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Definition of high blood pressure
What to do in case of hypertension?
For a better understanding of blood pressure The follow-up of a high blood pressure
High blood pressure damage High blood pressure and special cases
Why does high blood pressure exist? The self-measurement of blood pressure
How to measure high blood pressure? About Us
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VI - What to do in case of a high blood pressure

6.1 - First of all, to eliminate a false high blood pressure
6.2 - To eliminate an obvious cause responsible for a high blood pressure
6.3 - To start a treatment without drug: life style modifications
6.4 - According to the circumstances, to treat by using drugs
6.5 - Anti-hypertensive therapy
6.6 - Why does the doctor prescribe a given anti-hypertensive drug and not another? The choice of the first treatment.


6.4- According to the circumstances, the physician has to use an antihypertensive drug therapy

6.4.1- Indications of this treatment

According to the initial level of the high blood pressure, the existence of other cardiovascular risk factors and of the damage of high blood pressure on the heart, the arteries and the kidney, a antihypertensive drug will be prescribed.

CARDIOVASCULAR RISK FACTORS
DAMAGE ON CARDIOVASCULAR SYSTEM
• Tobacco
• Too high Cholesterol level
• Diabetes
• Age > 60 years
• Sex (Men, post-menopausal women)
• Previous family of cardiovascular disease for women aged < 65 years and men aged < 55 years
• Damage of the heart
- Hypertrophy on echography
- Pectoral angina/Infarction of the myocardium - cardiac Insufficiency • Stroke
• Damage of the kidney
• Damage of the arteries (including that of the eye)


The table below, extract from the last recommendations (1999), specifies the indications of the life style modifications and the antihypertensive drug therapy of a high blood pressure:

Level of Blood Pressure
(mmHg)
Risk A •No cardiovascular risk factor •No organic damage or cardiovascular disease
Risk B • 1 cardiovascular risk factor or more (not diabetes) •No organ damage or cardiovascular disease
Risk C •Organ damage or cardiovascular disease and/or diabetes
High normal
130-139/85-89
life style modifications life style modifications Antihypertensive drug therapy
Stage 1
140-159/90-99
life style modifications up to 1 year life style modifications up to 6 months Antihypertensive drug therapy
Stages 2 and 3
>160 / >100
Antihypertensive drug therapy Antihypertensive drug therapy Antihypertensive drug therapy


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These recommendations really help the practitioner in his attitude towards the treatment of his patient.

For a person of more than 60 years, high blood pressure is defined as a blood pressure higher than 160/90 millimetres of mercury (16/9). A pressure of 140/90 mmHg being the ideal.

The optimum blood pressure are the following:

  • Subjects without diabetes, renal insufficiency and of less than 60 years: 140/90 millimetres of mercury (14/9),

  • Subjects with diabetic mellitus and/or a renal insufficiency: 130/85 mmHg,

  • Old subjects of more than 60 years: 160/90 mmHg.

File last reviewed on : 18 dec 2011
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