Ipertensione
La pressione sanguigna è il risultato dell’eiezione da parte del ventricolo sinistro del cuore in un minuto (gittata cardiaca) tale da consentire il flusso di sangue negli organi e nei muscoli, in modo da mantenerli in uno stato di eutrofismo tramite il sistema arterovenoso, per le resistenze periferiche.
L’ipertensione è un problema estremamente diffuso causa la morte di 7,5 milioni di persone.
In Italia colpisce 16 milioni di persone, il 33% uomini e il 31% donne.
Questi dati sono stati forniti dalla SIIA ( Società Italiana dell’Ipertensione Arteriosa). Rappresenta la principale causa di malattie cardiovascolari, che in Italia causano 240 mila
morti ogni anno. Nonostante la disponibilità di terapie adeguate solo 1 paziente iperteso su 4 si cura
adeguatamente.
La pressione arteriosa non è un valore statico che rimane stabile in ogni momento della giornata, ma è dinamico, varia in continuazione secondo l’attività fisica e mentale del paziente.
E’ sufficiente muoversi, parlare animatamente, guidare l’automobile, guardare una partita di calcio in TV perché si innalzi. L’importante è che non superi ripetutamente il valore di 140 di massima (sistolica)e di 90 di minima (diastolica) in uno stato di riposo, perché allora vuol dire che il paziente soffre di ipertensione, ossia pressione alta.
La pressione alta è classificata in essenziale o primitiva e secondaria.
Circa il 95% delle persone è affetta da ipertensione essenziale , cioè senza evidenti cause mediche, senza sapere cosa la scateni.
Va fatta una distinzione tra ipertensione maschile e femminile, compare nei maschi di solito intorno ai 50 anni, in alcuni casi anche prima.
Per le donne invece si corre un rischio maggiore dopo la menopausa, durante l’età fertile grazie all’azione protettiva esercitata dagli estrogeni il rischio è minore.
L’ipertensione secondaria, che interessa il 5% della popolazione, è invece determinata da cause individuali, da affezioni renali, endocrine, uso di cortisone, obesità, malattie neoplastiche, anemie, uso continuo di alimenti,
come liquirizia. A differenza della pressione alta essenziale, dalla quale non è possibile guarire, si può solo curare, nell’ipertensione secondaria una volta individuata la causa si può guarire.
-Sintomi ipertensione
L’ipertensione raramente è associata a sintomi specifici, spesso il paziente scopre di soffrirne, durante una vista occasionale o mentre è in cura per un’altra malattia.
Chi ha sintomi evidenti soffre di:
-Mal di testa
-Stordimento
-Vertigini
-Tinnito o sibili alle orecchie
-Visione alterata
-Epistassi
L’ipertensione considerata un “killer silenzioso” rappresenta
un gravissimo fattore di rischio per le malattie cardiovascolari
e l’ictus. Per questi motivi si raccomanda di affrontarla tempestivamente
e di intraprendere la terapia giusta su parere del medico.
-Cosa fare in caso di rialzo improvviso
Cercare di stare in un ambiente caldo, evitare ambienti freddi, in quanto la temperatura bassa comporta la costrizione dei vasi sanguigni, di conseguenza si ha un aumento delle resistenze vascolari periferiche che tendono a far aumentare al pressione. Chiamare al più presto il medico per la somministrazione
dei farmaci.
-Come misurare la pressione
Il paziente deve essere rilassato, seduto comodamente, in un ambiente tranquillo, con temperatura confortevole da almeno 5 minuti.
Non si devono assumere assumere bevande eccitanti, caffeina né aver fumato prima (non fumare mai sarebbe l’ideale).
Non si devono compiere sforzi fisici prima o trovarsi in uno
stato di ansia e agitazione, oppure in un momento di stress.
Quali strumenti utilizzare:
Lo sfigmomanometro, il cui uso deve essere demandato al medico o a persona competente.
Gli apparecchi elettronici automatici a lettura digitale effettuata dal medico o dal paziente costituisce un aspetto emergente nell’ambito della misurazione pressione arteriosa.
L’automisurazione domiciliare rappresenta uno strumento utile per gestire la pressione arteriosa, ogni paziente può nel comfort
di casa sua controllare i valori di massima ( sistolica), di minima
( diastolica) e i battiti del cuore.
Questa pratica è decisamente salutistica se non fosse per il problema dell’accuratezza di misura, infatti spesso il paziente è molto scettico e teme sempre che l’apparecchio non sia preciso.
L’acquisto di un apparecchio efficiente risulta fondamentale.
-Cosa fare quando si scopre di avere dei valori pressori
superiori a 140 di massima e 90 di minima
Rivolgersi al medico subito ed eseguire gli esami necessari:
Controllo del fondo dell’occhio ( fundus oculi) perché la condizione dei capillari arteriosi della retina è una sentinella importante per l’ipertensione.
Ecocardiogramma per verificare se il cuore è ingrossato e quindi lavora troppo a causa dell’ipertensione.
Esami del sangue specifici per valutare la funzionalità renale, gli elettroliti e la funzione tiroidea, per capire se c’è una causa secondaria all’ipertensione.
Un esame indispensabile è il monitoraggio della pressione per 24 ore attraverso l’applicazione di un apparecchio chiamato Holter pressorio.
-Alimentazione e ipertensione
La terapia farmacologica non è l’unica strada da seguire per tenere sotto controllo la pressione, accanto alla terapia farmacologica l’associazione di una dieta adeguata può essere di grande aiuto.
Seguire le norme generali di una corretta alimentazione con la riduzione di grassi di origine animale e alimenti ricchi di sodio, seguire la dieta mediterranea, a base di pasta, olio di oliva, pane, cereali,verdura, frutta fresca; per quanto riguarda la carne rossa utilizzarla con moderazione.
Evitare al liquirizia.
Da consumare con moderazione gli alcolici e il sale, il sale non va eliminato ma dosato in quanto è indispensabile per il benessere del nostro corpo.
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