Jornal Médico – MTV: the risk factor for the leading cause of death in Portugal

Cardiovascular disease and the implications of arterial hypertension (HTA) are associated with an increasing number of admissions and decreased hope and quality of life. In this context, read the opinion article by Fernando Pinto, Senior Assistant Professor of Cardiology at the Centro Hospitalar de Entre o Douro e Vouga (CHEDV) and member of the Scientific Committee of the Portuguese Stroke Society.

Cardiovascular disease (CVD) is the leading cause of death, premature death (ie before the age of 70) and disability worldwide. Cerebrovascular accident (CVA) and acute myocardial infarction (AMI) account for about 85% of all cardiovascular diseases.

In our country, cardiovascular disease is responsible for more than 32,000 deaths a year, and it is estimated that they can reduce life expectancy by 12-14 years. In addition, DCCVs are responsible for a large number of hospitalizations and are one of the main causes of disability and dependence on others for basic daily activities (eating, dressing, personal hygiene, etc.).

Arterial hypertension (HTA), defined as blood pressure greater than or equal to 140/90 mmHg, is by far the largest risk factor for stroke (the main cause of death in Portugal: about 2/3 of all deaths due to stroke). ) and is one of the main risk factors for AMI, heart failure, kidney failure, peripheral arterial disease, dementia, etc.

In the vast majority of patients, hypertension does not cause specific symptoms for many years, and is often detected only when the aforementioned diseases occur, and it is well demonstrated that early diagnosis and correct and timely treatment of hypertension unequivocally significantly reduces the risk. severity) of cardiovascular disease and their serious consequences: disability and mortality.

Despite the fact that, especially in the last two decades, we have seen a very favorable development of cardiovascular disease in Portugal, we continue to verify that about 42% of adults have hypertension, of which almost 25% (1 out of 4) are unaware of the disease and of those diagnosed also about 25% do not take medication, which explains why less than half of patients with hypertension actually have their blood pressure checked and only about 12% (1 in 8) have their blood pressure in ideal values.

What is left to do?
In order to achieve the ultimate goal of increasing the number of years of life and quality of life, ie preventing the consequences of cardiovascular disease and in particular reducing stroke and its dramatic sequelae, it is crucial to diagnose hypertension more and better and to initiate rapid treatment, measures leading to its treatment, from the beginning the adoption of a healthy lifestyle, including reduction of salt and alcohol consumption and increased vegetables and fruits, exercise of regular physical exercise, correction of overweight or obesity and total smoking end. When these measures are insufficient, it may also be necessary to use antihypertensives.

The last 2 years have in many cases made it harder for the population to access health care that is very much focused on the pandemic that devastated us (and it still is …). It is up to all of us – users / patients, healthcare professionals and not only – to help restore / minimize this delay, which can have serious consequences in the medium term: the former measures blood pressure regularly (which can be done in several places, even at home) and, in case of hypertension, seek to resort to health care as soon as possible, but immediately begin to correct inappropriate lifestyle; healthcare professionals who actively encourage patients to monitor their blood pressure, making it easier for them to access their treatment and not unnecessarily delay the correction of hypertension (as well as any accompanying risk factors).

Scientific societies, in partnership with the media, must make the general public aware of the importance of these measures, and it is up to the political power and the state to outline and implement concrete measures to accelerate this mission, which is possible with the commitment of All!


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