Hypertension is the most common cardiovascular disease, there is no one, China has hundreds of millions of hypertension patients, but I from the clinical contact of many patients, still do not have a correct understanding of hypertension, the following from a few key information points to do a popularization.
1. What is meant by hypertension? How to diagnose hypertension?
This is the first and most critical question to be clarified. Hypertension is defined as a blood pressure higher than 140/90 mmHg at rest, but it is not diagnosed by an occasional physical examination or one or two high blood pressure measurements at an outpatient clinic. What I always tell patients is that people are not machines and cannot always have a blood pressure of 120/80mmHg. Blood pressure fluctuates with emotion, exercise, and environment, etc. Anyone who runs a 100-meter sprint can have a high blood pressure, so it is most important to get a clear diagnosis.
In the past, patients were required to have a blood pressure higher than 140/90mmHg after resting for at least 10 minutes at three different times of the day to diagnose hypertension, but this is more difficult to grasp, my suggestion is to do a 24-hour ambulatory blood pressure monitoring, if more than 25% of the measured blood pressure exceeds the standard in a day, it can be diagnosed. It is important to know that once hypertension is diagnosed, it requires long-term medication and the cost and effort invested is difficult to assess, so it is important to get it right when diagnosing!
I often encounter such patients in the clinic, very young, complaining of headaches, high blood pressure, measured blood pressure is indeed more than the upper limit, but carefully questioned the medical history, with continuous late night, continuous work stress, emotional irritability, long-term insomnia and other medical history, such patients I call it “hypertensive state”, not yet confirmed the diagnosis of hypertension. It is recommended that the above-mentioned causes be removed first, and then continuous ambulatory blood pressure monitoring, if the diagnosis is clear, and then long-term antihypertensive drugs.
In addition, there are now many obese patients, especially abdominal obesity, that is, we say that the stomach is very large patients, often patients with “metabolic syndrome”, will have high blood pressure, abnormal glucose tolerance, such patients are first recommended on the basis of drug control of blood pressure, active weight loss measures, we found that, when the weight is significantly After good control, blood pressure will also return to normal, antihypertensive drugs can be discontinued in due course, I have many such cases.
2.Why do you have hypertension?
This is a frequent question. 95% of hypertensive patients should be diagnosed with primary hypertension. The cause of the disease is not yet clear, may be related to genetic genes, do not bother, can not find the cause is not necessarily a bad thing. Only about 5% of hypertensive patients are secondary hypertensive disease, the main secondary factors include: renal artery stenosis, renal parenchymal damage, adrenal occupancy, pheochromocytoma, other neuroendocrine tumors, etc.
3, what kind of hypertensive patients need to exclude the possibility of secondary hypertension?
I often encounter hypertensive patients who insist on investigating the cause of hypertension, I will tell them that the first priority is to take medication to control blood pressure and not to put themselves into the 5%. However, if the following conditions occur, please consult a doctor as soon as possible to exclude the possibility of secondary hypertension: hypertension that cannot be controlled by three antihypertensive drugs, unexplained hypokalemia, abnormal urine, pain in the kidney area, full moon face, buffalo back, severe acne, unexplained paroxysmal hypertension, sudden blood pressure fluctuations based on the original well-controlled blood pressure, etc.
4. Is hypertension dangerous?
Clinically, we encounter two types of people in particular, one is quite careless, one is very fearful, in fact, we need to correctly understand the hazards of hypertension, effective control of the hazards. The cardiovascular system of the human body is like a set of water pump system, normal people in the pump pressure moderate can be safely used for life, while hypertension patients in the pump system pressure increased, resulting in the pump (heart) work pressure increased, long-term easy to aging, and water pipes (arterial system) in the pressure continues to increase, a long time lead to early hardening of water pipes, and even the risk of water pipe rupture.
So the harm of hypertension is not instant, is a long-term slow process, the process is often decades, so many patients with hypertension do not take drugs for decades are very good; but once not controlled, will lead to systemic cardiovascular system harm, the late treatment is very difficult, will appear hypertensive heart disease, coronary heart disease, diffuse atherosclerosis, stroke, hypertensive kidney damage, the Fundus bleeding, aortic coarctation, peripheral artery stenosis and a series of other diseases. Therefore, the treatment of hypertension focuses on long-term adherence to treatment, as long as the blood pressure can be controlled for a long time, so that the cardiovascular pumping system works within the normal pressure range, it can effectively avoid the occurrence of the above complications.
5. How to control hypertension? How to take medication?
As we all know, hypertension requires long-term medication, but what drugs to take, how to match, there is a lot to learn, not just a few words can be said clearly, which requires individualized medication strategy depending on the specific circumstances of the patient, and long-term follow-up for adjustment, so please find experienced cardiovascular specialist consultation, the current antihypertensive drugs, the combination of a variety of significant effect, basically can be very good control of blood pressure The combination of antihypertensive drugs is very effective and can control blood pressure well. The fundamental principles are two.
1, is a long-term stable lowering of blood pressure;
2, is to reduce blood pressure to meet the standard, the latest U.S. guidelines recommend that under 60 years of age to reduce blood pressure standard is 140/90mmHg or less, more than 60 years of age standard is 150/90mmHg or less. It is recommended to equip a blood pressure monitor at home and monitor and record it regularly, which will be very helpful for our doctor’s medication.
How to take the medication? Now the antihypertensive drugs are once a day, it is recommended to drink water and take antihypertensive drugs first thing in the morning, which is related to our high morning hormone level.
6. Are the side effects of antihypertensive drugs significant?
This is a common concern of many patients and a frequent problem in outpatient clinics. In fact, the antihypertensive drugs now used in clinical practice have undergone large-scale clinical drug trials and have a clear understanding of side effects, the incidence is very low and the benefits definitely outweigh the risks. In addition, now there are many kinds of antihypertensive drugs, such as a kind of antihypertensive drugs have side effects, you can timely replace other kinds, can effectively avoid the occurrence of side effects.
Hypertension is not a terrible disease, the key is the correct diagnosis and treatment!