VII - The follow-up of a high blood pressure
7.1 - The control of the blood pressure with the physician : the follow-up
7.2 - The control of the blood pressure by an automatic device at home
7.3 - Sometimes, an ambulatory blood pressure measurement during 24 hours is necessary
7.1- The control of the blood pressure with the physician : the follow-up
The blood pressure measurement by the physician remains essential for the follow-up of the high blood pressure.
The practitioner assesses whether the correct blood pressure is achieved and if the antihypertensive drugs are well tolerated.
At the beginning, when the high blood pressure is not balanced, the practitioner can measure the blood pressure once a month, then space out the visits progressively every 3 to 6 months. He carries out a complete clinical examination every year searching for complications of the high blood pressure, such as an analysis of the urine using a strip and the measurement of creatinine in the blood.
In addition, he carries out blood tests looking for other cardiovascular risk factors (cholesterol, diabetes), every year if the initial results are bad or every three years in the other cases.
An electrocardiogram and possibly a cardiac echography can be done if the practitioner suspects a cardiac damage induced by a high blood pressure. The electrocardiogram is carried out first.
The treatment of the high blood pressure is a long-term treatment, which can however be gradually decreased if side-effects are perceived and the blood pressure is well controlled.
The practitioner must then use a follow-up notebook to control the variations of the blood pressure according to the reduction of the treatment. This possibility can only be considered if the physician can check regularly his patient because a majority of hypertensive subjects who have decreased their antihypertensive therapy themselves still have high blood pressure a year later.
The antihypertensive treatment cannot be stopped quickly, in particular for the treatments with beta-adrenoreceptor blocking drugs and drugs that act on the cerebral receptor. This progressive reduction of the drug is accompanied by life style modifications, and requires a very strict monitoring.
|File last modified on : 28 sep 2003