The 30-year-old Chen Xiaohe is a corporate executive, at a young age is already the boss’s competent staff, because of hard work appreciated by the boss. The company’s main business is to provide a wide range of products and services to the public. Is it caused by working too hard? Wang Yunfei, Cardiovascular Disease Specialist, Guangdong Provincial Hospital of Traditional Chinese Medicine
The incidence of hypertension accounts for about 10% of the total population and is considered a common disease. However, people’s understanding of it, there are still many misconceptions, once you find your blood pressure is higher than the normal range, you can not help but associate it with stroke, coronary heart disease, kidney failure and other complications together, thus creating panic, and the resulting anxiety. Therefore, from the perspective of Chinese and Western medicine, we can clarify a few of the more confusing concepts for our patients, so that we can decipher the misunderstandings.
Elevated blood pressure is not equal to hypertension
It is reported that the age of 50 to 60 years old is the main age group of hypertension, but with the rapid development of society, people’s lifestyle and diet structure is changing, due to some bad lifestyle and habits lead to the frequent occurrence of such old age diseases as hypertension, and show a trend of gradual rejuvenation. This kind of report to see more, can’t help but let Chen Xiaohe general age of young people panic inside for a while: the other day physical examination blood pressure mildly elevated, is it necessary to quickly take antihypertensive drugs to treat it?
So, a physical examination found that blood pressure is elevated means suffering from hypertension? In fact, such an understanding is wrong, once elevated blood pressure does not mean that it is hypertensive disease, do not make a fuss!
Elevated blood pressure, hypertension and hypertensive disorders are three different terms, which are named according to the development pattern and time of the disease. A short period of elevated blood pressure in a young person is not hypertension, much less hypertensive disease.
Elevated blood pressure, hypertension, hypertensive disorders
Elevated blood pressure: It is a blood pressure that is occasionally measured above the normal limit at one time. The World Health Organization and the Cardiac Society Organization have set 140/90 mmHg as the limit for hypertension, which can easily be exceeded by normal people under normal stressful conditions. For example, when exercising on a treadmill, the maximum heart rate can reach 170 beats per minute or more, and blood pressure can spike to 180/110 mmHg, but blood pressure can fall back to normal values on its own after stopping exercise.
Hypertension: When the elevated blood pressure is maintained for a period of time, whether at home, in the office or with ambulatory blood pressure monitoring, the blood pressure measured in any of the states exceeds 140/90 mmHg, it is called “hypertension”. Hypertension that has no known cause is called “primary hypertension”, while those with a clear cause are called “secondary hypertension”.
Hypertensive disease: untreated hypertension is likely to damage various organs and produce related symptoms called “hypertensive disease”. The common complications of hypertension include hypertensive heart disease, hypertensive encephalopathy, hypertensive nephropathy and coronary heart disease, etc., which are named according to the development pattern of the disease and the different organs damaged.
Therefore, there is no need to be overly nervous about an occasional rise in blood pressure or early mild hypertension, and it is worth checking the causes of the rise in blood pressure, such as whether it is too stressful, too anxious, poor rest, fatigue, insomnia, etc. After eliminating the factors that can affect it, blood pressure has a chance to slowly return to normal.
Do I have to take medication for life if I have high blood pressure?
I often hear middle-aged and elderly people complain that they can’t live without antihypertensive medication when they have hypertension, and that they have to carry it with them everywhere they go, and that they have to become “medicine jars” for the rest of their lives. So, does a diagnosis of hypertension mean taking medication for life and is hypertension incurable in current medicine?
It is a misconception that people with hypertension must take medication for life
Does the label “hypertension” mean lifelong treatment? Actually, the term “lifelong” should be defined as the period from the union of sperm and egg into a fertilized egg until the end of the individual’s life. Many young people do not have high blood pressure and can return to the original point after intervention, and their blood pressure can return to normal values. In addition, some hypertension is not lowered for a long time, complications will occur over time, but with complications, such as heart failure, the blood pressure is instead at normal values or low values can no longer rise, at this time also do not need to use drugs, so the treatment of hypertension is not to take drugs for life.
The treatment of hypertension should be based on the different conditions of the patient to develop different treatment plans, in order to maximize the benefits of the patient, do not replace the surface with a point! Most patients with occasional elevations do not need to be that nervous.
All hypertension that has no medical explanation for its occurrence is labeled “primary”, but the fact that current medical technology has not found a cause does not mean that there is no cause, and there should be a trigger for each rise in blood pressure, and blood pressure will return to normal after the cause is removed. Today’s white-collar young people with high blood pressure, mostly related to mental tension, anxiety, working at height, long-term driving or night work, if the change of occupation or workplace to interrupt their occupational persistence, blood pressure can mostly be reversed; but many people are difficult to give up their careers, not able to leave the risk of pathogenic factors in young people, more than the level of hypertension can only be treated with drugs to control blood pressure within a certain safe level, to reduce hypertension This is called “escorting”.
Young people like this can insist on taking medication for several years, and then slowly reduce the amount or even gradually stop the antihypertensive medication after switching to a lighter job, and the hypertension will be reversed after the causative factors are removed in the early stage, and the blood pressure will not increase even without medication in the end stage.
Correct measurement of blood pressure values provides the basis for adjusting medication
During the treatment of hypertension, the blood pressure data measured regularly by the patient can be used as a basis for treatment and medication. How many times a day should blood pressure be measured? What is the most accurate measurement? The method and timing of blood pressure measurement used by the patient are most important.
Blood pressure can also fluctuate under stressful conditions such as the white coat effect, exercise, and mood. When is the best time to measure? The first point in time is when the body is in basal metabolism. The basal metabolic rate is measured in the early morning after waking up and lying still under the covers, and the blood pressure of the right upper extremity is the basal blood pressure (the difference between the left and right upper extremities is 10-20 mmHg). The second point of time is to lie still under the covers after a lunch break at noon and measure the blood pressure of the right upper limb. The third point is to measure the blood pressure of the right upper extremity after sitting still for 10 minutes before dinner.
The blood pressure values measured at these three time points represent the basal blood pressure for the day, and this type of monitoring is easier for patients to perform, thus helping them to understand changes in blood pressure and determine the efficacy of their hypertension medication regimen. This is because hypertension needs to be based on data, like a weather forecast, and can be accurately determined once a uniform standard is in place.
Nowadays, there are many medical devices, but which one is the most accurate and reliable? Although direct pressure measurement in the arterial lumen is the most accurate measurement method, but because it is an invasive operation, the patient is very painful and needs to take certain risks, and it is also more troublesome to do, so Italian Riva-Rozzi invented the indirect pressure measurement method of mercury column, which basically replaces the vascular invasion pressure measurement. However, the shortcoming is that this measurement method requires professional doctors and nurses to perform, not convenient for patients to operate at home by themselves. Patients can use electronic blood pressure manometer to measure their own blood pressure, and this instrument can basically meet the needs of blood pressure measurement, because electronic data is easy to fluctuate each point in time only need to measure once.
Hypertension patients can only reduce cardiovascular complications with proper treatment and regular monitoring
According to media reports, Ms. Zhang suddenly fainted when she stood up after having a bowel movement in the toilet. Ms. Zhang’s husband rushed her to the hospital’s emergency department, where she was diagnosed with a brainstem hemorrhage. Doctors pointed out that brainstem hemorrhage is
The doctor pointed out that brainstem hemorrhage is very serious and can be life-threatening at any time. Ms. Zhang had high blood pressure before, and due to
The brain hemorrhage was triggered by constipation and too much force when going to the toilet.
Many hypertensive patients due to cervical spondylosis, emotional, quarrels, sports and other intense factors, blood pressure suddenly soared to a very high peak, in the emergency department can often see patients with blood pressure up to 200-220/110-120mmHg, such patients burst blood vessels triggered by the chances of stroke, brain hemorrhage?
If the blood pressure is not properly lowered, it is also easy to trigger a stroke
In fact, there is no need to worry so much, the emergency department has a large number of such patients, but statistics show that the proportion of patients with cerebral hemorrhagic strokes is small. Among emergency patients with hypertension-related cerebrovascular disease, the incidence of cerebral infarction is more than cerebral hemorrhage. Three major conditions are required for hypertension to cause cerebral hemorrhage (hemorrhagic stroke): first, the blood pressure is high enough, with systolic blood pressure reaching 180-220 mmHg; second, the blood pressure rises suddenly again at a very high level, triggered by a fall, anger, quarrel, defecation, coughing, etc.; third, the structural defects of the cerebral blood vessels themselves, such as atherosclerosis, can make the local blood vessel wall weak, and under the influence of high pressure, it can protrude outward to form a hemangioma. This forms the weak point of the cerebral blood vessel wall, and cerebral hemorrhage is often located in this area.
Many hypertensive patients today are afraid of hemorrhagic stroke caused by high blood pressure, and doctors will use many antihypertensive drugs to bring down the patient’s blood pressure, but after the patient’s blood pressure is lowered, the blood flow becomes slower and slower, which is not a good thing. This is because hypertensive patients are often combined with hyperlipidemia, or diabetes. Both hyperlipidemia and hyperglycemia make the blood sticky, phlegmatic and wet, which is normal under high pressure flow and not easy to form blood clots. Once the treatment of vasodilatation, diuretic, etc., the blood flow becomes slow and sticky, it is easy to form thrombus, which is why some patients when the blood pressure is not lowered properly many patients have sudden hemiplegia after going to the toilet the next day, there is a cerebral infarction caused by cerebral thrombosis, that is, ischemic stroke. Therefore, patients should regularly monitor blood pressure, the value should not be too low, the elderly should be maintained at 130/80mmHg in a quiet state, lowering blood pressure at the same time also actively control blood sugar and blood lipids, middle-aged and elderly people should also add aspirin enteric tablets to prevent the occurrence of ischemic stroke.
Correct use of drugs to lower blood pressure to avoid cerebrovascular events
Many people do not know that atherosclerosis begins to occur when we are 6 years old, and as we age, blood vessels age themselves, only the degree and location of individual damage varies, and the more risk factors occur, the more damage occurs. Risk factors often spoken by doctors refer to: high blood pressure, diabetes, high blood fat, high cholesterol, high uric acid, obesity, smoking, work stress, anxiety, genetic factors, etc.
High-risk patients should be treated with a combination of platelet inhibitors, anticoagulants and blood-vitalizing herbs to reduce blood viscosity, lipids, blood sugar and red blood cells, and the incidence of stroke will be greatly reduced by the correct use of drugs to lower blood pressure. Long-term use of antihypertensive drugs if drug resistance occurs, or two drugs, or a combination of drugs, to be stable blood pressure and then reduce the amount, and finally to maintain, to reduce the side effects of chemical drugs on the human body.