
Pourquoi l'hypertension artérielle est-elle un gros problème ?
Revu par Dr Hayley Willacy, FRCGP Rédigé par Dr Sarah JarvisPublié à l'origine 28 nov. 2017
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You need it to survive - but while you're unlikely to know if you've got hypertension artérielle (hypertension), it's 'too much of a good thing'. Almost half of all Americans have high blood pressure as stated by de nouvelles directives released by the American Heart Association. And we can’t afford to be complacent this side of the pond either; over one in four adults have hypertension according to - slightly more lenient - UK guidance.
So how do you know if yours is just right? And why is it so important to 'know your numbers'?
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What is blood pressure?
Your blood pressure is the pressure inside your arteries as your blood is pumped around your system. When it's measured, you'll be given two figures, one 'over' the other. The upper one is the pressure in your circulation as your heart pumps blood out - every time your heart 'beats', it's actually pumping blood in a gush around your system. The lower one is the pressure that remains while your heart is resting between beats. 'Ideal' blood pressure is below one hundred and twenty over eighty - written as 120/80.
Symptômes de l'hypertension artérielle
It can be tricky to know if you have high blood pressure because only very rarely does it have any symptoms. It's usually only picked up if your blood pressure is checked by your GP. Though sometimes, if it's very high, you might experience headaches. Very occasionally people feel a bit dizzy or find their vision is affected.
Why is high blood pressure a problem?
Our blood pressure naturally goes up and down during the day, depending on what we're doing, how much stress we're under etc. Making your heart pump faster (for example, as when you're exercising) increases your blood pressure. Although de l'exercice régulièrement brings blood pressure down by making your heart stronger.
Consistently hypertension artérielle increases your chance of a AVC ou crise cardiaque. That's why it's so important to get your blood pressure checked regularly; to go back for regular check-ups if you're diagnosed with high blood pressure; and to take the treatment you're prescribed every single day. This will cut your risk of stroke dramatically.
What figures mean my blood pressure is high?
If you're otherwise healthy, your blood pressure is considered to be high enough to need treatment if the upper figure is above 160/100 - or if the average of many readings is above 150/95 . The aim of treatment is to get the upper figure below 140/90 (or an average over many readings of 135/85). If you have other conditions like diabetes or problèmes rénaux, the targets may be lower still (below 130/80).
Until very recently in the USA, hypertension was defined as 140/90 or higher. But now, high blood pressure will be diagnosed if the reading is 130/80 or higher. That takes the number of Americans in the 'high blood pressure' category from just over 1 in 3 to almost 1 in 2.
Quelles sont les causes de l'hypertension artérielle ?
As we get older, our arteries (like so many other bits of our bodies!) become stiffer and less flexible. This increases the risk of high blood pressure, especially in the upper reading. Whether your blood pressure is high enough to need treatment or not, it's worth taking steps to prevent it rising too much. Simple changes can cut your risks dramatically.
How to reduce blood pressure naturally
Since we can't do anything about one of the most common causes of raised blood pressure (getting older - sorry, more mature!), try to:
Perdez du poids
The guideline says: for every 1 kg you lose in weight, your blood pressure should drop by about 1 mm Hg. That means losing 10 kg should drop your blood pressure by about the same as a blood pressure-lowering tablet
Being overweight or obese increases your risk of developing high blood pressure. In fact, in about half of people with hypertension, excess weight plays a part. Of course, obesity increases the chances of developing diabète de type 2 et l'hypercholestérolémie, which are also risk factors for heart disease. For inspiration, give our How to lose weight the healthy way feature a read.
Watch your diet
The guideline says: a healthy diet like the DASH diet can cut your upper blood pressure level by as much as 11 mm Hg if you have high blood pressure
La régime méditerranéen, low in processed foods, refined carbs and saturated fat and high in fruit, veg and unrefined carbohydrates, has many proven health benefits. The DASH diet takes it one stage further, encouraging lower salt intake as well.
Cut down on salt
The guideline says: cutting salt, including hidden sources of salt, could cut your blood pressure by up to 6 mm Hg.
Salt has been used for thousands of years to flavour - and preserve - food. Yet it's only recently that we've learnt about its dangers - or lived long enough to experience them. Because the sodium in salt makes your body retain water. This, in turn, increases the amount of blood in your arteries - and that increases your pression artérielle. What's more, as you get older, your body gets less efficient at removing salt from your system through your kidneys - so the less you can cope with. UK guidelines recommend not more than six grams (about a teaspoon) a day from all sources in our food
Faites de l'exercice régulièrement
The guideline says: regularly reaching the government guidelines on faire de l'exercice could cut your blood pressure by up to 8 mm Hg if you have high blood pressure
Every little helps, but 30 minutes of the sort of exercise that leaves you mildly out of breath, five times a week, is ideal. Regular activity makes your heart stronger which means the organ can pump more blood with less effort (ie without raising your blood pressure).
Make mine a small one
The guideline says: if you drink d'alcool, sticking to less than 2 units of alcohol a day could reduce your blood pressure by 4 mm Hg
How to treat high blood pressure
There are lots of medications to treat high blood pressure. Your GP will work out the best one for you. Once you've found a pill that suits you, it's important to keep taking the medication every day. You'll also need to monitor your blood pressure regularly and go to your doctor for check-ups.
What does the future hold?
Sometimes medications for hypertension don't work well enough to bring people's blood pressure down to their target numbers - although that's often due to not taking the medicines as prescribed. Scientists are currently looking into alternatives.
One potential treatment is a procedure called renal denervation. It aims to reduce activity in the nerves around the arteries leading to the kidneys. A catheter is used to treat tissue around the artery with ultrasound, calming the nerves and potentially reducing blood pressure. Some trials have been very promising, although follow-up studies suggest the procedure might not be as effective as doctors initially hoped.
Researchers are also investigating a small implant called the MobiusHD which is implanted inside an artery in the neck. The device releases signals which tell the blood vessels in your arms and legs to dilate, which reduces your blood pressure.
How low can you go?
With all the focus on hypertension, it can be hard to remember that low blood pressure (hypotension) can be a problem, too. As a rule, the fitter you are, the lower your blood pressure. As long as you feel fine, a blood pressure as low as 100 over 60 is OK.
However, seriously low blood pressure can cause:
Light-headedness (especially when you stand up quickly).
Palpitations.
Some medical conditions that make your heart go too fast or too slowly can cause low blood pressure, as can some hormone disorders and, in the short term, so can blood loss or being very dehydrated. Fortunately, low blood pressure itself rarely causes serious problems.
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Questions fréquemment posées
Quelle est la pression artérielle « idéale » ?
Une lecture de la pression artérielle 'idéale' est considérée comme étant inférieure à 120/80. Cela signifie que le chiffre supérieur (pression systolique) est inférieur à 120, et le chiffre inférieur (pression diastolique) est inférieur à 80.
La pression artérielle change-t-elle au cours de la journée ?
Oui, votre tension artérielle fluctue naturellement au cours de la journée. Elle change en fonction de vos activités et de vos niveaux de stress. Par exemple, l'exercice physique peut temporairement augmenter votre tension artérielle, bien que l'exercice régulier aide généralement à la réduire en renforçant votre cœur.
Quels objectifs ma tension artérielle devrait-elle atteindre après le traitement ?
Si vous êtes par ailleurs en bonne santé, l'objectif du traitement de l'hypertension artérielle est de faire descendre la valeur supérieure en dessous de 140/90, ou une moyenne de plusieurs mesures en dessous de 135/85. Si vous avez des conditions coexistantes comme le diabète ou des problèmes rénaux, votre objectif de pression artérielle peut être fixé encore plus bas, généralement en dessous de 130/80.
Comment la perte de poids aide-t-elle à réduire la pression artérielle ?
Perdre du poids peut réduire considérablement votre tension artérielle. Pour chaque kilogramme perdu, votre tension artérielle peut diminuer d'environ 1 mm Hg. Chez environ la moitié des personnes souffrant d'hypertension, l'excès de poids est un facteur contributif. De plus, l'obésité augmente le risque de développer un diabète de type 2 et un taux de cholestérol élevé, qui sont également liés aux maladies cardiaques.
Comment la consommation d'alcool affecte-t-elle la pression artérielle ?
Si vous consommez de l'alcool, vous limiter à moins de 2 unités par jour pourrait aider à réduire votre tension artérielle d'environ 4 mm Hg. C'est l'une des méthodes naturelles pour aider à gérer votre tension artérielle.
Quels sont les traitements de pointe en cours de recherche pour l'hypertension artérielle ?
Les scientifiques explorent de nouveaux traitements pour l'hypertension artérielle. Une approche potentielle est la dénervation rénale, qui calme les nerfs autour des artères menant aux reins en utilisant des ultrasons. Un autre domaine de recherche concerne un petit implant appelé MobiusHD, placé dans une artère du cou, qui signale aux vaisseaux sanguins de se dilater et ainsi de réduire la pression artérielle.
À propos du critiqueVoir la biographie complète

Dr Hayley Willacy, FRCGP
Médecin généraliste, Auteur médical
MBChB (1992), DRCOG, DFFP, MRCOG (Part 1) MRCGP (2007), DFSRH (2013), MSc - medical education (2020)
Le Dr Hayley Willacy était médecin généraliste au NHS travaillant dans le nord-ouest de l'Angleterre, qui a pris sa retraite de la pratique clinique en 2022 après 30 ans.
Historique de l'article
Article également disponible en Anglais, Allemand, Espagnol, Français, Italien, Portugais, Hindi, Hébreu, Arabe, and Suédois.
28 nov. 2017 | Publié à l'origine
Écrit par :
Dr Sarah JarvisRevu par
Dr Hayley Willacy, FRCGP
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