If you have not had a medical checkup in a year, you can be hospitalized for a medical checkup, and the hypertension medication you are using now needs to be adjusted. There are two types of high systolic pressure (hypertension) One is aortic valve insufficiency, which can be determined by ultrasound of the heart and requires surgery if medication is not effective. The other type is in the elderly, where sclerosis of the large arteries leads to reduced compliance, characterized by high systolic pressure and high pulse pressure. This is commonly referred to as high pressure and low pressure, with a large difference in between. This condition can be determined by arterial function tests. Treatment with hydrochlorothiazide diuretics together with calcium channel blockers such as felodipine and indapamide. Angiotensin receptor antagonists such as telmisartan can also be added. Combine with folic acid tablets to treat the sclerosis of large arteries, and then with isosorbide mononitrate tablets and elastase to improve arterial compliance, dilate the heart’s blood vessels, and prevent cardiac ischemia caused by low myocardial perfusion pressure due to the drop in blood pressure. Lipid-lowering drugs of the tartar class have the effect of improving atherosclerosis, and the above drugs need to be taken on a long-term basis. There are very few cases of aortic stenosis, which is characterized by high blood pressure in the upper extremities and low blood pressure in the lower extremities. It is the result of blood flowing away from the narrowed aorta during diastole, and an arterial function test can also help with the diagnosis. Treatment for this condition requires surgery. In some cases, the heart has aortic valve insufficiency, as well as mitral valve insufficiency, both of which can lead to a lower diastolic blood pressure. An ultrasound of the heart is needed to determine this. Treatment for this condition also relies on surgery. In recent years, it has been recognized that increased stiffness and decreased elasticity of the arterial wall are deleterious results that occur with increasing human age. From age 30 to 80 years, systolic blood pressure increases almost linearly, while diastolic blood pressure increases until age 50 and then begins to decrease. The result of these changes is an age-related widening of pulse pressure. Recent studies have found that decreased aortic elasticity is an independent risk factor for the development of cardiovascular disease in the elderly. When the elasticity of the large arteries decreases by 35%, systolic blood pressure increases by 25% and diastolic blood pressure decreases by 12%, resulting in an increase in pulse pressure. Older people, especially those over 70 years old, have high pulse pressure if they have high blood pressure volatility, unstable blood pressure, and simple atherosclerosis. There are often symptoms such as dizziness and panic, and the pulse is slippery and deficient, or seen as a flood pulse. The symptoms are manifested as a deficiency of both spleen and kidney qi and yin. Combined with the use of Chinese medicine, pacifying the liver and submerging Yang, tonifying the kidney and benefiting Qi, removing phlegm and eliminating stasis, activating blood circulation, the treatment of symptoms such as blood pressure stability, lowering pulse pressure and eliminating dizziness in the elderly has a certain effect. Specific application because of the elderly blood stability is poor, must doctor check before using drugs. Therefore, the Internet can only give you a guide, not instead of seeing a doctor, to come to the doctor after the medication can be adjusted. In recent years, the field of hypertension pharmacotherapy has raised the issue of “attention to the external effects of hypotension”, that is, anti-hypertensive treatment should not be limited to lowering blood pressure, but also take into account measures to reduce arterial stiffness and improve the elasticity of large arteries. This is a new strategy in the treatment of systolic hypertension with low diastolic blood pressure. The goal of treatment is to selectively lower the elevated systolic blood pressure and not lower or even appropriately raise the low diastolic blood pressure, thus reducing the pulse pressure difference and establishing a new strategy and approach for the treatment of low diastolic blood pressure in the elderly. At present, it is believed that both antihypertensive effect, but also to improve the elasticity of the arteries of the main drugs are the following categories. 1, statins: statins not only regulate blood lipids, but also have the effect of improving arterial elasticity, because statins can not only upregulate endothelium-derived nitric oxide synthase expression, increase nitric oxide synthesis and release, but also reduce oxygen free radical production, long-term treatment may delay or reverse atherosclerotic lesions. 2, calcium antagonists: calcium antagonists through the reduction of smooth muscle intracellular calcium ion concentration and calmodulin, so that vascular smooth muscle diastole, blood pressure decreased, arterial diameter expansion. The application of high-resolution ultrasound found that amlodipine can significantly improve endothelium-dependent diastolic function, reverse carotid intima-media thickness and delay atheromatous plaque formation while effectively reducing systolic blood pressure and pulse pressure. Nifedipine controlled-release tablets also significantly increase the compliance and dilation of large arteries, prevent or reverse large artery hypertrophy, and increase arterial elasticity. Large clinical trials of systolic hypertension in the elderly have confirmed that long-term treatment with calcium antagonists can significantly reduce the risk of cardiovascular disease by the following possible mechanisms: (1) hypotensive effect, which reduces arterial wall tension; (2) inhibition of arterial wall remodeling, reversal of arterial hypertrophy, alteration of the ratio of elastin to collagen in the arterial wall, and increased vascular compliance; (3) improvement of endothelial function and enhancement of nitric oxide effect; (4) anti-endothelial hyperplasia and anti-atherosclerotic effects. 3. Diuretics: In hypertensive transgenic rats, sodium was found to induce changes in arterial structure and function. Excessive sodium intake affected arterial dilatability and compliance and caused a significant increase in arterial wall thickness and interstitial collagen. Small doses of diuretics may prevent collagen aggregation and relieve arterial stiffness. Numerous large clinical trials have demonstrated that diuretics can significantly reduce cardiovascular morbidity while lowering blood pressure. At present, diuretics have been used as the drug of choice for simple systolic hypertension in the elderly, but it is advisable to combine the drugs in small doses for better results. 4, aldosterone antagonists: aldosterone can also promote intimal and interstitial fibrosis of arteries and arterioles, collagen proliferation in the middle layer, so that the stiffness of blood vessels and myocardium increases. Anti-aldosterone treatment significantly reduces plasma type III collagen N-terminal peptide activity. Small doses of spironolactone and angiotensin-converting enzyme inhibitors can reduce the higher aldosterone activity in the body and control collagen renewal. In addition, we can use folic acid, elastase and nitrate to treat atherosclerosis. Nitrate, under the action of sulfhydryl group in the body, can form exogenous nitric oxide, which can directly relax the vascular smooth muscle of the aorta, enhance the diastolic function of the arterial wall and improve the elasticity of the aorta. Other risk factors can also be corrected to slow down the development of atherosclerosis, such as insulin sensitizers to improve insulin resistance in people with increased blood sugar, which can also improve arterial compliance. Many non-pharmacological therapies, such as lifestyle changes, smoking cessation, stress reduction, aerobic exercise, diet control, recipes that include increased intake of unsaturated fatty acids, and reduced salt intake, can also slow the development of atherosclerosis. The filling of the coronary arteries that supply blood to the myocardium is mainly in the diastolic phase of the heart, so the level of diastolic pressure will affect the perfusion pressure of the coronary arteries. Therefore, when the diastolic pressure (low pressure) is lower than 60mmHg, it will easily lead to insufficient perfusion pressure in the coronary arteries, resulting in myocardial ischemia and inducing angina pectoris in coronary heart disease. In particular, it should not be lower than 60 mmHg, otherwise it will affect the coronary perfusion and produce undesirable consequences. Therefore, coronary vasodilators such as isosorbide nitrate should be used in combination. It also needs to be combined with folic acid, or elastase, which can be taken orally for a long time to treat atherosclerosis. This type of elderly hypertensive patients, TCM believes that the body’s yin and yang imbalance, balance ability is not enough, often qi and yin deficiency, while the deficiency of yang upward, deficiency of wind within the movement caused by kidney deficiency yang hyperactivity. Chinese medicine evidence often manifests as Qi and Yin deficiency phlegm and stasis obstruction, the application of Chinese medicine to benefit Qi and nourish Yin, pacify the liver and submerge Yang while eliminating phlegm and eliminating stasis treatment, with Tianma hook vine drink with phlegm and eliminating stasis ghost acupuncture grass, half summer, poria, etc., as well as the supplementation of kidney Qi astragalus, red Jing Tian Shu Di, acupuncture Wu Jia. Or Chinese patent medicines, Astragalus Beneficial Qi Drops, compound Danshen, and quick-acting heart pills.