Treatment of chronic hypertension
In rare cases where a cause is found, the treatment of chronic hypertension can sometimes lead to the healing of hypertension (by surgically removing a Conn adenoma for example).
The treatment is based on an understanding of the physiopathological mechanisms of blood pressure regulation.
The treatment of hypertension aims at the normalization of blood pressure levels in order to prevent complications. This prevention, through some drugs, and on criteria of morbimortality, has been proven by tests for thresholds of 160/95 mmHg (140/80 mmHg in diabetics or after a stroke). There is no evidence to justify treatment for lower thresholds. The U.S. recommendations were for a BAC of less than 140/90 until the last update, which is now only 150/90 for a person over 60 years of age. Several means are available.
Hygiene and dietary rules
The rules relating to lifestyle and eating habits may sometimes be sufficient to normalize blood pressure and must always be proposed:
- weight loss, in case of overweight, to maintain BMI (body mass index) below 25 kg·m-2, or failing that, to achieve a 10% decrease in body weight initial weight
- removal of liquorice, if applicable;
- decrease in salt consumption, if possible less than 6g/day , avoid salt shakers on the table, cured meats, ready-made meals;
- limit the consumption of alcohol to less than 3 glasses of wine or equivalent per day in men and 2 glasses of wine or equivalent per day for women ;
- increase the consumption of dietary fiber, especially with a diet rich in vegetables and fruits, and decrease that of fats [24], especially so-called saturated fats;
- increase potassium intake (provided normal kidney function);
- fight against the associated risk factors (tobacco, cholesterol, diabetes, sedentary lifestyle);
- use a low dose estrogen pill;
- in neurotonics, avoid tea, coffee, possibly associate relaxation;
- if possible, lead a calm and regular life, respecting sleep hours;
- recommendation of physical exercise : regular aerobic physical activity (at least 30 minutes approximately 3 times per week );
- some studies have showned that regular consumption of chocolate or garlic slightly lowers blood pressure figures.
Medical treatment
It is administered for life. It must be, ideally, simple, effective and well tolerated. It must be explained naturally to the patient. The multiplicity of drugs implies that none is perfect. The choice is made by the doctor according to the type of hypertension, the associated diseases, the effectiveness and the tolerance of the different products. It is common that it is necessary to successively try several drugs before finding the one that suits the patient treated.