Question 1: What are the symptoms of hypertension and are there no symptoms to take medication?
The symptoms of hypertension mainly include headache, dizziness, lightheadedness, and head swelling, etc. In severe cases, they can be manifested as shortness of breath, dyspnea, swelling, visual impairment, nausea, vomiting, hemiplegia, oliguria, chest pain and other complication symptoms. However, there are not many people with typical symptoms, and many hypertension are asymptomatic, even systolic blood pressure up to 200 mmHg or more, and it is not uncommon to see people with no clinical symptoms or mild symptoms. The need for medication is based on the measured blood pressure, not on symptoms, and it is very dangerous to decide whether or not to take medication based on the presence or absence of symptoms.
Question 2: How is blood pressure measured? Are electronic blood pressure monitors inaccurate?
For adults with no clear previous history of hypertension, it is recommended that blood pressure be measured at least once every six months to a year. For patients with hypertension, blood pressure needs to be measured several times a week, sometimes multiple times on the same day at different times. It is generally best to rest for 5-10 minutes before taking a blood pressure measurement, and to avoid emotional stress, tea, coffee, and smoking for half an hour. The choice of sphygmomanometer generally uses the traditional mercury column sphygmomanometer in hospitals, and for self-measurement at home, it is recommended to choose an upper-arm electronic sphygmomanometer that conforms to international standards (ESH, BHS and AAMI), and it is not recommended to use a wrist or finger type. As for the accuracy of the electronic sphygmomanometer, the upper-arm electronic sphygmomanometer is currently considered to be as reliable and accurate as the traditional mercury column sphygmomanometer. Use each measurement 2-3 times, take the average, and keep records.
Question 3: Is hypertension a genetic disease?
The exact mechanism of hypertension is not very clear at present, but it is certain that it is a disease with a certain genetic tendency, but hypertension has obvious geographical and ethnic differences, and the tendency of family gathering may be more related to high salt diet, geographical environment and lifestyle relationship. Therefore, reasonable early dietary and lifestyle interventions are beneficial for the prevention and control of hypertension.
Question 4: Is it true that people with hypertension generally have a bad heart?
In terms of cardiac complications of hypertension, the main cause is left ventricular hypertrophy, enlargement and cardiac insufficiency caused by long-term uncontrolled hypertension. However, because hypertension and coronary heart disease, diabetes and other diseases have the characteristic of increasing incidence with age, and various cardiovascular diseases share many common pathogenesis and influence each other, so a high proportion of hypertensive patients have heart disease, especially long-term uncontrolled hypertension, middle-aged and elderly high-risk groups. The Chinese Hypertension Guidelines clearly state that hypertension is a major risk factor for stroke and coronary heart disease morbidity and mortality in our population, and that controlling hypertension can prevent cardiovascular and cerebrovascular disease morbidity and mortality.
Question 5: Do I need to take medication if my blood pressure is measured high? Shouldn’t blood pressure be controlled quickly to the target value?
High blood pressure is not the same as hypertension because there are many factors that affect blood pressure, such as stress, vertigo attacks, medications, etc. When these triggers are removed, blood pressure will return to normal if there are no hypertensive patients, and medication is not needed. Patients with mild hypertension without obvious complications and comorbidities can also be evaluated by changing their lifestyle and observing them for 3 months, and then consider taking medication if their blood pressure is not under control. For patients with hypertension with comorbidities, complications or cardiovascular risk factors should take medication for early intervention. Generally, except for hypertensive emergencies that require urgent and rapid blood pressure lowering, most patients should use gradual and smooth blood pressure lowering, especially in the elderly, where rapid blood pressure lowering may also lead to insufficient blood supply to vital organs.
Question 6: Is it true that hypertension medication cannot be taken easily, and once taken, it has to be taken for life and will have side effects?
Hypertension can be divided into primary hypertension and secondary hypertension. The so-called secondary hypertension is the elevation of blood pressure is caused by other clear disease, we call it “primary”, if early cure this primary disease, most patients will return to normal blood pressure, do not need to take drugs for life. Once diagnosed by a professional doctor, except for a low-salt diet, weight loss, moderate exercise and other non-drugs that can lower blood pressure to a certain extent, most patients need to take medication for life and cannot stop taking medication, which is similar to “drug addiction” and “tobacco addiction”. This is not at all the same thing as “drug addiction” or “smoking addiction”. According to long-term observations of large domestic and foreign populations, as the degree of elevated blood pressure gradually increases, various complications such as cardiac, cerebral and renal problems also increase rapidly, and the long-term survival rate also decreases rapidly. Therefore, the purpose of the “drug-based” antihypertensive program is to reduce various complications caused by hypertension, in order to reduce the rate of disability and death. All drugs have some degree of side effects, and there is no such thing as a drug without side effects. As long as the appropriate drugs are used under the guidance of a professional doctor, the side effects are manageable and the benefits must far outweigh the risks.
Question 7: If you have hypertension, you can’t start with expensive drugs, so you have to take expensive drugs all the time?
At present, the recommended first-line antihypertensive drugs are mainly divided into five categories according to their pharmacological effects, namely diuretics, beta blockers, calcium antagonists, angiotensin-converting enzyme inhibitors (ACEI) and angiotensin II receptor blockers (ARB); according to their duration of action, they can be divided into short-acting, medium-acting and long-acting drugs. Some of the long-acting formulations are due to the slow metabolic clearance of the drug itself, while some of the short-acting drugs are released slowly through the pharmaceutical process to achieve long-acting purpose. As can be seen, there is no classification of expensive drugs and cheap drugs in the classification of hypertension drugs. Because the price of drugs is mainly determined by the production cost of the drug itself, research and development costs, distribution costs, time on the market, suitable for the population (sales) and the price department pricing and many other factors, and the mechanism of action of the drug has very little relationship. When we choose antihypertensive drugs, we first choose first-line drugs, and then try to choose long-acting preparations that are taken once a day, because long-acting preparations have the effects of smoothly lowering blood pressure, reducing missed doses and better protecting target organs, and fewer complications. Technology continues to advance, and new drugs with extremely high development costs often have unique advantages over older drugs in some aspects and are promoted clinically. As a result, the price of newer long-acting drugs is relatively expensive, and with the extension of clinical use, research and development costs gradually recovered, and the number of manufacturers gradually increased, the price of drugs will gradually decline, and they will become “cheap drugs”. In addition, long-term use of antihypertensive drugs resistance and cross-resistance between different drugs is not obvious, stop using the drugs previously taken, replaced with different kinds of similar, different types of drugs and will not have much impact on the efficacy. Therefore, the statement “you can’t start taking expensive drugs for high blood pressure, so you have to keep taking expensive drugs” is completely wrong.
Question 8: Do I need an infusion when my blood pressure is high?
Except for hypertensive emergencies that require the use of intravenous antihypertensive drugs to control blood pressure under supervision, the vast majority of patients rely on oral antihypertensive drugs to achieve their goal. The current infusion of intravenous preparations of Western medicine and Chinese herbal medicine for many patients is of little use for long-term blood pressure lowering, except for the possible improvement of the patient’s symptoms.
Question 9: Are the side effects of TCM less than those of Western medicine?
Because traditional Chinese medicine requires diagnosis and treatment, each person will not be exactly the same, objectively speaking, the efficacy of pure Chinese medicine to lower blood pressure is not ideal, and there are not many varieties of pure Chinese medicine antihypertensive drugs on the market, and some literally Chinese medicine, in fact, are added with a variety of Western ingredients, and some Western ingredients are not the recommended first-line drugs, so Chinese (proprietary) antihypertensive drugs side effects are not necessarily small, or need to read the Therefore, the side effects of Chinese (proprietary) antihypertensive drugs are not necessarily small, or need to read the instructions and choose drugs under the guidance of a doctor. And many of the current advertising can completely cure hypertension disease is a complete fraud.
Question 10: What are the non-pharmacological treatment measures for hypertensive patients in addition to medication?
Non-pharmacological treatment for patients with hypertension is also very important, mainly: (1) low salt diet It is recommended that the daily salt intake per person should be less than 6g, or even lower, such as using less pickled products, MSG, soy sauce, and using measuring instruments to add salt; (2) balanced nutrition, reasonable diet Such as eating less animal fats and animal offal, it is recommended to use vegetable oil in moderation, especially olive oil, and eat protein-rich foods and (3) appropriate physical activity according to their own situation to choose the appropriate exercise mode and intensity, it is recommended to choose such as brisk walking, jogging, cycling, dancing and swimming and other aerobic exercise, avoid doing pushing, pulling, lifting and other long exercise; (4) weight control Overweight and obesity is one of the important causes of increased blood pressure, the most effective weight reduction measures are The most effective weight reduction measures are to control diet and increase physical activity; (5) Quit smoking and limit alcohol Smoking is one of the main risk factors for cardiovascular disease, even if it is passive smoking; Patients with hypertension do not advocate drinking alcohol, if they drink alcohol, the amount should be small, that is, the amount of white wine or wine (or rice wine) or beer is less than 50 ml, 100 ml and 300 ml respectively; (6) Adjust emotions and release mental stress. Reasonable non-pharmacological treatment is not only beneficial to control blood pressure, but also to reduce the development of all other cardiovascular diseases.