{"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\/pt\/zdrave\/koga-pri-visoko-kravno-ima-risk-ot-insult\/","title":{"rendered":"Quando h\u00e1 risco de AVC com hipertens\u00e3o?"},"content":{"rendered":"

A hipertens\u00e3o (press\u00e3o alta) definitivamente aumenta o risco de complica\u00e7\u00f5es cardiovasculares, como acidente vascular cerebral, ataque card\u00edaco, etc. Quando os valores da press\u00e3o arterial s\u00e3o muito altos, pode levar \u00e0 perturba\u00e7\u00e3o do c\u00e9rebro. Isto \u00e9 afirmado pelo Prof. Krasimira Hristova, MD. Ela \u00e9 diretora m\u00e9dica de um centro de doen\u00e7as cardiovasculares em Sofia e tamb\u00e9m especialista em cardiologia com mais de 25 anos de experi\u00eancia. Nesse sentido, existem algumas considera\u00e7\u00f5es importantes relacionadas \u00e0 o tratamento e monitoramento da press\u00e3o arterial elevada<\/a><\/strong>, que ser\u00e1 discutido neste artigo.<\/p>\n\n\n\n

Algumas das complica\u00e7\u00f5es da hipertens\u00e3o arterial podem ser tempor\u00e1rias, como ataques isqu\u00eamicos transit\u00f3rios. No entanto, outros levam ao AVC isqu\u00eamico ou hemorr\u00e1gico. Esta j\u00e1 \u00e9 uma condi\u00e7\u00e3o s\u00e9ria que pode deixar efeitos duradouros na sa\u00fade.<\/p>\n\n\n\n

Sangue com limites de 160-170 superior e 100-110 inferior \u00e9 perigoso<\/h2>\n\n\n\n
\"\u043c\u0435\u0440\u0435\u043d\u0435<\/a><\/figure>\n\n\n\n

As pessoas que foram diagnosticadas com hipertens\u00e3o por anos est\u00e3o em maior risco. Muitas vezes eles mant\u00eam valores altos e permanentes. Eles s\u00e3o considerados quando o limite superior (sist\u00f3lico) est\u00e1 em torno de 160-170 e o diast\u00f3lico inferior \u2013 acima de 100-110. O hipertenso t\u00edpico tamb\u00e9m tem outros problemas. Ele geralmente est\u00e1 acima do peso, come alimentos salgados e gordurosos, consome \u00e1lcool regularmente<\/a><\/strong>. Al\u00e9m disso, ele sofre de imobilidade. Muitas pessoas fumam para aliviar subjetivamente a tens\u00e3o interna e o estresse, mas tornam sua condi\u00e7\u00e3o ainda pior.<\/p>\n\n\n\n

Existe tamb\u00e9m o chamado hipertens\u00e3o noturna, quando a press\u00e3o arterial aumenta durante a madrugada. Isso \u00e9 dif\u00edcil de detectar no consult\u00f3rio m\u00e9dico, embora seja uma das principais causas de mau controle da hipertens\u00e3o. Todo cardiologista tem pacientes que tiveram complica\u00e7\u00f5es durante a noite.<\/p>\n\n\n\n

O que s\u00e3o 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

O principal objetivo de qualquer tratamento para hipertens\u00e3o \u00e9 controlar os valores elevados e traz\u00ea-los para limites aceit\u00e1veis. Eles devem ser monitorados com um holter por pelo menos 24 horas.<\/p>\n\n\n\n

\u201cO motivo \u00e9 que alguns dos valores durante o exame no consult\u00f3rio podem ser falsos positivos e, ent\u00e3o, o paciente apresenta press\u00e3o arterial normal. Al\u00e9m disso, no consult\u00f3rio, os valores podem ser relativamente normais e, posteriormente, tornam-se altos, n\u00e3o os notamos e negligenciamos o tratamento. <\/p>\n\n\n\n

Portanto, recomendamos, mesmo quando temos uma terapia estabelecida, colocar um holter para nos dar uma imagem real. \u00c9 errado fazer o acompanhamento em ambiente hospitalar, deveria ser em ambiente normal, quando a pessoa est\u00e1 em casa e no trabalho\u201d, comentou a Prof. Hristova.<\/p>\n\n\n\n

Qual \u00e9 o tratamento para pacientes com hipertens\u00e3o e hist\u00f3ria de acidente vascular cerebral?<\/h2>\n\n\n\n
\"\u043b\u0435\u043a\u0430\u0440\u0441\u0442\u0432\u0430<\/a><\/figure>\n\n\n\n

Os valores sangu\u00edneos alvo para esses pacientes de alto risco s\u00e3o 120-130 para o limite superior e 80-85 para o limite inferior. Deve-se tomar cuidado para que eles n\u00e3o fiquem muito baixos. Existe o risco de interromper a autorregula\u00e7\u00e3o interna do c\u00e9rebro. Se o sangue cair abaixo de 100 por 60, especialmente em pessoas mais velhas, isso \u00e9 um fardo adicional para o corpo.<\/p>\n\n\n\n

Se os valores estiverem acima de 160 por 100, os pacientes devem ser tratados. O risco de um novo AVC \u00e9 muito maior do que em pacientes que nunca tiveram um antes. Portanto, \u00e9 importante que as pessoas me\u00e7am o sangue de manh\u00e3 e \u00e0 noite, mas isso deve ser feito cerca de uma hora, uma hora e meia depois de terem tomado a medica\u00e7\u00e3o. N\u00e3o aconselhamos medir primeiro o sangue e tomar a medica\u00e7\u00e3o de acordo com os valores.<\/p>\n\n\n\n

A hipertens\u00e3o arterial \u00e9 perigosa mesmo que n\u00e3o haja sintomas<\/h3>\n\n\n\n

Valores de press\u00e3o arterial que ocorrem sem sintomas percept\u00edveis ou com queixas menores tamb\u00e9m s\u00e3o perigosos. O tratamento \u00e9 necess\u00e1rio para evitar complica\u00e7\u00f5es. Tamb\u00e9m n\u00e3o devemos negligenciar os pacientes com dist\u00farbios do ritmo, pois a hipertens\u00e3o pode ser uma das causas da fibrila\u00e7\u00e3o atrial.<\/p>\n\n\n\n

Quando considerar a troca de medicamentos para hipertens\u00e3o<\/h2>\n\n\n\n

Quando uma hipertens\u00e3o arterial n\u00e3o responde ao tratamento, falamos em esgotar o efeito dessas medica\u00e7\u00f5es. Isso acontece com os inibidores da ECA ap\u00f3s o quinto ou sexto ano de uso. A droga pode ser trocada quando atingimos a dosagem m\u00e1xima e n\u00e3o conseguimos um bom controle da press\u00e3o arterial. Meu conselho \u00e9, depois de passarmos pela terapia combinada, as doses m\u00e1ximas foram dadas, ent\u00e3o apenas prossiga para mudar a terapia.<\/p>\n\n\n\n

Os medicamentos modernos usados para tratar a hipertens\u00e3o arterial t\u00eam a\u00e7\u00e3o prolongada. Com eles, o efeito ocorre de forma mais lenta. Costumamos procur\u00e1-lo ap\u00f3s a segunda semana at\u00e9 o primeiro m\u00eas. Portanto, n\u00e3o vamos nos apressar, mas simplesmente tranquilizar o paciente de que n\u00e3o h\u00e1 como atingir valores de 120 a 80 ap\u00f3s uma mudan\u00e7a de terapia em apenas 2-3 dias. Algumas pessoas normalizam mais r\u00e1pido, outras precisam de um pouco de paci\u00eancia.<\/p>\n\n\n\n

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

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