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Skip to content A pressão arterial elevada, também chamada de hipertensão arterial sistêmica (HAS) , é uma condição de saúde comum, que se caracteriza por ter uma pressão nos vasos sanguíneos mais alta do que o valor normal. A pressão arterial é normalmente medida com um manguito inflável colocado em volta do braço e é realizada com frequência antes das consultas médicas ou quando há necessidade de fazer uma avaliação do paciente. Ao medir a pressão arterial, o profissional de saúde estará procurando na medição os valores de sístole e diástole. Existem diversos tipos de hipertensão, entre elas, a hipertenção arterial secundária.
O que é hipertensão arterial secundária? A hipertensão arterial secundária ocorre quando o paciente tem uma pressão alta causada por uma doença ou condição de saúde conhecida, daí é que surge a definição de hipertensão arterial secundária.
Pressão Arterial Sistólica (PAS): É a pressão do sangue no momento em que o coração se contrai para impulsionar o sangue para as artérias. Quanto mais o coração se contrai, maior é a pressão sistólica. Ela também é conhecida como pressão máxima.
Pressão Arterial Diastólica (PAD): É a força do sangue contra as paredes das artérias enquanto o coração relaxa e os ventrículos podem se encher de sangue novamente. É o período em que o coração relaxa entre as batidas – é também o momento em que a artéria coronária é capaz de fornecer sangue ao coração. Ela também é conhecida como pressão mínima.
As duas medidas são listadas juntas, sistólica sobre diastólica. Uma medição de pressão arterial normal é inferior a 120/80. Assim que a pressão arterial ficar acima dessa medida, o médico começará a monitorá-lo quanto à pressão alta. Essa é uma condição que pode ser tratada.
A hipertensão que não tem uma causa conhecida é chamada de hipertensão essencial ou primária. Em contraste, a hipertensão secundária tem uma causa conhecida.
Quão comum é a hipertensão secundária? Como a hipertensão secundária é rara, ocorrendo em apenas 5-10% da população, nem sempre é descoberta. O teste de hipertensão secundária pode ser caro, portanto, o médico normalmente espera para começar o teste até suspeitar fortemente de hipertensão secundária.
O que causa hipertensão secundária? A hipertensão secundária é a pressão alta causada por outra condição ou doença. Existem muitas condições ou doenças diferentes que podem causar hipertensão secundária, incluindo:
Doença renal: uma lesão nos rins ou nas artérias que são muito estreitas pode levar a um suprimento insuficiente de sangue ao órgão. Isso pode desencadear uma maior produção de um hormônio chamado renina. A renina leva à produção de substâncias no corpo (como a molécula de proteína angiotensina II) que podem aumentar a pressão arterial.Doença adrenal: localizada na parte superior dos rins, as glândulas adrenais produzem e regulam os hormônios. Quando há um problema com essas glândulas, os hormônios do corpo podem ficar desequilibrados e causar várias doenças. Essas condições de doença da glândula adrenal podem incluir:
Feocromocitoma (um tumor da glândula adrenal que produz em excesso epinefrina e norepinefrina – os hormônios de luta ou fuga).Síndrome de Conn ou aldosteronismo primário (uma condição em que o corpo produz em excesso o hormônio retentor de sal aldosterona). Síndrome de Cushing (uma condição em que há muito hormônio cortisol, um regulador do metabolismo de carboidratos e pressão arterial). Hiperparatireoidismo : nessa condição, as glândulas paratireoides (localizadas no pescoço) produzem hormônios que regulam os níveis de cálcio no sangue, e essa condição pode levar à hipertensão.Problemas de tireoide: a função tireoidiana anormal também pode causar hipertensão. Coarctação (constrição ou aperto) da aorta: Esta condição envolve o aperto da aorta (a artéria principal do lado esquerdo do coração). A coarctação restringe o fluxo sanguíneo normal. Apneia obstrutiva do sono: nesta condição, a pessoa é frequentemente acordada do sono e tem pausas na respiração durante o sono devido ao colapso das vias aéreas superiores. Uso de medicamentos Os efeitos colaterais de certos medicamentos também podem contribuir para a hipertensão secundária.
Medicamentos como:
Contraceptivos hormonais (pílulas anticoncepcionais) Agentes antiinflamatórios não esteróides (AINEs) Pílulas dietéticas Estimulantes Antidepressivos Supressores do sistema imunológico Descongestionantes Quais são os sintomas da hipertensão arterial secundária? Os sintomas de hipertensão secundária podem variar dependendo do tipo de condição ou doença que atua em combinação com a hipertensão. Além disso, pode haver dificuldade em controlar a pressão arterial elevada com o uso de apenas um ou dois medicamentos.
As diretrizes da American Heart Association agora definem a pressão arterial elevada como a leitura da pressão arterial 130/80 ou superior.
Exemplos de sintomas para algumas condições podem incluir:
Feocromocitoma: sudorese, aumento da frequência ou força dos batimentos cardíacos, dor de cabeça, ansiedade.Síndrome de Cushing: ganho de peso, fraqueza, crescimento anormal de pelos corporais ou perda de períodos menstruais (em mulheres), estrias roxas (linhas) na pele do abdômen. Problemas de tireoide: fadiga (cansaço), ganho ou perda de peso, intolerância ao calor ou frio Síndrome de Conn ou aldosteronismo primário : fraqueza devido aos baixos níveis de potássio no corpo.Apneia obstrutiva do sono: fadiga excessiva ou sonolência durante o dia, ronco, pausas na respiração durante o sono. Qual é o público alvo da hipertensão secundária? Como a hipertensão secundária é relativamente rara e o rastreamento das causas pode ser caro e demorado, nem todo paciente com hipertensão será testado para a doença. Seu provedor de serviços de saúde irá testá-lo se achar que há um caso forte e provável.
Existem vários fatores que ajudam a determinar se você deve ser rastreado para hipertensão secundária. Esses fatores incluem:
Idade : pacientes com menos de 30 anos que têm pressão alta sem histórico familiar ou outros fatores de risco de pressão altaHipertensão resistente: os pacientes com hipertensão resistente apresentam pressão alta que não melhorou apesar do tratamento ideal com pelo menos três medicamentos para a pressão arterial Obesidade : pacientes com sobrepeso e hipertensão que não respondem ao tratamento ao longo do tempo Sinais ou sintomas sugestivos de uma condição subjacente. Como é tratada a hipertensão secundária?
O tratamento para hipertensão secundária dependerá da condição secundária diagnóstica de seu médico. A hipertensão secundária irá durar enquanto você tiver a condição secundária. É melhor seguir várias dicas para controlar a pressão alta (hipertensão) durante o tratamento de sua condição subjacente.
Essas dicas incluem:
Comer uma dieta saudável com baixo teor de sódio Praticar exercícios regularmente Evitando fumar Manter um peso corporal saudável Limitando o álcool Nos casos em que se descobre que a causa da hipertensão secundária é um tumor, pode ser necessária uma cirurgia para tratar a doença. Para desequilíbrios hormonais e outras condições, medicamentos podem ser usados para tratar a hipertensão secundária.
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