Normally, when blood pressure is found to be a little high, many people don’t panic because it’s not that dangerous. However, if high blood pressure appears in some serious diseases, it is dangerous, such as coronary heart disease.
When they both appear together, how to treat and how to care for them? It’s the important thing, take a look, this can not be careless!
1, what is the relationship between high blood pressure and coronary heart disease? People with high blood pressure should know!
Coronary heart disease is mainly due to atherosclerotic lesions in the coronary arteries, which leads to narrowing or blockage of the blood vessels, making patients appear myocardial ischemia, hypoxia or necrosis, etc.
Atherosclerosis
Hypertension is one of the risk factors of coronary heart disease, which can cause damage to the endothelium of arteries and cause the development of atherosclerosis, and also accelerate the development of atherosclerosis, and the more severe the hypertension of patients, the more severe the atherosclerosis, and the higher the mortality rate of patients.
If the patient’s blood pressure rises sharply when coronary artery disease occurs, the atherosclerotic plaque will rupture, and then a thrombus will be formed to block the blood vessel, and when the disease progresses to a certain degree, myocardial infarction will occur.
Therefore, if hypertension patients combined with coronary heart disease, need to pay attention to, and actively carry out treatment.
2, when hypertension combined with coronary heart disease, how to treat?
When hypertension is combined with coronary heart disease, the target level of antihypertensive treatment is to reduce blood pressure to below 140/90 mmHg, or below 130/80 mmHg if tolerated, and it should be noted that diastolic blood pressure should not be reduced to below 60 mmHg.
However, in patients of advanced age and with severe coronary artery stenosis, blood pressure should not be too low.
In addition, in the specific treatment process, the choice of antihypertensive drugs differs for different types of patients with coronary heart disease.
Selecting antihypertensive drugs according to the condition
(1) Antihypertensive drugs for stable angina, choose beta-blockers and CCB, which can reduce myocardial oxygen consumption and reduce angina attacks and should be preferred.
When blood pressure control is not satisfactory, ACEI, ARB and diuretics can be used in combination.
(2) In non-ST-segment elevation acute coronary syndrome, the choice of antihypertensive drugs is different. For example, β-blockers and CCB are still preferred in patients with worsening exertional angina; when blood pressure control is unsatisfactory, RAS inhibitors as well as diuretics can be combined.
In addition, when the presence of vasospastic factors is considered, care should be taken to avoid the use of high doses of β-blockers because of the possibility of inducing coronary artery spasm.
(3) In patients with acute ST-segment elevation myocardial infarction, the antihypertensive drugs of choice are β-blockers and RAS inhibitors, which can significantly improve the long-term prognosis of patients when taken as secondary prevention after infarction, and should be used early if there is no contraindication.
CCB and diuretics can be used in combination when blood pressure control is unsatisfactory.
3.When hypertension is combined with coronary heart disease, all 4 nursing interventions should be done!
Patients with hypertension combined with coronary artery disease, in addition to actively cooperate with the doctor’s treatment, should also do a good job in the daily care of protective interventions.
(1) Psychological care
Most patients with hypertension combined with coronary heart disease will mostly have anxiety, depression, worry, disappointment and other adverse psychology.
Psychological communication
Family members and medical personnel should pay close attention to the psychological and emotional conditions of patients, care more about and encourage patients, respect patients’ privacy, chat more with patients, comfort patients, explain disease related situations to patients, make patients feel at ease and solid, eliminate patients’ bad psychology in time, and promote the achievement of good treatment results.
(2) Diet care
We should strictly follow the “three low, three high” dietary principles to treat their own diet, adhere to the principles of healthy diet, diet to ensure low fat, low sugar, low salt, pay attention to the protein and fiber supplement.
Also develop healthy eating habits, prohibit overeating, prevent constipation, and strictly control body weight.
(3) Exercise care
Depending on the specific situation of the patient, if the patient’s condition is stable and improving, you can arrange suitable exercise programs for the patient, for example, slow walking after meals, doing simple gymnastics, etc. are good choices.
But in the process of exercise, be sure to have a family member accompany you, pay attention to safety and prevent accidents.
(4) Other care
Quit smoking and limit alcohol, avoid staying up late, maintain regular work and rest, ensure that patients can ensure sufficient sleep, take medication strictly according to medical advice, and do not stop or reduce medication without authorization.
References
[1] China Hypertension Prevention and Control Guidelines Revision Committee, Hypertension Alliance (China, Chinese Society of Cardiovascular Diseases, Chinese Physicians Association, et al. Chinese guidelines for the prevention and treatment of hypertension (2018 revised edition) [J]. Chinese Journal of Cardiovascular,2019,24(1):24-56.
[2]Zhang Yame. On nursing interventions for hypertension combined with coronary artery disease [J]. World abstract of the latest medical information (continuous electronic journal),2020,20(48):226,228.
[3] Feng Baolian. Study on the relationship between hypertension and coronary heart disease[J]. Medical Information,2016,29(7):342-343.