The prevalence of arterial hypertension in Mexican adults is 49 percent and nearly 70 percent of them do not know they suffer from it, assures Sergio Alberto Mendoza Álvarez, a postgraduate academic at the Faculty of Medicine (FM) of the UNAM.
This disease plays an important role as a cardiovascular risk factor, along with diabetes, obesity, smoking, and chronic kidney disease, among others.
The study "Epidemiology of arterial hypertension in Mexican adults: diagnosis, control, and trends. Ensanut 2020" agrees that in Mexico, in 2018, 49.2 percent of the population with socioeconomic vulnerability had arterial hypertension and only 47.1 percent were diagnosed.
This condition, the study refers, is the one that contributes most to morbidity and mortality in the world: by 2019 it was estimated that there were 828 million people with this condition, causing 10.8 million deaths a year. Unfortunately, neither the diagnosis nor the treatment goals are being timely to prevent cardiovascular risk or a fatal cardiovascular event.
The Mexican population should have their blood pressure checked routinely to identify cases that are on the verge of becoming hypertensive and be able to change their lifestyle, and diet and undergo treatment to avoid it.
The groups that should adopt this habit are people over 30 years of age, those who are obese, overweight, smokers, alcoholics, diabetics, dyslipidemia, sedentary, as well as those with a family history of cardiovascular disease at an early age.
Measurement and control of blood pressure
The Pan American Health Organization (PAHO) is carrying out the HEARTS initiative in the Americas to address the problem. This year, the activities to be carried out in 1,380 health establishments in 22 countries, including Mexico, have as their slogan: Measure your blood pressure accurately, control it and live longer!
To take the blood pressure properly, the patient should preferably be seated, with the back upright and the arm at the level of the heart; measure it in both arms.
It is also recommended that the patient remain seated and calm for five to 15 minutes before taking the readings and that he/she has not consumed caffeine or exercised 30 minutes before.
Normal blood pressure figures range from 120 to 129 for systolic and from 80 to 84 for diastolic; the optimum is for patients to be below these parameters.
High blood pressure is considered normal when values are 130 to 139 for systolic and 85 to 89 for diastolic, according to the European hypertension societies.
When readings of 140 to 159 for systolic pressure and 90 to 99 for diastolic pressure are recorded, grade one hypertension is suspected.
If the patient presents 160 to 179 in systolic pressure and 100 to 109, grade two hypertension is estimated; while grade three implies high blood pressure levels: the systolic is equal to or greater than 180 and the diastolic is equal to or greater than 110.
Older adults may have what is called isolated systolic hypertension, in which the systolic pressure may be above 140, but the diastolic pressure may be less than 90.
"There are patients who come to the office stressed and may have isolated elevations in blood pressure. A comprehensive assessment should be made, and monitoring should be requested for seven days, two to three times a day, at different times, and a log should be kept," the university expert adds.
Another way to diagnose is to place a bracelet for 24 hours, which automatically registers every 30 minutes throughout the day and every 20 minutes at night.
Other warning signs are headaches that were not present before, ringing in the ears, dizziness, tiredness, fatigue or intolerance to physical activity, eye pain, palpitations, and even chest pain, as well as edema or swelling of the legs.
The treatment must be multidisciplinary since it is related to alternate risk factors; that is if they present diabetes, dyslipidemia, overweight, and obesity.
"If we work so that the patient, through diet and exercise, can lose weight, we can easily achieve a 10 to 15 percent reduction in blood pressure and lower triglycerides," he argues.
The diet is characterized by having six to eight servings of grains a day and emphasizes the consumption of fruits, vegetables, and low-fat dairy products. In addition, a physical activation routine of 150 minutes a week is recommended, or 30 to 40 minutes a day. Those who present systolic pressure between 150 and 160 also require medication.
Mendoza Álvarez warns that if there is no timely diagnosis, the heart presents complications. One of them is cardiomegaly, characterized by the fact that this organ becomes larger, but weak, and cannot pump enough blood to the body.
"People begin to have fatigue, shortness of breath, dyspnea (difficulty breathing). When they walk, or even when they sleep, they have shortness of breath, their legs swell and it can lead to an acute myocardial infarction or even death, especially when there is already a long time of evolution and if they have other complications such as diabetes and dyslipidemia," he emphasizes.