertension. This is, for example, a significant risk factor for blows. It also increases the risk of heart failure, atrial fibrillation, renal insufficiency, peripheral obstructive disease, or dementias such as Alzheimer's disease. (Sb)