VII -
The follow-up of a high blood pressure
7.1
- The
control of the blood pressure with the physician : the follow-up
7.2
- The control of the blood pressure by an automatic device at home
7.3 - Sometimes,
an ambulatory blood pressure measurement during 24 hours is necessary
7.1-
The control of the blood pressure with the physician : the follow-up
The blood pressure measurement
by the physician remains essential for the follow-up of the high blood
pressure.
The practitioner assesses
whether the correct blood pressure is achieved and if the antihypertensive
drugs are well tolerated.
At the beginning, when the high blood pressure is not balanced, the practitioner
can measure the blood pressure once a month, then space out the visits progressively
every 3 to 6 months. He carries out a complete clinical examination every year
searching for complications of the high blood pressure, such as an analysis
of the urine using a strip and the measurement of creatinine in the blood.
In addition, he carries out
blood tests looking for other cardiovascular risk factors (cholesterol,
diabetes), every year if the initial results are bad or every three
years in the other cases.
An electrocardiogram and
possibly a cardiac echography can be done if the practitioner suspects
a cardiac damage induced by a high blood pressure. The electrocardiogram
is carried out first.
The treatment of the high
blood pressure is a long-term treatment, which can however be gradually
decreased if side-effects are perceived and the blood pressure is well
controlled.
The practitioner must then
use a follow-up notebook to control the variations of the blood pressure
according to the reduction of the treatment. This possibility can only
be considered if the physician can check regularly his patient because
a majority of hypertensive subjects who have decreased their antihypertensive
therapy themselves still have high blood pressure a year later.
The antihypertensive treatment
cannot be stopped quickly, in particular for the treatments with beta-adrenoreceptor
blocking drugs and drugs that act on the cerebral receptor. This progressive
reduction of the drug is accompanied by life style modifications, and
requires a very strict monitoring.
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last modified on : 28 sep 2003 |
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