In May 2020, the International Hypertension Society’s “Hypertension Guidelines” was published, and we found a change in antihypertensive drugs. 1. The guide says how to recommend specific best standards. For single-agent treatment, you can use Pugli, Satan, Dipine, and diuretics. There are five categories of antihypertensive drugs that we commonly use at present, dipine, prepril, satan, luol, and diuretics; these five categories of antihypertensive drugs were the first choice of antihypertensive drugs. However, when the latest guideline recommends the use of a single antihypertensive drug, the recommended drugs are: dipine, prepril, satan, diuretic, and loller antihypertensive drugs are excluded. Not only that, in the combined antihypertensive combination, there is no recommendation for rol drugs. Recommendations for combined antihypertensive drugs: the first step, low-dose pril/sartan+dipine; the second step, full-dose pril/sartan+dipine; the third step, on the basis of pril/sartan+dipine+ Diuretic; the fourth step, Puli/Satan + Dipine + Diuretic + Spironolactone. Second, what kind of medicine is Rolle? Rolle is definitely a regular antihypertensive drug, our common metoprolol tartrate, metoprolol succinate, bisoprolol fumarate and so on. The imported metoprolol is our common Betaloc. Roll-type antihypertensive drugs are β-blockers, which mainly exert antihypertensive effects by inhibiting excessively activated sympathetic nerve activity, inhibiting myocardial contractility and slowing heart rate. Highly selective β1 receptor blockers have a high selectivity for β1 receptors. There are fewer adverse reactions caused by blocking β2 receptors, which can lower blood pressure, protect target organs and reduce the risk of cardiovascular events. Beta blockers are especially suitable for patients with hypertension with tachyarrhythmia, coronary heart disease, chronic heart failure, increased sympathetic nerve activity, and high dynamic state. That is to say, the antihypertensive drugs of the Roll type must be antihypertensive drugs. 3. Why the latest guideline does not recommend antihypertensive drugs for the treatment of high blood pressure, although the antihypertensive drugs are actually antihypertensive drugs. In general, the pressure-reducing amount of the Roll-type antihypertensive drugs is obviously milder. And the Roll-type drugs have a more important role in the cardiovascular field. 4. What kind of high blood pressure is also suitable for lollis? 1. High blood pressure + fast heart rate. If high blood pressure and fast heart rate, at this time, lowering the heart rate can not only lower blood pressure better, but also reduce the risk of cardiovascular disease, so if Heart rate at rest>80; 24-hour dynamic heart rate>75, we need to intervene; combined use of Lol antihypertensive drugs, because Lol not only lowers blood pressure, but also reduces heart rate. 2. High blood pressure + heart failure, heart failure caused by any reason, or heart failure caused by high blood pressure, as long as the blood pressure is not low, it is recommended to use Lol drugs, because Lol is the cornerstone of heart failure treatment, can reduce heart failure death rate. 3. Hypertension + angina pectoris. If hypertension is associated with angina pectoris and the heart rate is relatively fast, then you need to use loller to lower the heart rate and reduce myocardial oxygen consumption to control angina. Generally, the ideal heart rate of patients with angina is about 55 times at rest. 4. Hypertension + myocardial infarction Rolle drugs can prevent heart failure caused by myocardial infarction and prevent arrhythmia caused by myocardial infarction, thereby reducing the mortality of myocardial infarction. 5. Hypertension + rapid arrhythmia Rolle drugs can also treat various rapid arrhythmias, such as sinus tachycardia, atrial tachycardia, atrial fibrillation, ventricular tachycardia, and various premature beats. Even if there is no hypertension, as long as the blood pressure is not low, as well as heart failure or myocardial infarction or rapid arrhythmia or angina or hyperthyroidism and other diseases, will be the first choice of Lol drugs. Therefore, although the latest Hypertension Guidelines do not recommend Rolles as the first choice for single-hypertension or combined blood pressure reduction, for the above-mentioned types of hypertension or several diseases, Rolls are essential, even There is no substitute for medicine!
Regarding high blood pressure, many friends like to talk about racial differences. In fact, as high blood pressure, there is no obvious difference between domestic and foreign. The judgment of normal blood pressure level is basically the same in China and abroad. Is the standard of high blood pressure judgment 130/80 or 140/90? The normal blood pressure of the human body is generally around 120/80, some friends may be slightly higher, and some friends may be naturally lower, generally as long as not less than 100 /60, the body does not have obvious symptoms of discomfort, they all belong to the normal blood pressure range, and in the determination of hypertension, the guidelines of different countries have seen some differences in the past two years. In the American Hypertension Guidelines published in 2017, the internationally recognized high blood pressure judgment value was lowered. The guidelines pointed out that if the blood pressure exceeds the level of 130/80, it is a problem of high blood pressure. And in the new European version of the guide, the previous blood pressure value exceeds 140/90 to diagnose the problem of hypertension. These different regulations are different experts, combined with relevant data research, make different judgments, whether it is 130/80, or 140/90 high blood pressure judgment standards, usually speaking, if our blood pressure value has exceeded 120, the low pressure exceeds 80, even if there is no problem of high blood pressure, it is already a trend of rising blood pressure. In this case, we should arouse our active attention. If you want to control the blood pressure, you don’t have to wait until the diagnosis of high blood pressure to strengthen the regulation or treatment of blood pressure. If you can do the early life conditioning intervention as early as possible, the increase in blood pressure can often be improved. The adjustment of the drug greatly reduces the chance of developing a diagnosis of hypertension. Therefore, whether it is a Chinese or a foreigner, if the normal blood pressure value is generally below 120/80, it is a normal value. If it exceeds these two values or one of them, it should be actively valued. Combine with your own situation, do a good job of regulating and controlling blood pressure. 4 Myths about Hypertension Treatment There are many misunderstandings about the treatment of hypertension Strengthen conditioning interventions at the stage of increased blood pressure, this is a misunderstanding of hypertension control treatment, and in addition to such misunderstandings, there are many other misunderstandings in the treatment of hypertension, simply to say a few for everyone- — First, it is enough to just take medicine, not to do life conditioning. Hypertension life conditioning interventions include diet, exercise, mental adjustment, sleep, weight loss and many other aspects. Whether it is a primary hypertension problem, a life intervention without medication control to lower blood pressure, or a friend who needs medication to strengthen blood pressure control, life conditioning It is an indispensable and important means of blood pressure regulation. If you take medicine to control your blood pressure, it is like walking on one leg. It is impossible to keep your blood pressure stable. Second, worry about the side effects of long-term medication, antihypertensive drugs to stop eating. Some friends’ high blood pressure situation requires long-term adherence to medication control on the basis of life conditioning, but they are always worried about long-term damage to the liver and kidney, so they can not eat without eating, or do not eat without feeling, so do not insist on medication The result is that the blood pressure is high and low, and often fluctuates, which is more harmful to cardiovascular health than gains. Third, regardless of the safety risks, adhere to a long-term medication plan. There is no need to use rigid medicines. Sometimes, a blood pressure antihypertensive regimen can be used if the pressure control is good, but if the blood pressure cannot be controlled during the medication, it should be increased or combined; if In the process of taking medicine, if there is excessive blood pressure lowering, it is necessary to reduce the amount of medicine in time. If there is an intolerable adverse reaction, the medicine should be stopped in time and replaced with other blood pressure medicines. And the safety risk of medication, rigid medication, it is difficult to smoothly control the problem of high blood pressure. Fourth, blood pressure monitoring and measurement are never done during the hypertension control process. The ultimate goal of high blood pressure control is to control blood pressure smoothly to meet the standard, thereby reducing the physical health hazards caused by high blood pressure. And how to understand the control of blood pressure, basic regular blood pressure measurement is essential. Only regular blood pressure measurement and understanding of your own blood pressure control can timely adjust the blood pressure control program to maintain
Almost every day, someone asks me: “What should I do if my blood pressure is 90/60? What should I eat? Is it dangerous?” There is no way to answer such a question directly, because we judge whether a person’s blood pressure is normal or not. -140/60-90mmHg blood pressure standards, but also have to know a person’s usual blood pressure, and can not casually judge whether a person’s blood pressure is normal based on blood pressure like 90/60. 1. Is blood pressure like 90/60 normal? The theory is that the blood pressure is in the range of 90-140/60-90mmHg, that is, the high pressure does not exceed 140, not less than 90; the low pressure does not exceed 90, not less than 60; all are normal. However, if you have always been at this level, such as when you were a child, adolescents, middle-aged, or even old age, your blood pressure is at this level for a long time, then there is no problem. This means that your basic blood pressure, your own blood pressure is at In the normal range, it is slightly lower. Especially some thin women are more prone to such blood pressure, which is normal. However, if your blood pressure is usually above 120/80, even if it is a high blood pressure, just like this friend he said: High blood pressure is usually 130/90, and it has suddenly dropped to 96/64 in the past two days. Then this is definitely not normal! Second, the blood pressure is usually high, what happened to the sudden blood pressure of 90/60? 1. Measurement problem First of all, we have to measure the blood pressure again, because we can’t judge our blood pressure based on one blood pressure; our blood pressure is affected by many measurement factors, such as sphygmomanometer error, such as measurement method error and so on. Therefore, when the blood pressure fluctuates greatly, first rest for 5 minutes and measure again. If it is still very close to the last measurement, then you can judge that your blood pressure is at this level. There is also a possibility that it was high blood pressure before, and then started taking medicine, but usually rarely measured blood pressure, suddenly one day measured blood pressure and found: Ah! Why is it so low. This may be due to the fact that the blood pressure has gradually decreased. However, you haven’t monitored it and did not find that your blood pressure has been lowered in time. 2. Drug problems Most people with high blood pressure need to take antihypertensive drugs. Many people are anxious to see high blood pressure. They want to quickly lower their blood pressure to normal, but blood pressure can not be anxious, unless it is a hypertensive emergency, or high Blood pressure combined with acute myocardial infarction or heart failure requires rapid hypotension. Otherwise, for most people with high blood pressure, the blood pressure is reduced slowly and smoothly, rather than anxious. If you see high blood pressure and take antihypertensive drugs, especially long-acting antihypertensive drugs, the effect is slower; after taking the drug, the blood pressure does not immediately decrease, and you are anxious to continue to add drugs, then the result may be that When the medicine is effective, the blood concentration is large, and the blood pressure drops too low. There are many friends with high blood pressure who have been taking antihypertensive drugs for a long time. 3. The most dangerous problem is the low blood pressure caused by the disease. Normal blood pressure is normal, or high blood pressure. The sudden blood pressure has dropped from 130/90 to 90/60. Is it caused by disease? To be precise, this is already called shock; many people think that shock is just a matter of unconsciousness. Simply put, medical shock is hypotension, for example, blood pressure lower than 90/60 can be vaguely called shock; but if a person’s blood pressure is normal, or high blood pressure, sudden blood pressure drops, the original high blood pressure, the systolic blood pressure is higher than the original level A drop of more than 30% is also called shock. If the hypotension is caused by shock, it is very dangerous, and you need to seek emergency treatment immediately, because if shock is not rescued in time, the next step is life threatening. There are many reasons for shock, such as major bleeding, allergies, poisoning, acute pulmonary embolism, heat stroke, lack of water in the body, heart disease, etc. may all manifest as hypotension shock. At this time, you must see a doctor immediately, rescue the shock, and find the cause of the shock as soon as possible. In short, the original blood pressure 130/90, suddenly dropped to 90/60, must be paid attention to, only to find the reason to know whether it is dangerous, and then know how to be good!
Many diseases may have a certain relationship with heredity! Hereditary disease refers to a disease that is wholly or partly determined by genetic factors. It is usually congenital and can also be acquired. Such as congenital stupid type, multi-finger (toe), congenital deaf-mute, hemophilia, etc. These genetic diseases are completely determined by genetic factors, and only after a certain time of birth, the onset of disease, sometimes after several years, more than ten years or even several Ten years later, obvious symptoms will appear. What we often hear about: Congenital deafness, high myopia, thalassemia, red-green blindness, hemophilia, hirsutism of the external auditory canal, bronchial asthma, type I diabetes, rheumatoid arthritis, schizophrenia, epilepsy, congenital Heart disease, peptic ulcer, varicose veins of lower extremities, glaucoma, kidney stones, spina bifida, anencephaly, cleft lip, cleft palate, deformity, albinism, some tumors, etc. These diseases are all genetic diseases. As a cardiovascular doctor, we still talk about my cardiovascular related diseases. 1. What the hospital sees We can always meet a family in the hospital. When the father or mother has high blood pressure, diabetes, hyperlipidemia, and cardiovascular and cerebrovascular diseases, the possibility of children or siblings having these diseases is very high. . I personally met an uncle who had 6 brothers and sisters, 2 of whom had a heart stent, 1 had a heart bypass, 2 had a cerebral infarction, and 1 had a cerebral hemorrhage. All have cardiovascular and cerebrovascular diseases. Studies have shown that hypertension, diabetes, hyperlipidemia, cardiovascular and cerebrovascular diseases and genetics have a clear relationship. 2. Genetically-related diseases 1. Familial hypercholesterolemia The prevalence of familial hypercholesterolemia is 0.18-0.32%. It is an autosomal dominant genetic disease that leads to abnormal metabolism of low-density lipoprotein cholesterol. It is manifested by high levels of low-density lipoprotein, and early appearance of senile rings or characteristic xanthomas in multiple parts of the body, and early coronary heart disease. These people under the age of 40 years may have an old ring, or flat yellow tumors may form on the eyelids. There are two types: homozygous and heterozygous. Homozygous familial hypercholesterolemia often has the symptoms and signs of coronary heart disease around the age of 10, and the descending aorta, abdominal aorta, thoracic aorta, and pulmonary artery trunk are prone to severe atherosclerosis, heart valves and heart Membrane plaques can also form on the surface of the membrane, and most of them die of cardiovascular disease before the age of 30. Male heterozygotes can suffer from coronary heart disease when they are 30 to 40 years old, and the onset age of female heterozygotes is about 10 years later than that of men. 2. Type 1 diabetes suggests that genetic defects are the basis of type 1 diabetes. This genetic defect is manifested in the abnormality of HLA antigens in the sixth pair of human chromosomes. Research tips: Type 1 diabetes has the characteristics of familial incidence-if your parents have diabetes, then you are more likely to suffer from this disease than people without this family history. Type 1 diabetes often occurs in childhood or adolescence, and the onset is generally more rapid. Symptoms such as thirst, polydipsia, polyuria, polyphagia, fatigue, and weight loss, and rapid weight loss are very obvious. Some patients have ketoacidosis for the first time. . The third characteristic of type 1 diabetes is that it will eventually be treated with insulin without exception, so type 1 diabetes was originally called insulin-dependent diabetes. Three, three high and cardiovascular disease and genetic are related 1. Hypertension and hypertension are polygenic inherited diseases, parents have hypertension, and the probability of their children suffering from hypertension in the future is as high as 45%; one parent suffers from hypertension The probability of children suffering from high blood pressure is 28%, while the probability of children with normal blood pressure of parents is only 3%. 2. People with diabetes and a family history of diabetes have a significantly higher prevalence of diabetes than those with a negative family history. The parents have diabetes, and their children are 15 to 20 times more likely to have diabetes. 3. Hyperlipidemia has found that a considerable number of patients with dyslipidemia have one or more genetic defects. Abnormal blood lipids caused by genetic defects are mostly family-clustered and have a marked genetic tendency. 4. Cardio-cerebrovascular disease The basis of cardio-cerebrovascular disease is atherosclerosis. The latest “Practical Cardiology” writes that atherosclerosis has a family inheritance and is an independent risk factor. Modern medical research proves that, except for injuries, almost all diseases are related to genes. Different human genotypes have different sensitivities to environmental factors. Sensitive genotypes can cause diseases under the influence of environmental factors. 4. Genetic genes cannot be changed, but they must still be prevented. Prevention is effective and it is necessary that some people say that human gene recombination is not over
Hello everyone, I am a nephrologist. When it comes to high blood pressure, I think many people should understand that it is the most common and frequent chronic disease in my country. The factors that cause high blood pressure are different. Today I focus on introducing “renal hypertension”. Let’s be straightforward, that is to say, the increase in patients’ blood pressure is inseparable from “kidney problems”. Such patients often have very difficult blood pressure control, and may need to combine three or even four or more antihypertensive drugs to Regulate blood pressure. Why is blood pressure in patients with kidney disease so difficult to control? How to effectively solve this problem? Today I am going to do a popular science explanation for everyone on “renal hypertension”. Foreword ● Hypertension is a common complication of chronic kidney disease. There are epidemiological data showing that 80%-85% of patients will develop hypertension during the progression of chronic kidney disease. And as the glomerular filtration rate decreases linearly increases (that is, the worse the renal function, the greater the proportion of people with hypertension). There was a special scientific research team to investigate and follow up on this. One report from the MDPD showed that when the glomerular filtration rate dropped from 85ml/(min.1.73㎡) to 15ml/(min.1.73㎡) The prevalence of hypertension increased from 65% to 95%. ● I found a phenomenon, some people have this idea, thinking that my blood pressure is high, but I do not have headaches and dizziness, eating the smell of sleeping, the high point will be high, and it will not hinder me. Too much hurt the body. Note that hypertension is not only one of the important risk factors that cause the progression of chronic kidney disease, but also the risk factors for cardiovascular and cerebrovascular complications in patients with chronic kidney disease (such as myocardial infarction, coronary heart disease, cerebral infarction, cerebral hemorrhage, etc.). According to incomplete statistics, the current control rate of renal parenchymal hypertension in my country is 46% (140/90mmhg) and 20% (130/80mmhg). It can be seen that effective blood pressure prevention and control is still a long way to go. Causal analysis of hypertension and kidney damage ● Here I tell you that under normal circumstances, our kidneys have their own regulatory mechanisms. That is, the glomerular internal pressure and the average arterial pressure are in an “S” shape, that is, in the range of average blood pressure of 80-160mmhg, it regulates the contraction and relaxation of the small arterioles by the intrinsic muscle (this small artery constitutes the kidney Important blood vessels), so that the glomerular blood flow and glomerular filtration rate can be maintained stable. ●But when you suffer from chronic kidney disease, this self-regulating mechanism will be damaged, and this “S”-type regulating mechanism will slowly turn into a nearly “linear” type. Therefore, in patients with chronic kidney disease, even if the system blood pressure is slightly moderately increased, it can cause the internal pressure of the glomeruli to increase, resulting in the three high states of high pressure, high perfusion and high filtration in the glomeruli. And this “three highs” will cause progressive kidney damage. The common understanding is that “hypertension” and “kidney damage” will always hurt each other, causing the disease to progress in a bad direction. ●Compared with essential hypertension (more than 90% are clinically essential hypertension), this kind of renal hypertension will show such characteristics: ① blood pressure is difficult to control, and it is easy to develop into malignant hypertension, It is often necessary to combine several antihypertensive drugs, and the blood pressure compliance rate is still low. ②The incidence of cardiovascular complications is high, and its impact on cardiovascular disease has its own characteristics. A scientific research team has conducted a follow-up study of more than 20,000 community population. The results show that the relationship between hypertension and stroke in patients with chronic kidney disease is ” “J-shaped”, the systolic blood pressure is the lowest at 120-129mmhg, while the incidence of stroke below 120mmhg and above 130mmhg is significantly increased. How to effectively regulate renal hypertension? ●Pharmacological treatment ① For patients with chronic kidney disease, if proteinuria <1g/d, then blood pressure is recommended to be controlled at 130/80mmhg; if proteinuria>1g/d, then blood pressure is recommended to be controlled below 125/75mmhg. However, I personally think that blood pressure is not lower, the more beneficial it is, and everything is about one degree, because too low blood pressure will affect the blood perfusion of the kidney. Hypoperfusion is not a good thing for the kidney, so it is recommended to avoid low systolic blood pressure. At 110 mmhg, the diastolic blood pressure is below 60 mmhg. ②It is found in the clinic that in fact, many elderly people not only suffer from hypertension, but some people also have diabetes and other chronic diseases.
At the beginning of 2019, Dr. Wei from the emergency department accidentally measured his blood pressure 160/100 and was surprised! Later, it was 160/100 for several consecutive days, and the diagnosis of hypertension was confirmed. But doctors, like everyone, are reluctant to take medicine, but doctors know more about the dangers of high blood pressure. Later, Wei Zi from the emergency department found me and asked me what to do? I said, it must be reduced blood pressure, but for the time being can not take medicine, depending on whether you want to suffer a little bit. He said he would do anything to avoid taking medicine. I asked Wei Zi how much, he said 180. I said to 140, blood pressure will be normal. One year later, Wei Zi in the emergency department now weighs 148 and has not taken antihypertensive drugs. His blood pressure has dropped to about 138/88. I said that if I continue to lose weight, my blood pressure will be better. 1. The relationship between obesity and hypertension When the body mass index BMI ≥ 24, the risk of hypertension is 3-4 times, BMI ≥ 28, 90% have cardiovascular disease or metabolic disease. For every 1.7 increase in male BMI or 4.5cm in waist circumference, for every 1.25 increase in female BMI or 2.5cm in waist circumference, blood pressure increased by 1mmHg. Obesity leads to hypertension related to leptin resistance, sympathetic nervous system activation, insulin resistance, renin angiotensin, endothelial function, and kidney. The effect of weight loss (fat loss) on hypertension For every weight loss of 5.1kg, high pressure drops 5.55, and low pressure drops 3.57, the heavier the weight, the better the effect of reducing blood pressure by weight loss. 10kg weight loss can reduce blood pressure by 5-20mmHg . Second, how to judge the body mass index (BMI, BodyMassIndex) of obesity is an important standard commonly used in the world to measure the degree of human obesity and whether it is healthy, and is mainly used for statistical analysis. Ideal BMI (18.5 ~ 23.9) = weight (unit Kg) ÷ height squared (unit m) According to the standards set by the World Health Organization, Asian BMI (body weight index BodyMassIndex) higher than 22.9 is overweight. The world standard for obesity is: BMI is normal between 18.5 and 24.9, BMI greater than 25 is overweight, and BMI greater than 30 is obese. 3. The harm of obesity is not only high blood pressure According to research, the proportion of obese people suffering from high blood pressure is 20%-50%, much higher than the incidence of high blood pressure among ordinary people. Statistics show that 78% of men and 65% of women have hypertension related to obesity. Therefore, for obese hypertensive people, it is recommended to lose weight! Obesity can also cause abnormal blood lipids, increase heart load, induce diabetes, increase the risk of cardiovascular and cerebrovascular diseases, lead to fatty liver, prone to cancer, cause bone and joint diseases, and affect the reproductive system. Obesity is not just a matter of beauty. Obesity has become the fifth leading cause of human death. According to statistics, 44% of diabetes, 23% of ischemic heart disease, and 7%-41% of specific cancers are caused by obesity. At the same time, obese people will also experience severe snoring, difficulty breathing, impaired mobility, increased risk of fractures, high blood pressure, hyperlipidemia, diabetes, cardiovascular and cerebrovascular diseases, fatty liver, atherosclerosis and degenerative diseases, as well as dementia, respiratory tract Diseases, various cancers, and psychological diseases are closely related. Weight control, starting from me, weight control is not only for slimming, but also for lowering blood pressure, but also for overall health!
Recently, several kidney friends with diabetes and hypertension consulted, asking when can the medicine be stopped? In fact, diabetes and hypertension are incurable diseases, and the chronic renal failure caused by them is also incurable, requiring lifelong treatment. The following types of kidney disease cannot be eradicated: 1. Diabetic nephropathy Diabetes cannot be cured, and kidney disease caused by diabetes cannot be eradicated. 2. Hypertensive nephropathy Essential hypertension requires taking antihypertensive drugs for life, so hypertensive kidney damage cannot be completely cured. 3. Lupus nephropathy treatment of lupus nephritis is very long, most patients need to take small doses of glucocorticoid maintenance treatment for life to avoid recurrence. 4. In the literature statistics of hepatitis B related nephropathy, there are very few hepatitis B related nephropathy. However, this is just because patients with hepatitis B and kidneys rarely perform renal puncture. 5. Chronic renal failure includes the stage in which various kidney diseases develop into chronically impaired renal function. Because the kidneys have already hardened and necrotic cells cannot be regenerated, chronic kidney failure cannot be cured. There is no cure, is it worthless? No, incurable ≠ the end point is uremia. In fact, after middle age, anyone’s kidney function will gradually decline, but the kidney function of patients with kidney disease will decline faster. Even for incurable kidney disease, treatment can be used to delay the decline of kidney function and make it as close as possible to the decline of kidney function in normal people. Although the above nephropathy is incurable, it does not mean that the treatment has failed. When the patient is old, and near the end of life, renal function is still sufficient, is it not a success? My name is Bai Zhicheng. I am good at various glomerular diseases, such as IgA nephropathy, membranous nephropathy, hematuria, proteinuria, lupus nephritis, and treatment of chronic renal insufficiency. I have more than 40 years of clinical experience. You are welcome to pay attention to this account. For related questions, you can leave a message or private message. After seeing it, I will answer your confusion in detail.
At 8 o’clock on the weekend, a 62-year-old man was sent to the emergency department for treatment due to fatigue and numbness in the right limb for 1 hour during morning exercise. The emergency brain scan CT and other related examinations suggested that the patient had: infarction! The patient’s son informed the doctor that his father had high blood pressure and had no previous coronary heart disease, cerebral infarction, kidney disease, etc. Waking up in the morning to exercise may be a bit more intense, and then the right limb and head pillow numbness, and then the right limb felt fatigued , There is no strength in holding things in the right hand, and walking is unstable, and we can’t think of it as a cerebral infarction. In this regard, some medical experts said that people with high blood pressure do not want to have cerebral infarction, and do not rush to do “a few things” after getting up in the morning. So, do you know what these “several things” are? People with high blood pressure do not want to have a cerebral infarction. Four things you shouldn’t worry about when you wake up in the morning. 1. Don’t do strenuous exercise. Many people pay attention to health and have the habit of morning exercises. But for patients with hypertension, it is best to choose exercise in the evening. Because on the one hand, high blood pressure in the morning, on the other hand, the general temperature is relatively low in the morning, it is easy to cause vasoconstriction, it is easy to cause ischemia and hypoxia of organs and tissues. Moreover, people with high blood pressure should not exercise too vigorously. It is recommended to perform moderate-intensity aerobic exercise for 30 minutes to 60 minutes, such as playing badminton, brisk walking, jogging, swimming, etc. 2. Don’t strain too hard Conditions are getting better and better, meat and high-fat foods are eaten more, and many people have trouble with constipation, especially the weakened gastrointestinal function of the elderly. When a hypertensive patient is constipated, defecating hard will increase the pressure on the abdomen, and the pressure on the peripheral blood vessels will also increase, resulting in a reduction in the amount of blood returned to the heart, which can easily cause heart ischemia and heart failure. Therefore, hypertensive patients and elderly people usually eat more high-fiber foods. Don’t worry about going to the toilet. Go to the toilet if you want to. 3. Don’t get up too fast. Our blood pressure is not fixed during a day, there will be a normal fluctuation. The blood pressure fluctuation of the average person is called “two peaks and one valley” in medicine, which means 6:00 in the morning 8:00 is the highest time of the day, then it will drop, and then there may be a peak between 4:00 and 6:00 in the afternoon, and the lowest in the evening. Therefore, for patients with hypertension, getting up in the morning may be at the highest point of blood pressure, and the blood vessel conditions of general hypertensive patients are not good, and the blood vessel wall is relatively fragile. It is easy to cause the blood pressure to fluctuate too fast due to getting up too quickly, causing cerebrovascular rupture Bleeding. Therefore, it is best not for patients with hypertension to get up too quickly, get up slowly, sit up next to the bed and then stand up again. Fourth, do not smoke smoking is not just not to smoke in the morning, it is best to quit smoking. In the morning, after a night of sleep, the body does not replenish water. It is when the blood is most viscous that smoking produces carbon monoxide, resulting in insufficient oxygen supply in the blood, exacerbating the body’s hypoxia, and harmful substances such as nicotine in the smoke will also Damage blood vessels and induce cardiovascular and cerebrovascular diseases. Conclusion Hypertension is one of the most important risk factors for cerebral infarction. How can friends of patients with hypertension prevent cerebral infarction? In addition to taking antihypertensive drugs under the guidance of a specialist, pay more attention to your usual dietary habits. When taking medication regularly, you can’t ignore some details of life, such as getting up early and not doing the above four things. At the same time, eat more vegetables and fruits, eat a light diet, exercise properly, quit smoking and alcohol, and ensure adequate sleep and a good state of mind. These are the guarantees for maintaining health. (Some of the pictures in the article are from the source network, and the copyright belongs to the original author. Thank you for the picture author. If you find any violation of your copyright, please contact me and I will delete it.)
The level antihypertensive drugs are the most commonly used antihypertensive drugs among the six major antihypertensive drugs. The level of antihypertensive drugs is the most. There are dozens of types of antihypertensive drugs currently on the market. If different manufacturers are added, there are hundreds. A class of antihypertensive drugs. 1. Nifedipine, a short- and medium-acting dipine antihypertensive drug, 2 to 3 times a day; nifedipine sustained-release tablets I, 2 times a day; felodipine, 2 times a day; nitrendipine, 2 times a day ～3 times; Nicardipine, twice a day; 2. Long-acting dipine antihypertensive drug nifedipine sustained-release tablets III, once a day; Nifedipine controlled-release tablets, once a day; ammonia benzenesulfonate Clodipine, once a day; Levamilodi besylate, once a day; Felodipine sustained-release tablets, once a day; Lasidipine, once a day; Benidipine, once a day ; Lecadipine, 1 times a day; Manidipine, 1 times a day; Sinidipine, 1 times a day; Barnidipine, 1 times a day; 3. Many people who are not used as regular antihypertensive drugs Speaking of nimodipine, the nimodipine instruction manual can be used for: 1, ischemic cerebrovascular disease 2, migraine 3, cerebral vasospasm caused by subarachnoid hemorrhage 4, sudden deafness 5, mild 3. Moderate hypertension. Although the instructions say that it can be used for hypertension, and it also contains the word dipine, but in clinical work, we simply choose nimodipine to control blood pressure. Nimodipine is a calcium antagonist that selectively acts on cerebrovascular smooth muscle. It acts on cerebrovascular smooth muscle and is fat-soluble. It easily passes through the blood-cerebrospinal fluid barrier and binds with specific receptors of the central nervous system to expand cerebral blood vessels and increase cerebral blood. Flow rate has a protective effect on ischemic brain injury, especially on ischemic cerebral vasospasm. Having said so much, what do you mean? Nimodipine is mainly used to protect ischemic brain injury, which is to protect cerebral blood vessels. 4. Which high blood pressure drugs are the dipine antihypertensive drugs for? 1. Elderly hypertension is a common antihypertensive drug for elderly hypertension; 2. Peripheral vascular disease, such as vascular stenosis of the extremities combined with hypertension; 3. Simple hypertension, such as Only high pressure and low pressure are normal; 4. Stable angina, such as angina pectoris with hypertension; 5. Carotid atherosclerosis, such as carotid plaque with hypertension; 6. Coronary atherosclerosis, such as cardiovascular stenosis Complicated with high blood pressure. 5. Common side effects of dipine antihypertensive drugs Some of the more common side effects or adverse reactions: rapid heartbeat, facial flushing, ankle edema, gum hyperplasia, etc. Transient hypotension 5%; the incidence of lower extremity edema is 4% to 12.5%; dizziness, headache, nausea, fatigue and facial flushing 10%, relatively rare adverse reactions: individual tongue numbness, dry mouth, sweating, nausea, Loss of appetite, etc. It may also occur: stuffy nose, chest tightness, shortness of breath, constipation, diarrhea, gastrointestinal cramps, abdominal distension, skeletal muscle inflammation, joint stiffness, muscle cramps, nervousness, tremors, nervousness, sleep disorders, blurred vision, imbalance, male dysfunction Wait. In short, dipine antihypertensive drugs are the most commonly used antihypertensive drugs, and one of the first antihypertensive drugs for hypertension, and can be combined with diuretics, puli or satan, luol and other drugs to reduce blood pressure. Faced with side effects and adverse reactions, we need to calm down. Any medicine has two sides, and there are more or less side effects or adverse reactions. But it will only happen to a very small number of people. As long as we do a good job of monitoring, if it does not happen to ourselves and can play the role of antihypertensive, then it is a better antihypertensive drug for ourselves.
Boss Lu, 33, the owner of the barbecue shop, has dark skin and a tall body; I also had a barbecue at his barbecue stall before. When he recognized me, he left a phone number in case of emergency. On Monday, boss Lu called me and said that I have always been boring and lack of energy. I was short of breath when I walked down the aisle. I said do you usually have any diseases? He said it’s okay. He is usually like a cow. He can eat, drink and stay up late. I still don’t worry, let him come to the hospital to see, when I go to the hospital, my blood pressure is 200/110, I asked him how high blood pressure? Boss Lu said that for several years, he didn’t feel like it, he didn’t care. Then I quickly asked him to do a heart color Doppler ultrasound. The heart color Doppler ultrasound showed that the heart was enlarged and the hypertensive heart disease changed. The ejection fraction was 35% (the normal value was higher than 55%). I told him that he had to be hospitalized first, and the heart disease caused by long-term hypertension was not good. I did not dare to tell him too much truth, and then secretly told his wife that boss Lu’s long-term high blood pressure led to an enlarged heart, which is now heart failure and his condition is more serious. 1. Why hypertension can cause long-term pressure increase in heart disease and cause excessive increase in afterload, causing damage to the thickness of the blood vessel wall and the heart’s centripetal hypertrophy and relaxation during diastole. Eventually, myocardial contractility decreases, the heart cavity expands, and ventricular end diastole occurs. Increased volume, increased ventricular filling pressure and atrial pressure, obstructed pulmonary vein reflux, and acute hypertension or chronic left heart failure. Long-term poor control of hypertension can cause changes in the structure and function of the heart called hypertensive heart disease. Studies have shown that 70% of heart failure is caused by high blood pressure; at the same time, coronary heart disease, atrial fibrillation and other heart mergers may occur disease. To understand it simply, under normal circumstances, our heart is facing a blood pressure below 140/90mmHg, but when the blood pressure is higher than this value, especially like this 200/110mmHg. Our heart bears much more pressure than normal every minute and every second. Under high pressure for a long time, the heart will gradually deform, left ventricular hypertrophy, systolic and diastolic function decline, the heart expands, and the heart dysfunction, Hypertensive heart disease leads to heart failure. 2. Various data on hypertension and heart epidemiological survey The rate of heart failure patients with hypertension in my country is 54.6%. The incidence of heart failure in patients with hypertension is 28.9%, which is equivalent to stroke (30.0%). Studies have shown that for every 10mmHg of high pressure, the risk of heart failure is significantly reduced by 28%. Recent studies have confirmed that compared with standard antihypertensive therapy with high pressure <140mmHg, high pressure <120mmHg can significantly reduce the incidence of heart failure in patients with hypertension by 38% and cardiovascular death by 43%. These studies show the danger of hypertension to the heart. Controlling blood pressure can significantly reduce the risk of heart failure, and actively control blood pressure, with better results. 3. What are the manifestations of hypertensive heart disease: Early patients may have no obvious conscious symptoms, or there are general symptoms of high blood pressure such as dizziness and headache, and there is no specificity. If you do not control blood pressure for a long time, or if the blood pressure is not controlled well, the heart gradually expands, you may have fatigue, weakness, lack of energy, shortness of breath, chest tightness after exercise, breathlessness, difficulty in breathing; shortness of breath when lying down, improves after sitting up; the amount of activity is not Large, but with difficulty in breathing. In severe cases, patients may wake up in their sleep; in severe cases, they may sit and breathe, cough, and cough pink foamy sputum. Edema of both lower extremities, systemic edema, abdominal distension, and loss of appetite may occur in severe cases. Fourth, once the harm of hypertensive heart disease develops into hypertensive heart disease, it will not only cause chest tightness, suffocation, difficulty breathing and so on. Moreover, with the progress of the disease, daily meals, drinking water, brushing your teeth, washing your face, toilets, etc. will cause chest tightness in your daily life. The most serious thing will be that you can't lie down and sleep. The 5-year mortality rate of chronic heart failure is 50%, and the 1-year mortality rate of severe heart failure is 50%. 5. What should boss Lu do? Blood pressure must be actively controlled. First, the blood pressure should be reduced to a normal value, and the blood pressure should be monitored. Regular treatment of heart failure to prevent further enlargement of the heart, mainly based on Puli and Betaloc, can reduce blood pressure on the one hand, and can treat heart failure on the one hand. If you are uncomfortable, you can change to satan. Of course, the latest medicine for heart failure, Nuoxintuo can also be taken. Review the color Doppler ultrasound once every six months to see the changes in the heart structure. Abstain
In the morning, the outpatient clinic was still very busy. It didn’t drink water or go to the toilet. It was not clean until 12 o’clock. When I was ready to pack things off work, I pushed the door in and a young man came in and closed the door. I was nervous. After all, I didn’t know what the person meant. I said, “What are you doing? Who are you looking for?” The man was in his 30s and said, “Doctor, I just asked a question. Just now there are too many people and I am embarrassed to come in.” I was relieved and asked him: What was he embarrassed to say: “I have high blood pressure, but I have been embarrassed every night lately and can’t do anything.” It turned out to be a patient who had problems with sexual life due to high blood pressure , We can always meet such patients with hypertension in the hospital. Because long-term hypertension does affect some people, affecting their normal lives, especially men. 1. The effect of high blood pressure on sexual health 1. High blood pressure causes arteriosclerosis. Long-term high blood pressure can cause arteriosclerosis, and the blood flow supply will be restricted, resulting in reduced blood flow to the testicles. A study conducted by academics at the Medical College of Leuven University in Belgium showed that men have elevated erectile dysfunction regardless of their testosterone levels. Vascular diseases and low testosterone levels can affect erectile function. Of course, not all men will be affected by this reduced testicular blood flow, but it will also cause erection difficulties or difficulties in maintaining an erection due to other factors. For example, the cause of drugs and psychological reasons. 2. Some antihypertensive drugs can also cause Rolle drugs: Metoprolol and Bisoprolol will not only reduce sexual desire and affect erectile function, but also cause ejaculation dysfunction and serum total testosterone levels. According to current research evidence It shows that the Lol drugs have an adverse effect on male sexual function and semen quality. Thiazide diuretics: The impact on male sexual function is mainly the reduction of libido and ED, spironolactone can cause male breast development, reduce sperm motility and concentration, and decrease libido. Partially reduced blood pressure: Nifedipine and verapamil may cause sexual dysfunction. Some of the instructions for dipine indicate that taking dipine drugs for loss of libido, impotence, and sexual dysfunction, the incidence rate is less than 1%, which is an occasional adverse reaction. 3. Psychological factors Some men with high blood pressure may experience anxiety and depression once they have one or two erectile dysfunctions. They are afraid to have such problems again. The more worried they are, the more likely they are to cause dysfunction due to psychological factors. There is not much research on whether high blood pressure will affect women. On the one hand, there may be little impact, on the other hand, many people may be reluctant to express, so there is little research. Second, how to be good First of all, there is no perfect way, the best way is to prevent, not to hypertension. But for people who have already developed hypertension, they must first live a healthy life and control the process of arteriosclerosis. Arteriosclerosis is not only related to high blood pressure, but also to smoking, alcoholism, obesity, unhealthy diet, sedentary exercise, diabetes, hyperlipidemia and so on. The better the three-high control, the better the arteriosclerosis control, and the less likely to be sexual dysfunction. Changing bad habits such as smoking and drinking, obesity, unhealthy diet, and inactivity not only helps blood pressure control, but also prevents arteriosclerosis, and naturally reduces the occurrence of sexual dysfunction. Drug selection Try to choose drugs that have a small effect on heart function, such as puli or satan; if it is not possible, you can only find a specialist to diagnose and treat heart dysfunction, such as blue pills. Third, good blood pressure control is the key to good blood pressure control, not only can control arteriosclerosis, but more importantly, if the long-term hypertension is not well controlled, it will lead to heart enlargement, heart failure, angina pectoris, myocardial infarction, cerebral hemorrhage, cerebral infarction, Renal failure and other malignant consequences. Once these diseases occur, even if there is no erectile dysfunction, there is no such thought. Also, if the hypertension is not well controlled, the blood pressure will rise higher and the heart rate will be faster under agitated conditions, then the risk will increase. So no matter what, first control the blood pressure. 4. Prevention of high blood pressure is the only way to avoid embarrassment. About 4 adults in our country have about 1 high blood pressure, and we need everyone to have sufficient reasons to prevent high blood pressure. Some people say that hypertension is hereditary and cannot be prevented. Although some high blood pressure is indeed caused by heredity, there is still a large part that has nothing to do with heredity and is caused by your unhealthy life. Even if that part of the genetic guide
Speaking of folic acid, many mothers are very familiar with it. They eat this every day during pregnancy, because folic acid is a water-soluble B-vitamin, which plays an important role in the biosynthesis of human DNA, RNA, nucleic acid and protein. At the same time, it is also the material basis for cell proliferation and body development. In recent years, as scientists have conducted in-depth research on folic acid, it has been found that folic acid has a role in preventing neonatal neural tube defects. Therefore, it has become a consensus that pregnant women need to supplement folic acid before and during pregnancy. In addition, folic acid has also shown an important role in the field of cardiovascular disease treatment. Some scholars believe that folic acid supplementation can prevent stroke in the elderly. Is this really the case? Can supplementing folic acid prevent stroke in middle-aged and elderly? Stroke is also called stroke in medicine, including hemorrhagic and ischemic. Folic acid does not directly prevent stroke, but it can prevent stroke by indirect action. A large number of studies have found that the increase of plasma homocysteine level is closely related to atherosclerosis, and it is also an independent risk factor for cardiovascular and cerebrovascular diseases. According to epidemiological investigations, the proportion of H-type hypertension accompanied by hyperhomocysteinemia in hypertensive patients in my country is as high as 75%, and hypertension is also a high-risk factor for stroke. Folic acid can reduce the level of plasma homocysteine, thereby reducing the risk of atherosclerotic disease. At the same time, our country’s hypertension treatment guidelines also recommend that folic acid be supplemented with antihypertensive drugs for H-type hypertension to reduce the cause. Hypertension causes the risk of cardiovascular and cerebrovascular diseases. Therefore, folic acid supplementation can indirectly prevent stroke by reducing plasma homocysteine levels. In 2007, a meta-analysis of 8 randomized studies also showed that folic acid supplementation can reduce stroke risk by 18% . How to supplement folic acid? Replenishing folic acid does not prevent stroke by eating and drinking. Pay attention to the dosage and time of supplementation. The guidelines recommend a folic acid supplementation dose of 0.8 mg/d with good efficacy and safety in preventing stroke, and the need to persist for more than 3 years to reduce the risk of stroke. Which foods contain folic acid? Many foods, vegetables and fruits are rich in folic acid in daily life. Studies have shown that soybeans, peanuts, mung beans, millet, oats, corn, etc. have higher folic acid content, and the vegetables with higher folic acid content are mainly spinach, rape, mushrooms, oil wheat, lettuce, cabbage, green pepper, celery, cabbage And pumpkin. In terms of fruits, the content of folic acid in kiwi is relatively high, followed by persimmon, grapefruit, banana, orange, apple, hawthorn and pear. Therefore, to add folic acid from food, you can eat more food. Middle-aged and elderly people are the high incidence age of cardiovascular and cerebrovascular diseases, so they need to be prevented in life. If there is no cardiovascular and cerebrovascular diseases, folic acid can be supplemented through diet. If there are underlying diseases such as H-type hypertension, you may also need to take additional folic acid tablets to supplement, then it is best to supplement under the guidance of a doctor. References: 1. “Guidelines for the Primary Prevention of Cerebrovascular Diseases in China” (2015) 2. “Expert Consensus for the Diagnosis and Treatment of H-type Hypertension” 3. Shao Lihua, Wang Li. Analysis of the content of folic acid in grains and fruits and vegetables [J] , Food Science, 2014, 35 (24): 290-294 (part of the picture source network in the article, the copyright belongs to the original author, thank you for the picture author, if you find any violation of your copyright, please contact me, I will delete.)
As everyone knows, blood pressure higher than 140/90 is called hypertension, and long-term hypertension will cause many cardiovascular and cerebrovascular diseases, so we pay attention to high blood pressure. Once the blood pressure is found to increase, we must actively control blood pressure. To control blood pressure, we must first know how much blood pressure falls to be normal, how much falls to be ideal, and how much falls to best prevent cardiovascular and cerebrovascular diseases. 1. What is hypertension: blood pressure higher than 140/90 belongs to hypertension 120-139/80-89 belongs to the high value of normal blood pressure; the previous hypertension guidelines classified hypertension as three levels: 140-159/90-99, which belongs to grade 1 hypertension; 160-179/100-109 belongs to grade 2 Hypertension; greater than 180/110, which belongs to Grade 3 hypertension. The latest hypertension guidelines classify hypertension into 2 levels: 140-159/90-99 is grade 1 hypertension ≥160/100 is grade 2 hypertension. According to this standard, we all know that blood pressure drops below 140/90, It is not high blood pressure, so is it safe for everyone to lower their blood pressure to 140/90? If you think so, you are wrong. Below 140/90, you can only say that it is not high blood pressure, but not normal blood pressure, nor ideal blood pressure. Especially for young people, blood pressure should be strictly controlled and blood pressure should be lowered as much as possible. To below 130/80. 2. How safer is the blood pressure of young people? A recent study of more than 6.4 million people on Circulation showed that 64.2 million people aged 20 to 39 were selected. After 13 years of follow-up, 44,000 new cardiovascular events, including myocardial infarction, occurred , Stroke, heart failure or cardiovascular-related death. Studies have shown that compared with people with blood pressure <120/80mmHg, high pressure>120~129mmHg, low pressure <80mmHg, cardiovascular risk increased by 14%; high pressure 130~139mmHg, cardiovascular risk increased by 36%; low pressure 80~89mmHg The cardiovascular risk is increased by 32%; if both high and low pressure are increased, the risk is further increased. For 130–139/80-89mmHg, the cardiovascular risk is increased by 67%; for ≥140/90mmHg, the cardiovascular risk Increased by 140%. In view of this, even if people with hypertension lower their blood pressure below 140/90, if they do not lower it to a more ideal level, the risk of cardiovascular disease is still very high. Therefore, for 20-40 young patients with hypertension, blood pressure should fall below 130/80 in order to effectively prevent cardiovascular disease. 3. The blood pressure of special populations should be better controlled. In addition to young hypertensive patients, blood pressure should be more stringent, and obese hypertensive patients should also be stricter about their blood pressure levels. A newly published study shows that different weights have different criteria for lowering hypertension. Especially for people who are overweight, blood pressure should be lowered to be safe. For those with a body mass index <24, the ideal blood pressure is 130/80 mmHg, while for those ≥ 24, the blood pressure is less than 120/80 mmHg. The study included 45,925 participants. During a follow-up period of 12.5 years, 2548 people had strokes, including 1776 ischemic strokes and 719 hemorrhagic strokes. The stroke risk increased by 27.7% for every 20mmHg increase in high pressure; the stroke risk increased by 13.8% for every 10mmHg increase in low pressure. The final conclusion is: for those with a body mass index <24, the ideal blood pressure is 130/80mmHg, and for those ≥ 24, the blood pressure is less than 120/80mmHg. In addition to the blood pressure of young people and obese people should be more ideal, for patients with clear diabetes, angina pectoris, myocardial infarction, heart failure, etc., blood pressure should also be reduced to 130/80mmHg as much as possible. Of course, what we are talking about today is mainly young people, obese people and hypertensive patients with special diseases, and they do not involve age. Because with the increase of age, especially the elderly over 65 years old, blood pressure control is not so strict, but varies from person to person, as long as the elderly can tolerate, as much as possible to drop below 140/90. (Originally from science to rumors) In short, for young people, especially young people 20-40 years old, or obese people, we can not only meet the blood pressure below 140/90, but to lower the blood pressure to 1 as much as possible
Most people know that when the blood pressure is higher than 140/90mmHg, it is called hypertension! So is it okay if the blood pressure is lower than 140/90, and is it safe? 1. The blood pressure standard in the United States is 130/80. The 2017 American Hypertension Guidelines revised the original 140/90 hypertension standard to 130/80. That is, when blood pressure is higher than 130/80, hypertension must be considered. For a time, many people who were not hypertensive were considered to be hypertensive; at the same time, both our country and Europeans were expecting whether their hypertension standards would change. For several years in a row, our high blood pressure standard and the European high blood pressure standard are still 140/90; is it safe if the blood pressure is not higher than 140/90? of course not! Second, the blood pressure of young and middle-aged people is higher than 130/80. There is a cardiovascular risk study. In our young and middle-aged population, as blood pressure levels increase, the risk of cardiovascular disease, stroke and all-cause death increases. If taking antihypertensive drugs, this correlation will no longer be significant. For people aged 18-40, those with a blood pressure of 130-139/80-89 had an increased risk of cardiovascular disease of 82%, a stroke risk of 79%, and a risk of all-cause mortality increased by 72% relative to a blood pressure of <120/80. Previously, Beijing Anzhen Hospital also conducted a study. For people aged 35-59 years, compared with those with blood pressure <120/80, those with blood pressure of 130-139/80-89 had a 78% increase in cardiovascular disease risk. The risk of death increased by 1.5 times. A recent study also found that if the blood pressure ≥140/90, the risk of cardiovascular disease increased by 2.54 times; the risk of stroke increased by 2.21 times; the risk of death increased by 1.36 times. In general, if these hypertensive people can control blood pressure formally, if the blood pressure is controlled at a normal level, that is, below 130/80, then the risk of cardiovascular disease, stroke, and all-cause death does not increase. 3. How to control high blood pressure for young and middle-aged people, how much is the best blood pressure? The American guidelines recommend that people with blood pressure ≥140/90 start using antihypertensive drugs. My country recommends that when the blood pressure is higher than 140/90, but not more than 160/100, and there is no diabetes and heart, brain and kidney disease, you can start a healthy lifestyle first, observe for 3 months, if you can exercise through a low-salt diet, control weight To avoid staying up late, after quitting smoking and drinking, the blood pressure drops below 140/90, then continue to live a healthy life; how to start taking antihypertensive drugs after 3 months after the blood pressure is still higher than 140/90. American guidelines recommend that blood pressure exceeding 130/80, if the risk of atherosclerosis events ≥ 10%, or have diabetes or chronic kidney disease, it is recommended to use antihypertensive drugs. If the risk score is <10%, only lifestyle therapy is recommended. Our country's guidelines suggest that if blood pressure exceeds 140/90, and diabetes and heart, brain, and kidney disease are combined at the same time, then antihypertensive drugs must be started immediately. For young and middle-aged hypertensives, if possible, lower the blood pressure below 130/80 as much as possible, rather than just meet the standard below 140/90. For people whose blood pressure does not exceed 140/90, but has exceeded 130/80, don't secretly rejoice and feel that you are not high blood pressure, you can continue to let yourself go. Although this blood pressure is not high blood pressure, the risk of cardiovascular and cerebrovascular diseases is significantly increased. Even if you do not take antihypertensive drugs, you must strictly control your blood pressure in a healthy life. Recent studies have also shown that the earlier the onset of hypertension, the higher the risk of cardiovascular disease and all-cause death. Among young people diagnosed with hypertension before the age of 45, the risk of cardiovascular disease and all-cause death increased by 1.26 times and 1.59 times, respectively. In short, young and middle-aged people must monitor blood pressure. If they find that the blood pressure is higher than 130/80, they must pay attention to it. They must adhere to a healthy lifestyle and try to lower their blood pressure to below 130/80, so as to effectively prevent cardiovascular and cerebrovascular diseases!
Now there are more and more young people suffering from high blood pressure. Many people are in their 30s or even 20s, and they have already experienced an increase in blood pressure, or even a diagnosis of high blood pressure. How can young people regulate high blood pressure? In terms of medication, what are the more suitable options and precautions? Today I will briefly introduce you to this knowledge. The incidence and characteristics of hypertension in young people Compared with the problem of hypertension in the elderly, young people, especially young people with new hypertension, often have their own characteristics. The occurrence of hypertension in young people is often closely related to the increase in cardiac output and the acceleration of heart rate. The increase in cardiac output leads to an increase in the volume of blood in the arterial blood vessels, and the arterial blood vessel wall is subjected to more pressure. It will gradually increase, and the heart rate is too fast. When the heart is dilated, the blood flow back to the heart is insufficient, which will lead to an increase in diastolic blood pressure. Young people have new hypertension, and the elasticity of the blood vessel wall is still relatively good, and the degree of arteriosclerosis is also Smaller, if it is not actively controlled, hypertension will gradually affect the health of arteries and blood vessels. After the long-term development of hypertension, it will be transformed into hypertension caused by major arteriosclerosis and increased resistance to blood flow in the inner walls of arteries. . For young people with high blood pressure, the characteristics are also very clear, that is, the problem of low pressure rise often occurs first, and even many young people with high blood pressure are purely low pressure and high pressure but not exceeding the standard. The reason why it appears The characteristics of such high low pressure are closely related to the increase in cardiac output, the faster heart rate, the increase in sympathetic excitability, and the increased activity of the renin-angiotensin system. When regulating the problems of high blood pressure and high pressure in young people, we should also conduct targeted conditioning and treatment. Do young people have to take medicine to control hypertension? If it is a young person, and it is a newly discovered mild hypertension problem, of course, it is not necessarily to be controlled by taking medicine immediately. Whether to take medicine or not, we must make a comprehensive assessment to determine the degree of blood pressure increase and other cardiovascular disease risk factors. For example, young friends with simple low pressure and high problems have a diastolic pressure of just over 90, a high pressure of more than 130, and no risk of chronic diseases such as diabetes. In this case, it is not recommended to rush to take medicine. Life conditioning interventions to strengthen blood pressure control. Why there is low pressure and high, may have a certain relationship with the following life factors-obesity has a long-term taste, high salt, high fat, high sugar diet, long-term smoking, long-term heavy drinking, long-term emotional anxiety, tension, and stress often These life factors such as staying up and sitting for long periods of time are all controllable and help to improve the important aspects of blood pressure. For mild young people with high blood pressure or simple high blood pressure in young people, you may wish to start from the above Take a look at the aspects of life improvement and conditioning in a targeted manner. In many cases, if you can actively improve and adjust bad habits, and maintain healthy and good habits for a long time, high pressure problems, mild hypertension The problems can be effectively recovered and improved, and it is entirely possible to fully recover to a healthy level below 120/80. And if it is found to be more serious hypertension problems, such as secondary hypertension with a blood pressure exceeding 160/100, or there are other basic chronic diseases such as those found in diabetic patients, or after 3~ Young people who are still unable to effectively lower their blood pressure after 6 months of strict self-controlled life conditioning intervention should consider taking drugs to control their blood pressure. Drug selection for hypertension in young people For young people with hypertension, if it is evaluated that it is necessary to take drugs to strengthen blood pressure control, it is still necessary to remind everyone that the premise of medication must also be based on adequate life conditioning interventions Carrying out such blood pressure control is more effective. The problem of hypertension in young people is also very important to choose antihypertensive drugs in a targeted manner. From the perspective of the pathogenesis and characteristics of hypertension in young people, the choice of drugs that inhibit the activity of the renin system and the activity of the sympathetic nervous system is often the best choice. Such antihypertensive drugs can mainly consider sartans and common drugs A class of antihypertensive drugs, both of which are inhibitors of the renin-angiotensin system, for targeted conditioning and control of young people
In the life of high blood pressure, it is always “clear”, which causes great trouble for people to discover the disease in time. When blood pressure rises, it will send some dangerous signals, and we can make timely diagnosis of the patient’s illness through the “warning” issued by these high blood pressure. 1. Tinnitus: This is a typical disease caused by increased blood pressure. We can judge the onset of hypertension by the appearance of this disease, which is very important for the timely diagnosis of hypertension. Many people think that tinnitus is mostly caused by external noise. In fact, high blood pressure can also cause tinnitus, and it is binaural tinnitus, which lasts a long time. 2. Vertigo: This is a significant manifestation of increased blood pressure, but it is often confused by people, because many diseases may cause dizziness symptoms, such as high blood pressure, low blood pressure, anemia, cerebral thrombosis, etc. Among them, hypertension is the most common. The vertigo caused by high blood pressure is mostly caused by fluctuations in blood pressure due to emotional changes, mental stress, or mental stimulation. 3. Headache: Headache symptoms are very common in life, but everyone should not be taken lightly, and must be carefully identified. Headaches caused by high blood pressure have certain onset characteristics, not only the symptoms of headache, but also accompanied by Vomiting and vomiting, and the site of the disease is mostly in the hind brain. If this type of headache is severe and persistent, it may be a sign of conversion to malignant hypertension. Diagnosing hypertension can be achieved by the symptoms caused by the increase in blood pressure. Through the timely detection of the above-mentioned symptoms, a timely and effective diagnosis can be made for the incidence of hypertension, the extension of the disease can be controlled to the greatest extent, and the occurrence of serious complications can be avoided.
1. Patients who have been diagnosed with coronary heart disease: If you are already a patient with coronary heart disease, the chance of having another coronary heart disease attack will increase. Because arteriosclerosis is a long-term development process, once coronary heart disease is diagnosed, you must adhere to long-term treatment and take medicine for life. 2. Hypertensive patients: Patients with hypertension have a 2-3 times higher risk of coronary heart disease than normal people. Long-term blood pressure is high, which increases the burden on the heart, and long-term hypertension leads to vascular sclerosis, which leads to stenosis and obstruction, causing coronary heart disease. 3. Diabetics: Diabetics have disordered blood sugar metabolism, which will cause blood lipid dysfunction after a long time, which will lead to hypertension and coronary heart disease. Once diagnosed with diabetes, then in the treatment of diabetes, it should also be treated according to the coronary heart disease treatment plan, and early prevention and treatment of coronary heart disease. 4. Hyperlipidemia: People with high blood lipids have an increased chance of coronary heart disease, because too much fat is deposited on the blood vessel wall, to a certain extent, it will lead to narrowing and blockage of blood vessels, which in turn causes coronary heart disease. 5. Middle-aged and elderly people who smoke: Some harmful substances produced by smoking stimulate the vascular endothelium, causing damage to the blood vessel wall. Inflammation and other risk factors can cause plaque formation and blood clots to block blood vessels, which can cause coronary heart disease. . 6. Obese middle-aged and elderly people: Obesity is apt to cause many diseases such as high blood pressure, hyperlipidemia, and diabetes. Obesity itself also increases the load on the heart. Therefore, obese middle-aged and elderly people are more likely to develop coronary heart disease.
In 2020, the latest “Hypertension Guideline” is published. There is no change in the national hypertension judgment standard, but the hypertension classification has been changed. 1. Current blood pressure standards commonly used in China and Europe: “Chinese Hypertension Guide” Normal blood pressure: high pressure 90-120mmHg and low pressure 60-80mmHgmmHg; normal high value: high pressure 120-139mmHg and (or) low pressure 80-89mmHg; hypertension: High pressure ≥140mmHg and/or low pressure ≥90mmHg. That is, in our country and Europe, high pressure ≥140mmHg and/or low pressure ≥90mmHg need to consider the diagnosis of hypertension. But Americans’ blood pressure standards are lower than ours. The high blood pressure standards in the United States are high pressure ≥130mmHg and/or low pressure ≥80mmHg. 2. The classification of hypertension has also changed. The old guidelines stipulate that hypertension is divided into three levels: 120-139/80-89 belongs to high normal blood pressure; 140-159/90-99 belongs to grade 1 hypertension; 160 -179/100-109 belongs to grade 2 hypertension; greater than 180/110, belongs to grade 3 hypertension. The latest hypertension guideline in May 2020 canceled Grade 3 hypertension, and referred to Grade 2 and Grade 3 hypertension as Grade 2 hypertension, which means that later hypertension will be divided into two grades, Grade 1 hypertension and Grade 2 hypertension hypertension. All grade 2 hypertension is relatively serious hypertension. 3. Misunderstanding of high blood pressure 1. Diagnosis of high blood pressure by measuring blood pressure once Diagnosis of high blood pressure, only once the blood pressure in the clinic is high, high blood pressure cannot be diagnosed. It usually takes 1 to 4 weeks (depending on blood pressure level) to take 2 to 3 clinic measurements to confirm the diagnosis of hypertension. The previous requirement was that the blood pressure was higher than 140/90 for three times on different days. Now the different days are changed to 1-4 weeks, which means more time is given to rule out other factors that interfere with the temporary increase in blood pressure. It is more recommended that family blood pressure monitoring or 24-hour ambulatory blood pressure monitoring, which is more accurate than the blood pressure of the consulting room, that is, the hospital monitoring station. The diagnostic criteria for hypertension in households to measure blood pressure is ≥135/85mmHg, which corresponds to 140/90mmHg for blood pressure in the clinic. That is to measure blood pressure at home, ≥135/85mmHg is high blood pressure! The diagnostic criteria for hypertension after ambulatory blood pressure monitoring are: average high/low pressure 24h ≥130/80mmHg. daytime ≥135/85mmHg. nighttime ≥120/70mmHg. 2. High blood pressure is not uncomfortable and there is no need to treat it. Many people think that high blood pressure will cause dizziness, headache, and head swelling. In fact, most high blood pressure does not have these symptoms. Most people do not feel any symptoms when they have high blood pressure, but only actively measure blood pressure Found at the time. It has only been discovered when other diseases have been merged, or when complications of hypertension have occurred. High blood pressure without symptoms does not mean no harm. We can always see patients with cerebral infarction, cerebral hemorrhage, myocardial infarction, heart failure, and renal failure. In fact, most of them are caused by long-term hypertension without control. Therefore, to find that hypertension must be measured frequently, not by feeling. Secondly, if you notice high blood pressure, whether you feel it or not, you must find a way to lower your blood pressure to a normal level. 3. Antihypertensive drugs are the only way to lower blood pressure. When it comes to antihypertension, most people think that only antihypertensive drugs can lower blood pressure. In fact, this is not the case. There are two ways to lower blood pressure. One is to live a healthy life. The basis of blood pressure is suitable for all people with high blood pressure; one is antihypertensive drugs. Whether you eat or not take antihypertensive drugs, you have to live a healthy life. Low-salt diet, adhere to exercise, control weight, avoid staying up late, reduce stress, stay away from tobacco and alcohol, etc. These can lower blood pressure. For newly discovered grade 1 hypertension, if there are no complications, then you can not take medicine and reduce blood pressure through the above methods, many people can eventually achieve normal blood pressure. 4. Once you start taking antihypertensive drugs, you have to eat them all your life. Some people say that high blood pressure is addictive. In fact, it is not that antihypertensive drugs will cause addiction, but that if our blood pressure cannot be controlled by a healthy life, we can only take medicine. Because if you do not take medicine, the result is long-term high blood pressure, resulting in heart, brain, kidney and other diseases. If we can lower our blood pressure to normal through a healthy lifestyle, then we can not take antihypertensive drugs, and even some people who are taking antihypertensive drugs, through weight loss, low salt
I often encounter such patients in the outpatient clinic. When I enter the door, I say: Come to the doctor and give me a blood pressure measurement! Of course, this is a very legitimate requirement, but most people report that my sphygmomanometer is inaccurate, and the measurement at home is relatively normal. It is high blood pressure when I arrive at the hospital. It seems that my sphygmomanometer needs to be replaced, or the mercury sphygmomanometer is accurate. I have to repeatedly say to many patients: Generally, it is not the problem of the sphygmomanometer, but it is more accurate to measure the blood pressure at home, and the blood pressure in the hospital is relatively high. 1. The blood pressure measured in the hospital is mostly high. One of the most common is white coat hypertension, that is, because the subject is nervous, he will be nervous as soon as he arrives at the hospital, and he will be nervous when he meets the doctor. High, then the measured blood pressure may be higher than 140/90mmHg. However, when you go home to measure, the environment is familiar, the comfort is high, and you are not nervous. After measuring the blood pressure, it will be lower than 140/90mmHg. This will make many people do not know which one should prevail. On the other hand, when we go to the hospital, it is inevitable that activities such as driving, queuing, waiting, climbing stairs and other emotions will affect blood pressure results. So cardiovascular doctors are more recommending that everyone go home to monitor blood pressure; another advantage of going home to monitor blood pressure is that our blood pressure is the blood pressure at all times, not going to the hospital every two weeks to a month to measure the blood pressure once it is done. Too. We need to develop the habit of monitoring blood pressure at home. 2. Recommendations for hypertension guidelines On June 22, 2020, the American Heart Association (AHA) and the American Medical Association (AMA) issued a joint policy statement on home self-blood pressure monitoring. The statement pointed out that home self-blood pressure monitoring helps improve the diagnosis and management of hypertension. That is, this guide recommends that you measure blood pressure at home rather than go to a hospital or clinic to measure blood pressure. Our country’s high blood pressure guidelines also state that everyone should conduct home self blood pressure monitoring. In fact, many international hypertension guidelines recommend measuring blood pressure at home. 3. The benefits of measuring blood pressure at home. Measuring blood pressure at home can exclude white coat hypertension, and the detection of hidden hypertension. It can also help to diagnose stubborn hypertension, find early morning hypertension, observe the effect of long-term blood pressure control, and improve the patient’s blood pressure. Pressure medication compliance. Studies have shown that measuring blood pressure at home can help lower blood pressure by 2.5~3.8/1.5~1.8mmHg. The 2019 Chinese family blood pressure monitoring guidelines stipulate that when measuring blood pressure at home, if the average blood pressure exceeds 135/85mmHg, you may consider diagnosing hypertension, and the blood pressure in the clinic is 140/90mmHg. That is to say, the blood pressure standard at home is lower and cannot be delineated according to 140/90, but 135/85. 4. It is most suitable to measure blood pressure several times. The frequency of blood pressure measurement is different for different people. For newly discovered hypertension or hypertension patients with unstable blood pressure, it is recommended: 2019 China’s family blood pressure monitoring guidelines recommend that it should be 1 hour after waking up in the morning. Take blood pressure before taking antihypertensive drugs, before breakfast, before vigorous activities, and after dinner and before going to bed in the evening. During the adjustment of antihypertensive drugs, continuous self-monitoring blood pressure for 5 to 7 days. Once the blood pressure reaches the standard, and the blood pressure continues to stabilize within a few months, measuring 1 to 3 days per week may be sufficient. The 2019 China Guide recommends that those with good blood pressure control should take their blood pressure at least 1 day a week. Friends of high blood pressure, blood pressure is their own, health is their own, we can not give the doctor the measurement of blood pressure! Each of us is the first person in charge of our own health. Hypertensive people manage their own blood pressure. We must start by monitoring our blood pressure at home!
Pregnant hypertension is a relatively common pregnancy disease, which has a series of effects on pregnant women and fetuses, and needs early treatment. So the incidence of hypertension in pregnancy is special, how should treatment and care be taken? First of all, for those pregnant women with mild illness, you can take care of yourself and rest at home. During the rest, the family must pay close attention to the physical condition of the pregnant woman. Once there are symptoms such as blurred vision, upper abdominal pain and headache, Seek medical attention and take antihypertensive measures in time. If there are no obvious symptoms, you can rest and wait for delivery, and at the same time, daily blood pressure measurement and recording. In order to ensure that both pregnant women and children have enough oxygen, some oxygen inhalation can be performed appropriately to avoid the situation of hypoxia due to high blood pressure, which will cause harm to the baby. If the condition is more serious, headache, dizziness and blurred vision, you should take antihypertensive measures for treatment. You can adjust it by taking oral antihypertensive drugs and bed rest. Antihypertensive is mainly to prevent serious maternal and fetal complications such as eclampsia, cardiovascular and cerebrovascular accidents and placental abruption. The blood pressure lowering process must be stable without excessive fluctuations, and medication must be adhered to so that effective treatment can be obtained. If the condition is really serious and the symptoms cannot be improved, you can also consider using surgical methods to premature the fetus and terminate the pregnancy. Of course, this is only used in the case of individual serious cases. General pregnancy hypertension can be controlled by different means. Therefore, in the case of pregnancy-induced hypertension, expectant mothers do not need to worry too much, which is not conducive to health. They should maintain a happy state of mind, actively cooperate with treatment or rest in rest, I believe this must be conducive to pregnancy type The recovery of hypertension is also more conducive to the health of the baby. For pregnant mothers, pregnancy hypertension is not terrible, optimistic and positive attitude is essential, as long as you follow the doctor’s instructions, take adequate rest and take antihypertensive drugs on time, with balanced nutrition and appropriate activities, it will be safe Through this special period.