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41 PRACTICAL QUESTIONS AND ANSWERS ABOUT HYPERTENSION AND HYPERCHOLESTEROLEMIA - 2008

KEY POINTS  ΕΡΩΤΗΣΕΙΣ
  • Hypertension is one of the leading factors that increase the risk of a myocardial infarction and a stroke worldwide.
  • After the age of 55, systolic (maximum) blood pressure is more dangerous than diastolic (minimum).
  • Hypertension does not have any symptoms.
  • The diagnosis of hypertension is established when, in the physician's office, systolic blood pressure is consistently over 140 or diastolic blood pressure over 90 or both in 2-3 different visits. The same diagnostic criteria are also valid for older patients.
  • Optimal blood pressure control eliminates the danger of a cardiovascular incident due to hypertension.
  • The target of treatment is: systolic blood pressure below 140 and diastolic blood pressure below 90. In patients with diabetes or renal disease the target is even lower (below 130 and 80). In Greece, less than 25% of hypertensive persons are being treated effectively.
  • Blood pressure should be measured at home 1-2 times per week, only in a state of relaxation.
  • In order to measure blood pressure reliably at home, the best available method is the use of those automatic devices which are applied at the arm. Automatic devices which are designed for measuring blood pressure at the wrist are not currently recommended.
  • Body weight reduction as well as salt and alcohol restriction may help to lower blood pressure.
  • Antihypertensive drugs should be taken every day, usually early in the morning just after awakening. Temporary drug treatment modifications due to temporary fluctuations of blood pressure should not be made.
  • The use of sublingual drugs that lower blood pressure too abruptly is under any circumstances wrong and potentially harmful.
  • High LDL-cholesterol (the "bad" one) significantly increases the risk of a myocardial infarction. On the contrary, high HDL-cholesterol (the "good" one) reduces the risk of a myocardial infarction.
  • High LDL-cholesterol is the result of an impaired metabolism as well as of an inappropriate diet.
  • Body weight reduction, a healthy diet and daily exercise improve cholesterol levels.
  • The criteria for drug treatment commencement are mainly based on LDL-cholesterol level as well as the total cardiovascular risk of each patient, which depends on the presence of concomittant conditions (eg. hypertension, diabetes, heart disease).
  • The treatment of high cholesterol and blood pressure is, in the majority of cases, lifelong.

WRITING GROUP
G. Stergiou, Chairman
A. Achimastos
E. Andreadis
I. Avramopoulos
M. Elissaf
N. Karatzas
T. Mountokalakis
D. Papadogiannis
K. Siamopoulos
E. Varsamis
K. Vemmos
D. Vlahakos