1.Q: Who is prone to hypertension?
A: Heredity: People with a family history of hypertension are prone to hypertension. When both parents have normal blood pressure, the possibility of their children suffering from hypertension is only 3%; while both parents suffer from hypertension, the possibility of their children suffering from the disease will be as high as 45% to 50%. Tao Bo, hypertension department, Shanghai Ruijin Hospital
Age: Generally speaking, the older you are, the higher the prevalence of hypertension. People with hypertension can reach more than 50% in people over 65 years old. people whose blood pressure is still normal at the age of 55 have a 90% chance of developing hypertension in the rest of their lives.
Obesity: A large number of studies at home and abroad have shown that being overweight is an independent risk factor for the development of hypertension. For every 1 increase in body mass index (weight divided by height squared in kg/m2), the risk of hypertension increases by 10%.
Inappropriate diet: The risk of hypertension is increased in those who eat too much, high-calorie diet components, especially excessive intake of animal fat, excessive salt intake, and alcoholism.
Lack of exercise: Long-term adherence to sports is good for maintaining normal blood pressure, but the opposite is easy to increase blood pressure.
Stress: People who are engaged in highly stressful activities for a long time, including work stress and mental stress, such as brain workers, drivers, workers in three shifts and people who are often under stress, anxiety, anxiety, abnormal excitement and psychological imbalance for various reasons, have a higher prevalence of hypertension.
Menopausal women: Due to the rapid decline of estrogen levels in women during menopause, the sympathetic nervous system is excited, the vasodilatory center is abnormally sensitive to regulation, and small blood vessels are prone to spasm.
Generalized language: vulnerable people should pay more attention to blood pressure monitoring.
2.Q: Can teenagers also suffer from hypertension?
A: Yes, they can. It is estimated that the prevalence of hypertension among adolescents in China is 1 to 3 percent. This is mainly due to the fact that adolescents are in the growth and development period, blood pressure increases with age. In addition, genetics, obesity, improper diet, lack of exercise, high academic stress and some secondary causes such as renal parenchymal, renal vascular and endocrine diseases can also cause hypertension in adolescents.
Summarizing language: we should pay attention to the prevention and treatment of hypertension in adolescents.
3.Q: Are older people more prone to hypertension?
A: Yes. Generally speaking, the older you are, the higher the prevalence of hypertension. The common causes of hypertension in the elderly are the following: 1, vascular elasticity is reduced, the intima is thickened, often accompanied by atherosclerosis, resulting in reduced buffering capacity of the blood vessels, so that the pressure generated by the contraction of the heart is almost completely unchanged to the aorta, so that the aortic systolic pressure increases rapidly, and in diastole the aorta does not have enough elastic retraction to maintain diastolic pressure, resulting in increased pulse pressure, which is the elderly simply This is the main cause of systolic hypertension in the elderly; 2, the central and peripheral pressure regulating system in the elderly have different degrees of impairment, resulting in high blood pressure volatility in the elderly; 3, the elderly have reduced renal function, reduced renal blood flow, reduced glomerular filtration rate, impaired reabsorption, secretion and concentration functions, reduced sodium discharge capacity, easily causing water and sodium retention, resulting in volume dependent blood pressure elevation.
Conclusion: Blood pressure is more likely to rise in the elderly, and blood pressure control should be given more attention.
Introduction of other cardiovascular risk factors and their relationship with hypertension (diabetes, etc.)
4.Q: What is the relationship between elevated blood lipids and elevated blood pressure?
A: Elevated blood lipids and elevated blood pressure are both major risk factors for atherosclerosis, and they are both independent of each other and closely related to each other. A lot of research data shows that many hypertensive patients have disorders of lipid metabolism, especially the content of triglycerides is significantly higher than normal people, followed by the increase of total cholesterol and LDL cholesterol, while the content of HDL cholesterol is lower; on the other hand, many patients with hyperlipidemia are often combined with hypertension, and the two are causal. The presence of both is associated with a doubling of the incidence of cardiovascular disease.
In summary: elevated lipids cannot be ignored.
5.Q: What is the relationship between elevated blood sugar and hypertension?
A: Many hypertensive patients are often accompanied by diabetes, and diabetic patients are also often accompanied by hypertension, the two are called homologous diseases. Hypertension and diabetes may have a common genetic predisposition; diabetes is prone to kidney damage, and kidney damage can raise blood pressure; blood vessels in diabetic patients are more sensitive to angiotensin, which has an elevating effect on blood pressure, and therefore more likely to cause hypertension. The incidence of cardiovascular and cerebrovascular diseases will also increase exponentially with the presence of both.
Conclusion: Elevated blood sugar should not be ignored.
6.Q: What is the relationship between elevated gout or blood uric acid and elevated blood pressure?
A: A large number of epidemiological studies have consistently confirmed that elevated blood uric acid is an independent risk factor for the development of hypertension. more than 25% of patients with primary hypertension have combined hyperuricemia. For every 59.5 umol/l increase in blood uric acid level, the relative risk of developing hypertension increases by 25%. Blood pressure is no longer elevated if blood uric acid is normalized by concomitant administration of blood uric acid lowering drugs such as allopurinol or benzosulfan.
Summarize the language: blood uric acid elevation also need to pay attention to.
7.Q: Hypertension, obesity, hyperlipidemia, hyperglycemia will occur at the same time?
A: Will. Hypertension, obesity, hyperlipidemia, hyperglycemia at the same time the chance is very high, medical collectively called metabolic syndrome. Patients with metabolic syndrome have a significantly higher incidence of cardiovascular disease than normal people.
Generalized language: metabolic syndrome is more dangerous.
8.Q: What is hypertensive emergency? What are the manifestations of hypertensive crisis and hypertensive encephalopathy respectively?
A: Hypertensive emergencies are manifestations of severely elevated blood pressure (BP>180/120mmHg) with progressive target organ insufficiency. Hypertensive emergencies include hypertensive encephalopathy, intracranial hemorrhage, acute myocardial infarction, acute left ventricular failure with pulmonary edema, unstable angina, and aortic coarctation aneurysm.
Hypertensive crisis includes hypertensive emergencies and hypertensive sub-emergencies (severely elevated hypertension without target organ damage). Therefore, whenever blood pressure is severely elevated, regardless of the presence of blood pressure encephalopathy, intracranial hemorrhage, acute myocardial infarction, acute left ventricular failure with pulmonary edema, unstable angina pectoris, and aortic coarctation aneurysm, it can be called hypertensive crisis. Most patients with hypertensive encephalopathy have three major features: headache, convulsions and impaired consciousness, which are called the triad of hypertensive encephalopathy.
Generalized language: Hypertensive emergencies should be immediately sent to hospital for treatment.
9.Q: What are the characteristics of hypertension in the elderly?
A: The characteristics of hypertension in the elderly: 1, mainly elevated systolic blood pressure, pulse pressure difference is large. 2, blood pressure fluctuations. 3, blood pressure is susceptible to postural changes, the incidence of postural hypotension is higher. 4, more complications, comorbidities. Therefore, blood pressure should be measured regularly during anti-hypertensive drug therapy and the amount of medication should be adjusted at any time. The selection of medication should take into account the indications and contraindications for the use of medication for complications and comorbidities. Drugs that can cause postural hypotension, such as α1-blockers and tachyphylaxis, should be used with caution. The speed of lowering blood pressure should be slow, and blood pressure should not be lowered too low.
Conclusion: Caution is needed in the use of medication for hypertension in the elderly.
10.Q: What is white coat hypertension?
A: If the blood pressure measured in the hospital is higher than the normal standard, but the ambulatory blood pressure is normal, it is called white coat hypertension. According to domestic and international research, some white coat hypertension may be a prehypertension state, easy to develop into a real hypertensive disease.
Summarizing language: white coat hypertension should not be ignored.
11.Q: What is intractable hypertension?
A: When the application of at least three different mechanisms of action of drug therapy still can not be controlled in the normal range of blood pressure, known as refractory hypertension (Refractory hypertension), the current academic community is mostly known as refractory hypertension (Resistant hypertension). Pseudo-refractory hypertension, such as white coat hypertension and white coat effect, must first be excluded before diagnosing refractory hypertension. In addition, a thick upper arm without a suitable cuff can also cause pseudo-obstinate hypertension. The causes of intractable hypertension are: poor compliance with treatment, still applying blood pressure raising drugs, failure to adjust lifestyle (weight gain, heavy alcohol consumption), volume overload (inadequate diuretic therapy, progressive renal insufficiency, high salt intake), and undetected other causes.
Conclusion: Intractable hypertension needs to be treated by a medical professional.
12.Q: Can poor sleep cause blood pressure to rise?
A: Under normal conditions, blood pressure is lower when a person is asleep than when awake, but in most patients with severe obstructive sleep apnea syndrome, blood pressure can be significantly higher after sleep. In addition, a study by Columbia University found that sleep disorders can also directly affect a person’s blood pressure level. People who sleep effectively for less than 6 hours a day have twice the risk of developing hypertension and have a high average 24-hour blood pressure and heart rate.
Conclusion: Poor sleep affects blood pressure.
13.Q: Is there occult hypertension?
A: Occult hypertension (Masked hypertension) is a clinical phenomenon in which a patient has normal blood pressure in the office and elevated ambulatory blood pressure or self-measured blood pressure at home. There is growing evidence that occult hypertension is closely associated with cardiovascular disease.
Conclusion: The treatment of occult hypertension should not be neglected.