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Juan Carlos Santacruz, CEO, Colombian Heart Foundation (CHF).
Miguel Urina, MD.
Hypertension is one of the most frequent disorders in medical consultations. It is also one of the main risk factors for cardiovascular and cerebrovascular disorders, the leading causes of death globally. In order to tackle this burden, great efforts have to be made to diagnose, control and treat hypertensive patients early.
Hypertension, also known as high blood pressure, is the single largest contributor to the global burden of disease and the leading risk factor for cardiovascular disease (CVD). Out of the 17 million CVD-related deaths per year, 10.4 million are attributable to complications related to hypertension. Arterial hypertension is easily identifiable and treatable in the initial stages, but it is often silent in this phase. Therefore, periodic blood pressure measurement is vital for establishing an early diagnosis.
Measuring blood pressure is easy, but it requires following a series of steps to ensure the results match the reality. Health professionals should learn how to measure blood pressure. While doctors and nurses learn this at school, other non-medical health professionals such as physical therapists, nutritionists, respiratory therapists, physical educators and dentists are unaware of the process, and a hypertension control programne cannot be optimal without an adequate blood pressure measurement system.
Health professionals should promote periodic blood pressure measurement at least every 6 months on individuals older than 25. Diagnosing high blood pressure at its early stages could help reduce many side effects and medical, socioeconomic, and psychological repercussions.
The lack of identification of arterial hypertension allows multiple systemic alterations in the heart, brain, kidney and retina, and increases the morbidity and mortality of hypertensive patients. High blood pressure shortens people’s life expectancy, so its treatment is vital to reduce cardiovascular morbidity and mortality.
The true magnitude of the problem is hampered by the fact that there is a significant amount of hypertensive patients who are not aware of their condition. The situation worsens in childhood and adolescence due to the lack of blood pressure measurement at these ages. On many occasions, the development of the disease occurs slowly, progressively, and asymptomatically.
To facilitate the early diagnosis of hypertension, it is essential to take basic steps that guarantee the identification of accurate numbers in the contraction phase of the heart, where blood is pumped into the vessels (systole – maximal), and in the relaxation phase, which allows blood to enter the heart (diastole – minimal). Individuals and their physicians need to make decisions based on the accurate numbers of an individual’s blood pressure, to determine from the findings whether initial lifestyle treatment is necessary or whether those individuals require pharmacological treatment.
White coat hypertension is a phenomenon that may involve an overestimation in the diagnosis of hypertension and, consequently, an over-medication of hypertensive patients. Therefore, it is vital that not only health professionals, but caregivers, parents, teachers, and health and safety leaders in companies learn how to take blood pressure correctly. Some patients tend to show higher levels of hypertension at the clinic or doctor’s office than at home. It has been shown that the blood pressure elevations throughout the day in the subject’s own environment tend to correlate better with hypertensive complications than the readings taken in the clinical context.
These patients are identified within the category called “White Coat Hypertension” (WHT). In recent years, research on WHT has proliferated. The first studies date back to 1940 when Ayman and Golshine specified that the blood pressure registered at home was systematically lower than that registered by the doctors in consultation.
Reisser, Reeves and Armington found that blood pressure was higher when measured by a doctor than when a nurse did it. We can argue that WHT is a problem to consider in the evaluation, diagnosis and treatment of high blood pressure and that BP Self-Monitoring is an ideal instrument to rule out WHT.
The Online Blood Pressure Measurement Course is designed with a compendium of steps, conditions and forecasts to ensure accurate high blood pressure readings. The course was designed by the Omron Academy and endorsed by the European Society Hypertension, the Colombian Society of Cardiology and Cardiovascular Surgery and the Colombian Heart Foundation. The course was promoted on the social media platforms of the Colombian Society of Cardiology and Cardiovascular Surgery, the Colombian Heart Foundation and allies such as the Colombian Association of Sports Medicine, the College of Respiratory Therapy, the Colombian College of Nutritionists, the Colombian Society of Pediatrics and the Colombian Dental Federation. To enroll, please communicate your interest to comunicaciones@corazonesresponsables.org.
We are reaching to barbers and hairdressers in the promotion of care as a lifestyle. With the course’s certification, these professionals can take the blood pressure of their clients in beauty salons. Customers receive a card where their diastolic and systole numbers are recorded, as well as a methodological guide on self-monitoring and healthy lifestyle habits. Several initiatives around the world have linked barbers and hairdressers in randomized studies, but in the case of Colombia, our aim is to improve early diagnosis by increasing the habit of taking blood pressure in people and encouraging them to visit their doctor according to the findings.
Blood Pressure Self-Monitoring allows BP measurements to be recorded over a period of 7 days. An individual can obtain the average of the maximum and minimum levels and contrast it with the circadian variation of BP and the response of BP to different events in daily life. This becomes extremely useful information for early diagnosis of hypertension.
For a correct clinical evaluation, the American Society of Hypertension recommends a rest period prior to the reading of blood pressure and its repetition on various occasions over time.
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