118/78 blood pressure..What is normal blood pressure? – Does it vary with age? –
Dr. George: With reference to the blood pressure figures, the maximum values considered “normal” have been changing in recent years and this modification has been occurring towards the decrease.
I mention as an example that in 1985 the criterion that was used to talk about hypertension figures was different from the current one, and 10 years ago it was also different from the current one.
118/78 blood pressure
In 1985 we said that the maximum normal figures were 140 mm of mercury for the maximum or systolic and 95 mm of mercury for the minimum or diastolic.
It is also accepted that over the decades of life, when a person entered the decade of the 60 years naturally could accept a systolic of 160 and when he was 70 years could accept maximum 170 figures. (This was the case 20 years ago). During the decade of the 1990s new knowledge about the pathophysiology of arterial hypertension was developed, based on the results on thousands of people in follow-up for many years.
These studies have given birth to new criteria to define the maximum acceptable figures for arterial hypertension. Thus, the North American guidelines of 2003, known as ATP III, set the maximum and 130 mmHg (millimeters of mercury) maximum and 80 mmHg the minimum.
And if the person has Diabetes, it is suggested that the pressure does not exceed 120 mmHg. Therefore values above these figures are considered desirable to be corrected.
This means that this is the desirable number, since it has been found that people with 160 mm maximum live Typically up, a few years younger than those with 150 mm Hg maximum, and has 150 live Typically up a little less that the one that has 140 and this way the cutting of better results in longevity in the figure of 130 mmHg is achieved.
This is very well documented, especially with modern imaging techniques that show the damage of high blood pressure on the arteries of different organs, and the dysfunction that they then produce in the same organ. One of the most important in preventing its damage is the kidney.
PRESSURE OF PULSE OR DIFFERENTIAL PRESSURE
Just as there is a systolic and a diastolic pressure, there is also the so-called Pulse Pressure or differential pressure, that is, the difference between the systolic (maximum), and the diastolic (minimum).
In recent years the importance of knowing PULSE PRESSURE has been demonstrated, which should not exceed 65 mmHg. The pulse pressure (PP) is related to the pulsatile factor and the distensibility of the artery.
The scientific evidences that relate the PP and the prognosis are increasing. Thus, it has been proven that a pulse pressure greater than 65 mmHg is associated with:
– increased cardiovascular risk
– increased possibility of increased insulin resistance
– greater possibility of left ventricular hypertrophy
– greater possibility of plate formation at the carotid level
– greater possibility of presenting asymptomatic myocardial ischemia.
The elevation of the pulse pressure represents a marker of alteration of the vascular wall of the great capacitance arteries, particularly in adults.
Therefore, it would be epidemiologically equivalent to an additional risk factor, such as left ventricular hypertrophy.
From a pathophysiological point of view, O’Rourke says that increased vascular stiffness determines the PP high causes increased parietal systolic left ventricular stress and other conditions that result in increased left ventricular hypertrophy and ischemia greater.
The practical implication of this new knowledge requires give greater weight TREATMENT OF A PATIENT having 165/90 (pulse pressure of 75 mmHg), that one with 145/100 (45 mmHg PP).
In the same sense and for practical purposes preventive of progression of cardiovascular damage, a person who has 140/80 of pressure is better than another who has 130/60.
HEALTH COAUTORS AND DISEASE COAUTORS.
By knowing these new aggressor elements of the organism, and knowing that they are slowly producing damage in different vital organs, the intention of Medicine is towards prevention, therefore and in application to a millennial concept that has come to us from Hippocrates 2,500 years ago , with its message of “PRIMUN NON NOCERE” which would mean:
“BEFORE ANYTHING DOES NOT PRODUCE DAMAGE” or also: “BEFORE ANYTHING AVOID DAMAGE”, modern medicine wants to reach the patient before he gets sick, hence every time it is more strict with the normal blood pressure figures, and pulse pressure or “differential” is also taken into account and all this constitutes a very important cultural change, which is a real challenge for the 21st century, and which compromises not only to the doctors, but to the whole medicine, and to the whole community.
These forums are a very valuable opportunity for doctors to be able to send messages to the population, to help generate convictions about the importance of health care, messages that point to prevention, are far-reaching in terms of the impact they may have over thousands of people. If we already know what happens to a person over the years, if not controlled, we must be energetic from the early stages, so we do not have to regret later.
This must also commit society, in terms of a change of attitude regarding health and illness.
Health is not a gift from heaven that comes to us and we can do whatever we want “until the disease comes”, because this is the cause of many tragedies that we have to live on a daily basis, because although many patients get sick and medicine can cure, other times it is not possible, because the person dies in the acute event,
or is left with a disability, be it a stroke with a serious sequel, or a heart attack with a loss of quality of life, and when this happens we all We regret not taking the measures in time. That is the reason why the last guides have been very energetic with the maximum value, which is now 130/80.
The important thing about these changes is that we currently have extraordinary drugs that produce a stabilization of the pressure figures and a stoppage in the progression of the damage they may be causing, but we must remember that the pillars of the treatment of hypertension, as well as diabetes or dyslipidemias, not only focus on modern medication, but also in:
– adjusting the diet, adhering to healthy life regimens,
– to the realization of a daily physical activity, from 45 to 60 minutes (walk, jog, bike or swim), for 4 days a week and if they were 5 days better yet.
– and in learning to handle stress and everyday emotions.
With these 4 pillars (medicines, diet, exercise and better management of the stress of everyday life), we will be safe from the damage that hypertension may cause in our body.
This care must be maintained over time and not as a percentage of the population that once controls the pressure figures, suspends any medication, or suspends any dose, or begins to alternate physical activity, or becomes more permissive with the excesses in the feeding, it is in this situation where we go back into an area of risk.
People often have no memory but the disease does have it, and will be waiting for these periods where we stop aligning with the intelligence that protects our body to harm us.
Therefore without falling into extremism, or food fundamentalisms that are those situations where we do not allow ourselves a single excess, even if it were a special situation, we must in general be aligned with our health and not conspire against it as we do repeatedly and in multiple ways.