{"id":28000,"date":"2023-05-31T11:58:34","date_gmt":"2023-05-31T08:58:34","guid":{"rendered":"https:\/\/bolenzdrav.com\/?p=28000"},"modified":"2023-05-31T11:58:37","modified_gmt":"2023-05-31T08:58:37","slug":"koga-pri-visoko-kravno-ima-risk-ot-insult","status":"publish","type":"post","link":"https:\/\/bolenzdrav.com\/es\/zdrave\/koga-pri-visoko-kravno-ima-risk-ot-insult\/","title":{"rendered":"\u00bfCu\u00e1ndo hay riesgo de accidente cerebrovascular con presi\u00f3n arterial alta?"},"content":{"rendered":"

La hipertensi\u00f3n (presi\u00f3n arterial alta) definitivamente aumenta el riesgo de complicaciones cardiovasculares como derrames cerebrales, ataques card\u00edacos, etc. Cuando los valores de la presi\u00f3n arterial son demasiado altos, puede provocar una interrupci\u00f3n del cerebro. As\u00ed lo afirma la Prof. Krasimira Hristova, MD. Es directora m\u00e9dica de un centro de enfermedades cardiovasculares en Sof\u00eda, y tambi\u00e9n especialista en cardiolog\u00eda con m\u00e1s de 25 a\u00f1os de experiencia.En este sentido, hay algunas consideraciones importantes relacionadas con el tratamiento y seguimiento de la presi\u00f3n arterial alta<\/a><\/strong>, que ser\u00e1 discutido en este art\u00edculo.<\/p>\n\n\n\n

Algunas de las complicaciones de la presi\u00f3n arterial alta pueden ser temporales, como los ataques isqu\u00e9micos transitorios. Sin embargo, otros conducen a un accidente cerebrovascular isqu\u00e9mico o hemorr\u00e1gico. Esto ya es una condici\u00f3n grave que puede dejar efectos duraderos en la salud.<\/p>\n\n\n\n

La sangre con l\u00edmites de 160-170 superior y 100-110 inferior es peligrosa<\/h2>\n\n\n\n
\"\u043c\u0435\u0440\u0435\u043d\u0435<\/a><\/figure>\n\n\n\n

Las personas que han sido diagnosticadas con hipertensi\u00f3n durante a\u00f1os corren mayor riesgo. A menudo mantienen valores altos y de forma permanente. Se consideran tales cuando el l\u00edmite superior (sist\u00f3lico) es de alrededor de 160-170 y el diast\u00f3lico inferior es superior a 100-110. El hipertenso t\u00edpico tambi\u00e9n tiene otros problemas. Suele tener sobrepeso, come alimentos salados y grasos, consume alcohol regularmente<\/a><\/strong>. Adem\u00e1s, sufre de inmovilidad. Muchas personas fuman para aliviar subjetivamente la tensi\u00f3n interna y el estr\u00e9s, pero empeoran a\u00fan m\u00e1s su condici\u00f3n.<\/p>\n\n\n\n

Tambi\u00e9n est\u00e1 el llamado Hipertensi\u00f3n nocturna, cuando la presi\u00f3n arterial aumenta en las primeras horas de la madrugada. Esto es dif\u00edcil de detectar en el consultorio del m\u00e9dico, mientras que es una de las principales causas del mal control de la hipertensi\u00f3n. Todos los cardi\u00f3logos tienen pacientes que tienen complicaciones solo por la noche.<\/p>\n\n\n\n

\u00bfQu\u00e9 son los valores sangu\u00edneos falsos positivos?<\/h2>\n\n\n\n
\"\u0445\u0438\u043f\u0435\u0440\u0442\u043e\u043d\u0438\u044f<\/a><\/figure>\n\n\n\n

El objetivo principal de cualquier tratamiento para la hipertensi\u00f3n es controlar los valores altos y llevarlos a l\u00edmites aceptables. Deben ser monitoreados con un holter durante al menos 24 horas.<\/p>\n\n\n\n

\u201cLa raz\u00f3n es que algunos de los valores durante el examen en el consultorio pueden ser falsos positivos y entonces el paciente tiene presi\u00f3n arterial normal. Adem\u00e1s, en el consultorio los valores pueden ser relativamente normales, y luego se elevan, no los notamos y descuidamos el tratamiento. <\/p>\n\n\n\n

Por ello recomendamos, aun cuando tengamos una terapia establecida, colocar un holter para que nos de una imagen real. Es incorrecto hacer el monitoreo en condiciones hospitalarias, debe ser en un ambiente normal, cuando una persona est\u00e1 en casa y en el trabajo\u201d, coment\u00f3 la Prof. Hristova.<\/p>\n\n\n\n

\u00bfCu\u00e1l es el tratamiento para pacientes con hipertensi\u00f3n y antecedentes de accidente cerebrovascular?<\/h2>\n\n\n\n
\"\u043b\u0435\u043a\u0430\u0440\u0441\u0442\u0432\u0430<\/a><\/figure>\n\n\n\n

Los valores sangu\u00edneos objetivo para estos pacientes de alto riesgo son 120-130 para el l\u00edmite superior y 80-85 para el l\u00edmite inferior. Se debe tener cuidado de que no bajen demasiado. Existe el riesgo de interrumpir la autorregulaci\u00f3n interna del cerebro. Si la sangre cae por debajo del 100 por 60, especialmente en personas mayores, esto es una carga adicional para el cuerpo.<\/p>\n\n\n\n

Si los valores est\u00e1n por encima de 160 por 100, los pacientes deben ser tratados. El riesgo de que se repita un accidente cerebrovascular es mucho mayor que en pacientes que nunca antes han tenido uno. Por lo tanto, es importante que las personas se midan la sangre por la ma\u00f1ana y por la noche, pero que esto se haga alrededor de una hora, una hora y media despu\u00e9s de haber tomado su medicaci\u00f3n. No recomendamos medir primero la sangre y tomar medicamentos de acuerdo con los valores.<\/p>\n\n\n\n

La presi\u00f3n arterial alta es peligrosa incluso si no hay s\u00edntomas<\/h3>\n\n\n\n

Los valores de presi\u00f3n arterial que se presentan sin s\u00edntomas perceptibles o presentan molestias menores tambi\u00e9n son peligrosos. Se necesita tratamiento para prevenir complicaciones. Tampoco debemos descuidar a los pacientes con trastornos del ritmo, porque la hipertensi\u00f3n puede ser una de las causas de la fibrilaci\u00f3n auricular.<\/p>\n\n\n\n

Cu\u00e1ndo considerar cambiar los medicamentos para la hipertensi\u00f3n<\/h2>\n\n\n\n

Cuando una hipertensi\u00f3n arterial no responde al tratamiento, hablamos de agotar el efecto de estos medicamentos. Esto sucede con los inhibidores de la ECA despu\u00e9s del quinto o sexto a\u00f1o de su uso. Se puede cambiar el f\u00e1rmaco cuando hayamos llegado a la dosis m\u00e1xima y no podamos conseguir un buen control de la tensi\u00f3n arterial. Mi consejo es, despu\u00e9s de haber pasado por la terapia combinada, se han dado las dosis m\u00e1ximas, luego solo se procede a cambiar la terapia.<\/p>\n\n\n\n

Los medicamentos modernos que se usan para tratar la hipertensi\u00f3n arterial son de acci\u00f3n prolongada. Con ellos, el efecto se produce m\u00e1s lentamente. Por lo general, lo buscamos despu\u00e9s de la segunda semana al primer mes. As\u00ed que no nos apresuremos, simplemente aseguremos al paciente que no hay forma de alcanzar valores de 120 a 80 despu\u00e9s de un cambio de terapia despu\u00e9s de solo 2-3 d\u00edas. Algunas personas se normalizan m\u00e1s r\u00e1pido, otras necesitan un poco de paciencia.<\/p>\n\n\n\n

Editora Ina Dimitrova<\/em><\/p>","protected":false},"excerpt":{"rendered":"

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