Optimal Blood Pressure In People With Hypertension?
Hello doctor, I want to ask. What is the optimal pressure for hypertension? And how long do I take amlodipine?
Hello Jati Suryo Buwono,
Based on the American College of Cardiology blood pressure can be classified into:
Normal: <120 / <80 mmHg (systole / diastole)
Elevated: 120-129 / <80 mmHg
Grade I hypertension: 130-139 / 80-89 mmHg
Grade II hypertension:> = 140 /> = 90 mmHg
The diagnosis of hypertension is made after measurement> = 2 times at> = 2 different visits. Measuring blood pressure is as ideal as possible to get accurate results. If possible, patients can perform blood pressure checks using a device at home or outside a health facility to check the possibility of increased blood pressure due to feelings of fear of a doctor / health facility (white coat hypertension).
Hypertension can be divided into primary hypertension (90-95% of cases of hypertension) and secondary hypertension (arising from other diseases).
In addition to periodic blood pressure checks, hypertensive patients also need additional tests to look for risk factors (obesity, smoking, diabetes mellitus, heart abnormalities, blood vessels, kidney disorders, other metabolic disorders) and complications (damage to organs such as the brain, heart, kidneys, vessels blood) which may be related to hypertension. Investigations such as electrocardiography, echocardiography, examination of blood lipid function, examination of blood sugar levels, examination of kidney function, are some of the tests that may be done in hypertensive patients.
Treatment of hypertension includes:
Lifestyle modification: lose weight, limit salt consumption / day, limit alcohol consumption, meet calcium and magnesium needs / day, don't smoke, do physical / aerobic activity for at least 30 minutes / day.
Drugs, if lifestyle modification is not able to reduce blood pressure: ACE inhibitors, calcium channel blockers (amlodipine), diuretics, ARBs, beta blockers, etc.
Management of comorbid hypertension
Various guidelines have different blood pressure targets. Based on the 2014 ACC and JNC 8 the target blood pressure in adult hypertensive patients is <140/90 mmHg. Some other guidelines suggest a blood pressure target of <130/80 mmHg for adult patients with comorbidities such as a history of heart attack, stroke, peripheral arterial disease, aortic aneurysm. Target blood pressure can be achieved with lifestyle modification + treatment (monotherapy or a combination of several types of drugs).
Treatment of hypertension is determined by the doctor looking at the results of the examination and blood pressure response to the treatment. Patients are required to carry out periodic blood pressure checks (controls) so that the dose can be adjusted so that the target blood pressure can be achieved. Most hypertensive patients have to take the medicine for a long time. Most patients may be concerned about the side effects of long-term medications, however, hypertension medications given have gone through lengthy clinical studies, the benefits of taking these drugs far outweigh the potential risks they have. Usually the drug will be held at the lowest dose that is able to control blood pressure below the target.
Discontinuation of anti-hypertensive drugs is only based on the doctor's consideration. In a medical study patients who were stopped treatment can maintain normal blood pressure for 6 months -2 years. The study also reported that about 22-50% of patients could be stopped after 1 year of treatment with antihypertension, without high blood pressure returning.
Please consult further with your treating doctor and do regular blood pressure control. Thus the explanation from me, hopefully useful.