The importance of blood pressure checks, how to regulate them and what lifestyles to adopt when the heart must not get tired
How important is it to keep your blood pressure under control if you have heart failure and why? What are the other things to be more careful about?
This is answered by Piergiuseppe Agostoni, Director of the Critical and Rehabilitative Cardiology Department of the Monzino Cardiology Center and Full Professor of Cardiology at the University of Milan (here the cardiology FORUM mentioned one of the experts).
It is always very important to keep blood pressure under control in patients with heart failure.
This rule holds regardless of the left ventricular ejection fraction, which is the instrumental parameter most used in cardiology to evaluate the effectiveness of the heart’s pumping function and therefore measures the severity of the decompensation. In fact, a low pressure allows to reduce the afterload of the left ventricle and therefore to reduce the work of the heart.
I sometimes tell my patients that the pressure must be as low as possible, measuring it before the onset of symptoms such as dizziness when standing or with the acquisition of an upright position. Patients often stop their heart failure therapy because their blood pressure is low or normal. This is a grave mistake. It must be said that since many anti-sufficiency drugs are also used for the treatment of arterial hypertension, an error of this kind is understandable; but it should be avoided by explaining to the patient why he has to take the therapy. It should also be noted that high blood pressure is associated with episodes of acute decompensation and the only possible prevention is accurate anti-decompensation therapy.
In summary, in heart failure, the pressure must be kept low without ifs and buts. To realize how important this control is, you need to understand what heart failure is: a syndrome, i.e. a set of different diseases affecting different organs, all of which originate from the fact that the heart does not work well and therefore cannot pump sufficient oxygen to the rest of the body. Hence the need not to tire it, as I said at the beginning, to preserve its reduced functionality.
Decompensation is one of the most frequent pathologies in the western world and is growing steadily now also in emerging countries. Fortunately, thanks to recent advances in cardiovascular research, an increase in incidence corresponds to a decrease in mortality. In the last 10 years in Italy survival has increased from 75% to 88%. So we have more tools: more knowledge and more drugs; however, the self-control and active participation of patients is essential to keep this disease in check. As? Certainly adhering to pharmacological therapies, but also adopting a healthy lifestyle, above all by doing physical activity, which is the real anti-compensation pill and by keeping one’s blood pressure low.
July 19, 2023 (change July 19, 2023 | 09:20)
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