Hypertension is conventionally defined by figures voltage greater than or equal to 14 / 9. Reducing these numbers will reduce the risk of complications cardiovascular and the risk of dementia. The treatment is based on systematic rules of hygiene and diet, and where appropriate drug against the hypertension.

Hypertension from 14 / 9
Hypertension is defined by consensus by blood pressure systolic (SBP) greater than or equal to 140 mmHg and / or blood pressure diastolic (PAD) greater than or equal to 90 mmHg or beyond 14 / 9.
At least two measurements must be made, just minutes apart, during the
same visit. Measures must then be confirmed in three successive consultations over a period of three to six months.

Calculation of cardiovascular risk
The decision to support a person hypertensive depends on the values of its blood pressure but also the risk cardiovascular overall. And that's the main objective: to reduce the risk cardiovascular.
Namely, too, that beyond 50 years, systolic blood pressure is a prognostic risk factor cardiovascular more important than diastolic blood pressure, especially among older subjects. Thus the rise of the first digit is most disturbing.

The risk cardiovascular overall assessment based on risk factors:

- age (over 50 years in men and more than 60 years in women);

- smoking (current or stopped for less than 3 years);

- family history of accidents Cardiovascular Early:

- Myocardial infarction or sudden death before the age of 55 years with the father or a relative of first degree male

- Myocardial infarction or sudden death before age 65 in the mother or a relative of first degree female

- Stroke early (before 45 years);

- diabetes;

- cholesterol (dyslipidemia: LDL-cholesterol greater than or equal to 1.60 g / l (4.1 mmol / l), HDL-cholesterol greater than or equal to 0.40 g / l (1 mmol / l)

- abdominal obesity (waist circumference greater than 102 cm in men and 88 cm in women) or obese;

- sedentary (no regular physical activity, about 30 minutes three times per week);

- excessive consumption of alcohol (more than 3 glasses of wine per day in men and 2 drinks per day for women).

Several levels of risk Cardiovascular have been identified based on voltage measurements and the number of risk factors.
For example, the risk is low with a blood pressure of 140-159/90-99 and no risk factor. The same blood pressure associated with one or two risk factors indicates a medium risk, which is also the case with higher blood pressure (160-179/100-109), whether or not one or two risk factors .
The risk is high, regardless of blood pressure when the figures coexist three risk factors and / or diabetes, cardiovascular disease or renal impairment.

The hygiene and diet
These measures are aimed at all patients hypertensive with or without pharmacological treatment associated. It is necessary to define in collaboration with the medical precise objectives, realistic and spread over time for each person hypertensive. In some cases, revaluation should take place within six months (low risk) or 1 to 3 months (medium and high risk).

-Limiting salt (NaCl) to 6 g per day.

-Reduce weight if overweight.

-Practice a Regular physical activityTailored to the patient's clinical status (minimum 30 minutes three times a week).

-Limiting alcohol consumption: less than 3 glasses of wine or equivalent per day in men and 2 drinks for women.

-Quitting smoking.

-Diet rich in vegetables, fruit and low in saturated fat (animal fat).

Drug treatment of hypertension
The decision to prescribe a medication depends on the numbers of voltage levels and cardiovascular risk.
Firstly, a single antihypertensive drug is proposed. In case of insufficient response within a period of at least 4 weeks, or side effects, it is recommended to choose another drug against the hypertension or a combination of several drugs. In case hypertension or significant risk cardiovascular high, this period may be shorter.

Purpose of the management of hypertension
The main objective of the management of the hypertensive is to reduce its risk cardiovascular the long term. More pragmatically, the benefit of treatment is directly correlated to declining numbers of tension.
In case hypertension simple, the goal is to go below 14 / 9. But if diabetes partner or renal failure, it is recommended to lower the numbers below 13 / 8.
When the voltage objectives are achieved, monitoring is based on a consultation every three months in case of risk cardiovascular high or every six months in other cases.