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Many people think that just taking a tablet is enough to reduce their blood pressure and resolve the problem and therefore they do not need to adopt any further measures. This belief is incorrect. In patients whose hypertension is diagnosed in early stages, changes to their lifestyle are just as important as simply taking their medication, if not more so. Factors associated with lifestyle that can affect hypertension are: being overweight, dietary salt intake, alcohol and tobacco consumption, and a sedentary lifestyle. If these factors have been corrected but without managing to reduce blood pressure to normal values, then drug therapy (medications) will be started but while always maintaining the lifestyle changes.
Diet. Studies conducted in Spain have demonstrated beyond any doubt that the Mediterranean diet decreases the death rate associated with cardiovascular disease, particularly that of ischaemic stroke, because it reduces blood pressure, as well as blood sugar and lipid levels. The Mediterranean diet, which is rich in fruits and vegetables, nuts (walnuts, hazelnuts and almonds), with more fish than meat, more white meats (chicken, rabbit) than red meats (veal, beef, ox meat), extra virgin olive oil and small quantities of red wine, along with a low salt intake (by eliminating cured meats, canned foods and ready-made meals) and no sugary beverages, is the best option for hypertensive patients.
Exercise. Patients should complete regular, non-competitive aerobic exercise (walking, cycling, swimming, etc.). This should preferably be completed on a daily basis rather than alternate days, and 1 hour is better than 30 minutes. Either way, you should only exercise at full level after building up over a period of time.
Sleep. Refreshing sleep increases everybody’s quality of life and patients with well-controlled hypertension do not normally suffer sleep problems. It is important to sleep well as insomnia increases blood pressure.
Sex. Men with high blood pressure can experience a lack of desire when they first develop the condition due to psychological problems. Most antihypertensives do not include a lack of desire or erectile dysfunction among their side effects; however, the coadministration of traditional beta blockers and diuretics at high doses can induce these side effects, particularly in smokers and people with diabetes and advanced arteriosclerosis or neuropathy. Erectile dysfunction can be considered a symptom of arteriosclerosis and is a vascular risk factor that worsens the prognosis for hypertensive patients.
Travelling. Hypertension does not prevent patients from travelling, they may fly or travel to mountainous areas. However, people who do not normally live at altitude are known to experience an increase in blood pressure if they travel to areas at very high altitudes. This increase tends to be moderate, unless you go above heights of 5,000 metres.
Social and emotional support. People with high blood pressure need to be aware of their disease, even if it does not produce any symptoms, and know that if they follow a healthy lifestyle and take their medications regularly, then they can continue to live normally for a long time without having any complications in the brain, heart or kidneys.
Side effects of antihypertensive drug therapy
Given that hypertension is a chronic condition, treatment is continuous and in most cases must be followed for life. Patients who need drugs to reduce their blood pressure are exposed to their side effects; however, fortunately current antihypertensive drugs have very few or even no side effects.
The most common side effects are:
Swollen ankles (only associated with a specific group of medicines called calcium channel blockers).
Persistent cough (this only presents with a group of drugs called angiotensin-converting enzyme inhibitors).
If side effects develop, your doctor may change the drugs for others that have none (angiotensin receptor blockers are free from side effects).
Nowadays, treatment typically involves the combination of several antihypertensives, so long as they can be combined in just a single tablet, which ensures that one drug cancels out the side effects of another included in the combination. For example, swelling in the ankles caused by calcium channel blockers is reduced through the coadministration of an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker.
The side effects of diuretics do not have any symptoms, but they may affect blood sugar and cholesterol levels. Therefore, patients with high blood pressure must undergo regular blood tests, at least once a year, to determine if either of these imbalances have arisen.
One of the problems associated with diuretics is that potassium is excreted in the urine and so its concentration in blood falls. In addition to certain measures the doctor can take, such as combining the diuretic with another antihypertensive drug that compensates for this loss, the patient must be aware that the consumption of salt can also affect potassium loss. As salt intake increases, so does the loss of potassium.
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Substantiated information by:
Antonio Coca PayerasMedical InternistInternal Medicine Department
Cristina Sierra BenitoMedical InternistInternal Medicine Department
Dolors Estrada RaventósServicio de Medicina Interna
Miguel Camafort BabkowskiMedical InternistInternal Medicine Department
Mónica Doménech Feria-CarotMédica InternistaServicio de Medicina Interna
Rosa Soriano GiménezNurseInternal Medicine Department
Published: 20 February 2018
Updated: 20 February 2018
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