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La hipertensión puede avanzar durante años sin producir síntomas y no es exclusiva de las personas mayores. ¿A qué edad deberíamos empezar a preocuparnos por nuestra presión arterial? En este episodio hablamos de cómo reconocerla, medirla correctamente, por qué no debemos normalizar una presión un poco elevada y qué tan importante es seguir el tratamiento.
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00:00If I could eliminate high blood pressure from the world,
00:02What percentage of preventable deaths could be avoided?
00:06And that's half, or rather, half of the deaths that occur in the world
00:10that can be prevented by diseases
00:12They are related to hypertension.
00:14We are starting to see more and more young people
00:17due to family circumstances or lifestyle
00:21They begin to develop high blood pressure, and that is very dangerous.
00:24And high blood pressure can lead to complications
00:27that affect virtually any part of the body,
00:31since the whole body receives blood.
00:33So, if those blood vessels are damaged,
00:36that specific organ will be damaged.
00:46Dr. José David Cruz, welcome to the viewer
00:49Welcome to this Health Consciousness video podcast.
00:52Thank you so much for accepting the invitation.
00:54Hi Diego, thank you so much for the invitation and for being here.
00:58Well, doctor, I'm sure that everyone who hears or sees us...
01:04Have you ever heard of hypertension?
01:08They either suffer from it themselves or have a family member, usually a father, mother, grandfather,
01:14who suffers from it.
01:16How common is it to have high blood pressure in today's world?
01:21Okay, sure, and they've heard it, as you say, because either they suffer it or they don't.
01:25or a family member or acquaintance also suffers from it, but also because of health
01:31He has made a very important effort to make people aware of that.
01:34However, we still have a long way to go.
01:36Roughly one in three people over 40 years old
01:39They have high blood pressure, and in Colombia it is estimated that there are more than 6 million of them.
01:44of people we know have high blood pressure.
01:48But various studies tell us that perhaps half of them don't know this.
01:54and they're out there walking around with a disease that will affect them in a few years
01:59And they don't know it.
01:59That's valuable to touch on there, to begin with, two very basic points and that's first
02:06Because it is a silent disease, because it takes us so long to feel it ourselves
02:12And well, from that first symptom we go to the doctor and that's where they diagnose us.
02:19And secondly, it also helps us to define it, because we are talking about hypertension.
02:24And sometimes we may not know exactly what we are referring to.
02:29Perfect, so hypertension, as you said Diego, is a disease
02:33And I'm emphatic about that because many people consider it a characteristic,
02:38a condition such as having black hair and blue eyes
02:42And sometimes patients come to my office and ask you
02:45What illness do you suffer from? And they tell him, no, but I take these five medications
02:48For the pressure. So that's where we have to start addressing the problem.
02:52and to raise awareness that it is a disease with implications
02:55for health. And it happens because of the pressure inside the blood vessels,
03:00which is living tissue, increases and that can progressively damage them.
03:05We are becoming increasingly strict in our definition of high blood pressure,
03:08There are different scientific societies that set different pressure cut-off points,
03:14But in general, if one has a systolic blood pressure, which is the big number,
03:18The one above, above 130 millimeters of mercury, or the number below,
03:23which is diastolic, above 80 millimeters of mercury, persistently,
03:27In other words, it's not a single isolated shot, but something that one averages out.
03:30from several measurements, because that person has high blood pressure.
03:34And the thing is, all the organs, all the parts of the body,
03:37They receive blood through the blood vessels, the arteries.
03:41And high blood pressure is not usually sudden, but appears gradually.
03:46Then, those blood vessels can gradually adapt.
03:50to that increase in blood pressure, and at first they do not produce symptoms precisely for that reason.
03:55But there comes a point when they can't take it anymore, and those organs begin to get damaged.
03:59that receive blood at very high pressure.
04:02And that's where the name "the silent killer" comes from.
04:07because it greatly affects health, but at first it produces nothing.
04:10or in some cases it can produce very nonspecific symptoms,
04:14Headache, ringing in the ears, sometimes blurred vision, tiredness,
04:18that people don't attribute, well, let's say, to hypertension,
04:21And it's difficult to link those symptoms to having high blood pressure.
04:26That experience you shared in the consultation is interesting.
04:29because then being hypertensive has become somewhat normalized,
04:32And above all, being one has been underestimated, hasn't it?
04:35That's right, and it's the most common condition or disease in the world.
04:41And we doctors have a statistical measure to say
04:46how much a disease could affect the general population,
04:50which is called the population attributed risk.
04:52And if I could eliminate high blood pressure from the world,
04:55What percentage of preventable deaths could be avoided?
04:59And that's half, or rather, half of the deaths that occur in the world
05:03that can be prevented from diseases are related to high blood pressure.
05:08And it becomes more frequent as people get older.
05:12that high blood pressure appears.
05:14So, traditionally we have associated it with diseases
05:18of older adults, and I would believe that if one were to live long enough
05:22will eventually develop high blood pressure,
05:25But we are starting to see more and more young people
05:28due to family circumstances or lifestyle
05:32They begin to develop high blood pressure.
05:35And that's very dangerous because, as I said,
05:37The risk of high blood pressure is that it will persist over time.
05:40So, if I develop high blood pressure at 25 or 30 years old,
05:44It's not common, but it can happen.
05:46Well, I have another 50 or 60 years to develop the complications.
05:50Unlike a person who develops high blood pressure at 70 or 80 years old.
05:53He will no longer be exposed to that condition for so long.
05:56Of course, and in a country that is aging so rapidly, that precision is important.
06:02And what factors specifically contribute to developing hypertension, doctor?
06:07If hypertension is a complex disease, we call it that, or multifactorial.
06:12We cannot say that hypertension in most cases is caused by a single cause,
06:17but by a rather complex combination of different factors.
06:22Definitely, genetic predisposition is the most important factor.
06:25If you have family members who have had high blood pressure, the risk increases significantly.
06:30And age too. Those are the two most important factors.
06:34which are precisely the two things we can't do anything about.
06:37Our family, because we were born, is the one we have, and the inevitable passage of years.
06:43But there are many other factors related to the environment and lifestyle.
06:48that we can intervene and some that are simpler than we think.
06:52So, for example, physical activity or a sedentary lifestyle can contribute to having or not having high blood pressure.
06:59Your diet, especially your salt intake, is super important.
07:04Sleep quality and quantity are very important.
07:08Stress management and weight control are, let's say, the most important environmental factors.
07:15Other things to note would be medications.
07:18Sometimes some over-the-counter medications, such as pain relievers and anti-inflammatories,
07:24Indiscriminate use can lead to high blood pressure.
07:27So, it is also important, or can even worsen it, in people who already have it.
07:31It is important, therefore, that people do not self-medicate for any other condition either.
07:36Impacting all these factors, I suppose, is exactly what you were saying.
07:41It is to delay or for hypertension to appear, to appear as a product of age.
07:48and not from this other bunch of things we can do wrong on a daily basis.
07:53Exactly. And if it's already appeared, well, let's just say we haven't lost the battle.
07:58In fact, if we noticed it appeared, we have the advantage because we know it's there.
08:02and that we can intervene.
08:05So, if you don't have high blood pressure, but you have risk factors,
08:08For example, because of your family or your age, do all these things that help you prevent it.
08:13But if it has already appeared, all the more reason to do them, because we are not only trying to prevent it,
08:18but control it.
08:19We know that if a person has high blood pressure,
08:22but he manages to control his blood pressure levels,
08:24Well, this person will reduce the risk of suffering the resulting complications.
08:28of high blood pressure.
08:30Sure. You mentioned at the beginning how hypertension has a lot of connections.
08:34with a whole bunch of other diseases and so on.
08:36And I thought it would be interesting to revisit it and have it help us understand that a little better.
08:41Because, of course, the person can say, no, well, I only have high blood pressure and that's it.
08:47I mean, what if I don't take the medication or do nothing?
08:51Well, I'm just going to continue having high blood pressure.
08:53which implies exactly how to not control hypertension.
08:58Okay. Well, not controlling hypertension is quite risky.
09:02because those risk factors we mentioned are also risk factors
09:05for other diseases such as diabetes, such as high cholesterol,
09:10such as obesity and heart disease.
09:13And high blood pressure can lead to complications that affect virtually any part of the body.
09:20Since the whole body receives blood, right?
09:23So, if those blood vessels are damaged, that specific organ will be damaged.
09:28High blood pressure can lead to Alzheimer's or dementia, and can cause strokes.
09:34It can cause bleeding in the brain, and that can lead to lasting effects.
09:39With a limitation in the person's functionality, it can produce blindness,
09:44It is one of the leading causes of blindness worldwide,
09:47due to bleeding in the retina or retinal detachment.
09:50It can also cause heart attacks or heart failure.
09:53because the heart is the one that has to counteract all that excessive pressure
09:57that are in the blood vessels.
09:59It is also the leading cause of dialysis worldwide.
10:02then it causes kidney failure or can damage the arteries that supply blood to the limbs
10:06and it is also a major cause of limb amputation.
10:10Furthermore, it's impressive what stopping the medication entails.
10:16Because many people then go and get diagnosed, they are diagnosed with hypertension,
10:22They prescribe a series of medications, and this person, along with many others, feels a little better.
10:27Or they say the pressure is under control, then they start to be a little reckless.
10:32with medications, and also what effect do these errors have on adherence to treatment?
10:39It's a challenge, and I must admit it, because we're asking people
10:44that they take medication every day for practically the rest of their lives
10:48And there's nothing more difficult than creating a habit.
10:51So I think we need to motivate them very well
10:54And part of the motivation is to give them all this information that we're discussing.
10:57Because obviously, if someone tells you to take a tablet every day...
11:01It can prevent everything we mentioned, I think anyone would be willing.
11:06One difficult aspect of adherence is that, like any other medical intervention, it's a difficult part.
11:10Well, treatments for high blood pressure do carry a risk of adverse effects, of course.
11:16Having high blood pressure is bad, but having very low blood pressure is also bad.
11:19And with those treatments, that can happen, that blood pressure drops a lot.
11:23So I think the most important thing for patients to achieve adherence is
11:27It's about having good communication with your healthcare professionals
11:32so that they can be informed of all these changes that appear with the treatment,
11:37If your blood pressure drops, attend your check-ups.
11:39Take the requested laboratory measurements
11:42so that the doctor can adjust the treatment.
11:45There are many options for blood pressure medications.
11:49And it's not that one is necessarily better than the other in all scenarios,
11:53There is a specific one for each patient, but blood pressure control
11:58It is very important to achieve goals quickly
12:02and keep it on track for as long as possible
12:07And that's what has the greatest impact on reducing those cardiovascular complications.
12:11That's also valuable because if I understand correctly, then
12:15The approach to intervention is highly individualized, depending on each patient.
12:20Because I also suppose the context matters, the illnesses he has suffered before,
12:26their conditions, that is, it's not about a person starting to take
12:31the medications the neighbor takes because they have similar hypertensive experiences.
12:38Yes, the treatment definitely needs to be individualized.
12:42Since it is such a common disease and affects so many people,
12:45Well, it's to be expected that it will be very different for each person.
12:48Obviously there are some common points and it is worth highlighting them,
12:53The first step would be to confirm the diagnosis because, while having high blood pressure is bad, it is also important to confirm the diagnosis.
12:57And not treating it is very bad not having it and thinking you have it and not treating it.
13:02because we're going to the other extreme.
13:04Then the high blood pressure needs to be confirmed.
13:06There is a phenomenon called white coat hypertension,
13:08People get nervous going to the doctor, they get there,
13:12Their blood pressure rises, and then they are labeled as hypertensive.
13:16So a very good tool for this is to keep a blood pressure diary,
13:21that the person learns to take their blood pressure correctly,
13:24Your doctor can educate you on that because they have many specific steps to do it.
13:27and she takes it at home and keeps a diary and takes it to the doctor.
13:31Or a test called ambulatory blood pressure monitoring,
13:35They put him in a device for a day and he is having his blood pressure checked regularly
13:38And that's the best way to confirm if a person has high blood pressure.
13:42So that should be the case for everyone: confirm the diagnosis.
13:45And the second thing that is for everyone is the lifestyle treatment.
13:51So there are even patients with high blood pressure who can improve with lifestyle management alone,
13:55Without medication, they manage to control their disease.
13:58So, recommendations that would apply to practically anyone are,
14:03If you are overweight, lose at least 5% of your weight through physical activity and exercise.
14:07And if you need help with medication, reduce your salt intake as much as possible.
14:13one teaspoon of salt throughout the day, including food preparation
14:17and what is put on the table.
14:20One isn't constantly measuring exactly how much salt is in a glass,
14:23But the less there is, the better.
14:26And there are salt supplements that do not contain sodium chloride.
14:31but potassium chloride, because what makes you sick in salt is sodium.
14:36And these have been demonstrated in experiments, an experiment that was done in China on thousands of people,
14:41that reduces the time it takes to stop and reduces the risk of complications.
14:45So definitely cut down on salt.
14:47Do 150 minutes of physical activity per week,
14:51vigorous or moderate activity, getting enough sleep, and reducing stress.
14:56There are experiments that have shown that doing meditation exercises, breathing exercises, tai chi,
15:01It lowers blood pressure almost as much as a blood pressure medication would.
15:06So that's it, for everyone.
15:08And if that's not enough, we start with the medications.
15:12And we have many families and types of blood pressure medications.
15:16that each one has as an additional benefit for another disease.
15:19So if I also have kidney disease, will this work for me?
15:22If I also have diabetes, this one will work for me.
15:24If I have heart disease, this will work for me.
15:26And that's where we doctors start to integrate everything
15:30and decide which one is best for each patient and adjust it all the time.
15:34In other words, a person is dynamic; a person is constantly changing their lifestyle habits.
15:38It develops new diseases.
15:40Therefore, we shouldn't simply stick with the initial treatment,
15:43but to monitor and adjust it as needed.
15:46No, very interesting because then in the non-pharmacological options,
15:50which they always have to be, of course, as long as possible,
15:54until the doctor advises otherwise.
15:57There are many ways, and many ways that are also close to enjoyment.
16:01what a person likes to do,
16:04What you were saying, meditation and so on,
16:07These can be very effective methods when implemented on time and so on.
16:11to be able to prevent high blood pressure.
16:14Yes, of course, it's about finding a purpose and following it.
16:18I sometimes like to tell my patients,
16:21Okay, let's do all this and with this we'll gain a few more years of life.
16:26For a better quality of life, think about what you want to do all the time.
16:28with those extra years he's gaining
16:31and focus on that routine of what you want to do,
16:33those things that will allow him to achieve that.
16:36Many of those things you mention
16:38that help one to have low blood pressure,
16:40but they also actually benefit one's overall health.
16:43Exactly, yes, having good blood pressure is important.
16:46It's about feeling well in general, it's about overall health.
16:50And that's why, let's say, from the perspective of internal medicine
16:52And cardiology views all of this in a comprehensive way.
16:56and it's about seeing the patient as a whole
16:59and see how all those interventions benefit him.
17:03Obviously, understand that the person is not just a patient,
17:06He has other things in his life
17:07And expecting it to do everything at the same time is difficult.
17:09But we have to start looking for that first thing
17:13which will be the first big step
17:15that will give him the motivation
17:17And he's going to show him that he can change.
17:19and that he will feel the benefit in his life
17:22and start there.
17:23So, let's see what that aspect is.
17:26which is easier to improve
17:28or that has the greatest impact.
17:29If my patient tells me,
17:30No, it's just that I'm looking at my phone.
17:33until 11 or 12 at night
17:36and I wake up at 4 or 5 in the morning,
17:39Well, man, that's probably the first factor
17:40that we can intervene.
17:42I mean, well, in this consultation the goal is going to be
17:45that you go to bed between 9, or at the latest 10 at night,
17:48that he doesn't look at his cell phone so late
17:49and that he sleeps at least 7.9 hours.
17:51In the next consultation we will look
17:52how do we adjust the diet plan,
17:55how do we adjust the exercise
17:57and about their diet for now,
17:59Reduce the salt a little.
18:00and we're making adjustments little by little.
18:01Do not add sugar to drinks
18:03And so, little by little.
18:05Small habits,
18:06almost like small steps day by day
18:08that become sustainable,
18:10that can become part of people's habits.
18:15Exactly, that's the idea.
18:16And if the medication arrives,
18:17What you were saying a little while ago,
18:20not to be a little afraid of medications,
18:23knowing that they are there
18:26because a doctor says so,
18:28considering the entire individual context
18:30and that those medications are going to do
18:33who will surely be able to live much longer
18:37with this condition controlled.
18:40Exactly.
18:41And let's say,
18:42in medicine,
18:43Well, there are no absolute truths in everything.
18:46It is a very dynamic science,
18:48It changes a lot.
18:49Some things are more difficult to investigate than others.
18:52But if there is anything that exists
18:53a great deal of scientific evidence
18:55It is high blood pressure,
18:56precisely because of how frequent it is
18:58and because of the impact it has on global health.
19:02So,
19:03Everyone is interested in researching hypertension.
19:06So,
19:06any medication your doctor is prescribing.
19:08Regarding high blood pressure,
19:10I assure you he has a lot of studies
19:12and that millions of people have used it
19:15before you
19:16and they have benefited from that.
19:18Again,
19:18Any medication has adverse effects.
19:20No doctor can promise you
19:21give him a medication that has no adverse effects.
19:23What your doctor needs to do is anticipate it.
19:26warn him
19:27So, what could they be, so you can be aware?
19:29And if he does present them,
19:31notify him
19:31and we adjust to any other option
19:34that might be best for you.
19:36Clear.
19:36You were just mentioning
19:37to the young
19:39and hypertension,
19:41of course,
19:42It's a condition one imagines
19:44in adulthood,
19:45older adulthood
19:48And I understand,
19:49As I was saying,
19:49that cases in young people
19:51are infrequent,
19:52But what should I be thinking today?
19:55a young man
19:55who is also living
19:57in a world
19:57with ultra-processed foods,
20:00with little physical activity,
20:02with a bunch of conditions?
20:03What should I be thinking today?
20:05a young man
20:05from this conversation?
20:07Okay, that's it.
20:08The first thing is that
20:09although it is infrequent,
20:12well, if it were to appear
20:13is the one who benefits the most
20:14to find it in time
20:15Because, as I say...
20:16is older
20:16so that they appear
20:17the related problems
20:18with hypertension.
20:20The second thing is that
20:21if you have other risk factors
20:22such as those we already mentioned,
20:23although hypertension
20:25in people under 40 years old
20:26It's not that common,
20:27Well, it may appear.
20:28And the third thing is that
20:29we talked
20:31of hypertension in general
20:32as if it were
20:32a single disease,
20:33but they exist
20:34two types of diseases.
20:36Essential hypertension
20:37or primary,
20:38which is almost
20:3990 or 95%
20:40of the cases,
20:41Which is what we're talking about,
20:42and there is secondary hypertension,
20:45that is no longer
20:45This multifactorial disease
20:47that we were talking about just now
20:48if it's not an illness
20:48that has a cause
20:49in particular.
20:50They usually are,
20:51For example,
20:52heart disease,
20:53some valve
20:54that is altered,
20:55hormone disorders
20:56such as hyperthyroidism,
20:58have elevated cortisol
20:59due to abnormal production,
21:02excess calcium,
21:03excess of other hormones.
21:04It's strange,
21:05But it can happen.
21:06So,
21:07if you happen to see
21:08that arterial subtension
21:09It's high,
21:10even if you are young,
21:11Well, you have to consult
21:13or if you have symptoms
21:14related to
21:14high blood pressure
21:15He needs to consult,
21:16It needs to be confirmed
21:17and in this case,
21:18before we begin
21:19to do the whole treatment,
21:20It is time to expand the studies
21:22to search
21:23those rare causes
21:24secondary hypertension
21:26Because if you have it,
21:28the treatment
21:28It's not so much anymore
21:29This thing about medications
21:31and lifestyle
21:32which is important,
21:33but the cornerstone
21:34of the treatment
21:35That's where you need to correct the cause.
21:36Sometimes they need surgery
21:37or specific treatments
21:39for that hormonal disease.
21:42So,
21:42one of the red flags
21:43for secondary hypertension
21:45is that it happens
21:45at very young ages,
21:47also for example
21:47that appears suddenly
21:50very severely
21:50or hypertension
21:52that was previously controlled
21:53well with few medications,
21:54Now he needs many,
21:55They're like red flags
21:56food for thought
21:57in secondary hypertension.
21:58Clear,
21:59very interesting
21:59because it is possible,
22:01infrequent,
22:02But it is possible
22:02be alert
22:03with more red flags,
22:04but also then
22:05meanwhile
22:06work in all
22:07these modifiable factors
22:10that allow
22:11all young people,
22:12I hope they grow old.
22:13They will continue to grow,
22:15They will continue to live
22:16and that must be avoided
22:18that hypertension
22:19appear at an age
22:21earlier
22:22than it should.
22:23Exactly,
22:24We forgot
22:25one very important
22:26and I can't stop
22:26overlook it
22:27smoking,
22:29smoking
22:29and not only
22:30could be
22:31the conversion cigarette
22:32but also
22:32the electronic cigarette.
22:34And alcohol,
22:36Well,
22:36science is still debating
22:38a little alcohol
22:39It may be beneficial or not,
22:41but in general
22:41there is no evidence
22:42tell us
22:43that a doctor
22:44I could recommend
22:45some amount of alcohol
22:46to produce
22:47something good for your health.
22:49If you enjoy it
22:50and he takes it in moderation,
22:51probably then
22:53It won't generate anything for him
22:54bigger problem,
22:55Besides, life
22:55It's meant to be enjoyed.
22:56We don't want to be either.
22:57restrictive doctors
22:58which is that it can't be done
22:59do nothing
23:00and we are in a ballot box
23:01glass
23:01so that nothing happens to us
23:02to life,
23:02You have to experience it,
23:03But that's exactly it
23:04That's what they're looking for
23:05the interventions
23:05in high blood pressure,
23:06so that people can live
23:07more and better.
23:08Yeah,
23:09in all of these,
23:10regarding alcohol
23:11I understand that the maximum
23:13It's always less,
23:14It's better.
23:16Ask
23:18complete absence
23:19Well, sometimes
23:20It's difficult
23:20because of everything you say
23:22And that's because
23:22finally it is part
23:24of some spaces
23:25socialization
23:26and so on,
23:27but even
23:28in those spaces
23:29Less is better
23:30and I find it interesting
23:32about young people
23:33this topic
23:34of vaping
23:35that each time
23:35it is more common,
23:36There is evidence
23:38against hypertension
23:39but also
23:40compared to other problems
23:41health
23:41It is becoming more and more solid,
23:42No?
23:42Yeah,
23:43OK,
23:45Well, it was, let's say
23:46the habit
23:47that we got
23:47to live in our time,
23:49No?
23:49My teachers,
23:51Some caught up with me
23:52to tell
23:52because when they
23:54It was their turn to see
23:55that the doctors
23:55They recommended cigarettes
23:57for some diseases
23:59and formed
23:59in the consulting rooms
24:00And it was normal.
24:01And unfortunately
24:03well when
24:05a condition
24:07or a habit
24:07because it's unhealthy
24:09Sometimes it's difficult
24:09to realize quickly
24:10then surely
24:12life,
24:14the story,
24:14time
24:15will prove us right
24:16but vaping
24:17definitely
24:18has shown
24:19that in young population
24:21and in general
24:22But since it's more frequent
24:23in young population
24:24has an impact
24:25in health
24:25very important
24:26both respiratory
24:27such as cardiovascular
24:29and definitely
24:30It's not a good habit
24:33for high blood pressure.
24:35And if,
24:36And I understand, Doc
24:37which of course
24:38if the idea
24:39It's about making habits
24:40small
24:41and make them sustainable
24:43Nor would there have been
24:44that underestimate
24:45like exactly this
24:46vaping
24:48I don't know
24:49I vape very little
24:50but sustained
24:51Well, that's what it has
24:52an impact
24:53The same applies to health
24:54if it is
24:55if it remains
24:56in time.
24:57Yeah,
24:57It's difficult
24:58because, let's say
24:58the topic of vaping
24:59They have introduced it
25:00as the lesser evil
25:02There are even studies
25:04that they are trying to demonstrate
25:05if it's less bad
25:07vaping is better than smoking
25:08and compare
25:08to those who smoke
25:10conventional cigarette
25:10with those who smoke
25:11electronic cigarette
25:12so
25:14if you tell
25:15that study
25:15or that investigation
25:16vaping
25:17it's less bad
25:18that smoke
25:19Well, that shouldn't be the case.
25:20be enough
25:21to tell him
25:21to the people
25:22vape
25:22because
25:23the alternative
25:24is not doing
25:24neither
25:25Yeah?
25:27then I think
25:27which is valuable
25:28and well, let's say
25:29it's worth it
25:30mention it
25:31people who smoke
25:33and that has
25:33a dependency
25:34of tobacco
25:35or that has
25:35a dependency
25:36of the electronic cigarette
25:37Well, it's through a process.
25:39chemical that occurs
25:40in the brain
25:41Yeah?
25:41so, just like that
25:42I don't tell him
25:43to the one who has
25:43high blood pressure
25:44Hey, relax
25:45calm so that
25:46his blood pressure drops
25:47And well, not really.
25:48I can tell you
25:48to the one who is vaping
25:49Hey, stop vaping!
25:50and because it has
25:51a dependency
25:52about that
25:53then some people
25:54They can do it
25:55but if not
25:56because they also exist
25:57non-pharmacological measures
25:58and pharmacological measures
26:00to drive
26:01well, topics
26:02like a cigarette
26:03or vaping
26:04that sometimes
26:05We do not resort to them
26:06People don't consult
26:07for that
26:07clear
26:08and be very aware
26:09that all this
26:10It has to do with
26:11All of this can affect
26:12the conditions
26:14such as hypertension
26:15and hypertension
26:16in turn is connected
26:17with a bunch of other things
26:18like we're talking
26:19what you were saying
26:20a few minutes ago
26:21And that is understanding
26:22the patient
26:23or understand each other
26:24fully
26:26holistically
26:26that everything
26:27It is part of
26:28of a whole
26:28Yes, and let's say
26:30I mean, I think that
26:31a doctor who treats
26:32to a patient
26:32with high blood pressure
26:34He's doing it, then.
26:35a link
26:36for a long time
26:37even for life
26:38that is, to pretend
26:39adjust the treatment
26:40blood pressure
26:41for a patient
26:41in a single consultation
26:42It seems to me
26:43Well, it's impossible.
26:45How do I say it?
26:46each consultation
26:47has to look
26:48better understand
26:48what is daily life like?
26:50of that person
26:50and how can we
26:51start putting it in there
26:52those small changes
26:54while we go
26:55checking how it's going
26:56the pressure
26:57Meanwhile, how are we doing?
26:58seeing if there has been
26:59a complication
26:59or unrelated
27:00with hypertension
27:01if there is another illness
27:02if the person is happy
27:04if you are enjoying
27:04life
27:05all that needs to be done
27:05integrate it into the consultation
27:07marvelous
27:08doctor
27:09I will ask him
27:10that we resume
27:11some things
27:12because I would like to
27:12end with
27:13if a person
27:14wants tomorrow
27:15start doing
27:16three things
27:17to avoid
27:18or to control
27:20better
27:20your pressure
27:22that should
27:23start doing
27:23ready
27:24the first
27:25spot
27:26and the most important
27:28is to measure
27:29blood pressure
27:30we cannot control
27:31something we are not
27:32measuring
27:33if you already know
27:34who has hypertension
27:35arterial
27:35a fortiori
27:36You should wear
27:37a daily log
27:38of your blood pressure
27:39But if it doesn't have
27:40high blood pressure
27:41or doesn't know he has it
27:42Well, check the pressure.
27:44the recommendations
27:45that are done
27:46at a general level
27:46is if a person
27:47is over 40 years old
27:49minimum
27:49once a year
27:50should be measured
27:51blood pressure
27:52if they are under 40 years old
27:54could be
27:55every 2 or 3 years maximum
27:57with the exception
27:58that it has to be
27:59blood pressure
28:00correctly measured
28:01and look at it
28:02and register it
28:03because if you
28:03keeps the number
28:04and does nothing
28:05He doesn't tell her.
28:05a healthcare professional
28:06Well, he's not doing anything.
28:08then measure
28:09register
28:10and tell your doctor
28:11blood pressure
28:13secondly
28:15is
28:16when I find
28:17blood pressure
28:18well
28:18check if there is already one
28:20a complication or not
28:21because sometimes
28:21We arrived late.
28:22and they may already be
28:23the complications
28:23They need to be handled
28:24He's going to do that, then.
28:26consulting your doctor
28:27and taking the exams
28:29that your doctor
28:30I sent it to you
28:31and the third
28:32Well, it's a start.
28:32to do
28:33all interventions
28:34healthy lifestyle
28:36that we have mentioned
28:38But if I could
28:38rescue the ones that seem
28:40which are
28:40They have a better balance
28:42among the easy
28:42which are
28:43to begin
28:44to implement
28:44and how effective
28:45that can become
28:46I would say that
28:48reduce
28:49at the minimum
28:50salt consumption
28:51It's difficult
28:52But it can be done
28:53progressively
28:54And if it costs you a lot
28:55look for those supplements
28:56that they have
28:57potassium chloride
28:58instead of
28:59sodium chloride
29:00a teaspoon of salt
29:01per day
29:02not for food
29:03not because of preparation
29:03per day
29:05a teaspoon of salt
29:06per day
29:08meditation exercises
29:09relaxation
29:10breathing
29:12tai chi
29:13so be it
29:1430 seconds a day
29:15or even
29:16all these watches
29:17smart
29:18they place one
29:18reminders
29:19pause
29:20relax
29:21and they also remember him
29:23to move more
29:24which would be the third
29:25intervention
29:26What can we do?
29:27today
29:27to begin
29:28check
29:29or prevent
29:30blood pressure
29:30so
29:32man
29:32I'm going to the third floor
29:33Today I'm going to take
29:34the stairs
29:35instead of the elevator
29:37I'm going to walk
29:38to the bus stop
29:38from the bus
29:39do it a little
29:40faster
29:40we started to move
29:42some more
29:42go to work
29:43this standing time
29:44on the computer
29:45Those are the three
29:47interventions
29:47It is not enough.
29:48but definitely
29:49They're going to have
29:50an impact
29:51very positive
29:52in your health
29:53and are relatively
29:54easy to implement
29:55and to maintain
29:56exactly
29:56Dr. José David Cruz
29:57thank you so much
29:58through this space
29:59I'm sure
30:00that to people
30:01who listened to us
30:02They leave with a couple
30:03of messages
30:03and hopefully homework
30:05to gradually adapt
30:06to their daily lives
30:07very important
30:08Thank you very much
30:09these minutes
30:10Thank you very much
30:11very interesting
30:12the discussion
30:12thank you