Winter is a high season for cardiovascular diseases, so how to let the elderly in the family spend the whole winter peacefully is an issue we must be concerned about. Today I will talk about three aspects that the elderly need to pay attention to in winter.
1.The effect of outdoor and indoor temperature on blood pressure
Hypertension, coronary heart disease and cerebrovascular disease are epidemiologically more prevalent in the north than in the south, which is clearly related to the low winter temperature and long winter time in the north. Some studies have shown that outdoor temperature below 50C, for every 100C decrease in temperature, systolic blood pressure increases by 6, 2mmHg, while for every 10mmHg increase in systolic blood pressure, the risk of cardiovascular and cerebrovascular increases by 21%, and the mortality rate of cardiovascular and cerebrovascular diseases in winter increases by about 41% compared to summer. Compared with outdoor temperature, the effect of indoor temperature on blood pressure is significantly greater than that of outdoor temperature. For every 10C decrease in indoor temperature, blood pressure increases by 0.22mmHg during the day and 0.34mmHg at night.
Outdoor temperature is difficult for us to control, but indoor stability we have a way to adjust, so we must remind the elderly, winter air conditioning, keep the indoor temperature at 22-25 degrees is appropriate. This money can not be saved, sometimes in order to save money, do not turn on the air conditioning, by increasing the dose and type of antihypertensive drugs to make blood pressure standards, not only can not play a role in saving money, but to increase the side effects of drugs, if the emergence of cardiovascular and cerebrovascular complications, resulting in serious consequences will be more than worth the loss.
2, the morning peak blood pressure and the morning exercise
To remind the elderly to pay attention to the early morning blood pressure, because the early morning hours (6-10 o’clock) blood pressure is the highest point of the whole day blood pressure, also called morning peak blood pressure.
(1) Because 6-10 a.m. is the most sympathetic time of the day, sympathetic excitement leads to higher blood pressure and faster heart rate, which is very unfavorable to patients with coronary heart disease.
(2) At the same time, many elderly people take antihypertensive drugs the day before are not really long-acting drugs, and the concentration of antihypertensive drugs in the blood stream is the lowest by the next morning. And in winter, this time of the lowest temperature, if the elderly in this time, especially when the sun is not yet out, risking the morning peak blood pressure, do strenuous exercise, resulting in the early morning blood pressure peak on the basis of blood pressure and then further increase, prone to cerebral hemorrhage, myocardial infarction and other serious consequences, the elderly in the early morning exercise is the occurrence of sudden death is not uncommon.
(3) So how to avoid this situation?
First of all, we should pay attention to our own early morning blood pressure, to be able to correctly measure early morning blood pressure
(4) Secondly, if your blood pressure rises in the morning, ask your doctor to help control your blood pressure in the morning, and recommend an upper-arm automatic blood pressure monitor for home self-measurement.
So do not go out early in the morning to exercise, must wait for the sun to come out, after the temperature comes up, after the peak of self-measured blood pressure at home, blood pressure is stable, and do not do excessively strenuous exercise, it is recommended that jogging, brisk walking and playing tai chi and other activities are appropriate.
3.Matters related to the taking of statins
Patients who are at high risk of atherosclerosis need to take aspirin and statin lipid-lowering drugs for prevention. The public awareness of aspirin is relatively high, and many people immediately associate it with liver damage when they mention “statin” lipid-lowering drugs (representative drugs include Sulforaphane, Lysergic, Cortisol, Lipitor, etc.), and refuse to use it when they think of liver damage.
In fact, statin is nature’s best gift to mankind, and it is the one drug that has been proven to extend human life. It is not only a lipid-lowering drug, but its greater role lies in its multiple effects beyond lipid-lowering, such as anti-atherosclerosis, anti-inflammatory, oxidative stress reduction and atherosclerotic plaque stabilization. So if there are no clear contraindications (patients with severe liver damage, creatine kinase >5x and severe rhabdomyolysis), use a statin lipid-lowering agent if you have the following four conditions.
(1) clinically manifest atherosclerotic cardiovascular disease such as acute coronary syndrome, previous history of myocardial infarction, stable angina, unstable angina, transient ischemic attack, cerebral infarction or peripheral arterial disease.
(2) Elevated primary low-density lipoprotein cholesterol (LDL-C) ≥ 190 mg/dl (4, 9 mmol/l).
(3) Patients with type 1 and type 2 diabetes, aged 40-75 years, with low-density cholesterol (LDL-C) of 70-189 mg/dl (1, 8-4, 9 mmo/l), without clinical manifestations of atherosclerotic cardiovascular disease.
(4) Those who have neither diabetes nor atherosclerotic cardiovascular disease manifestations, but have a 10-year cardiovascular disease risk of ≥7,5%.
In the above four cases, the advantages of using statin lipid-lowering drugs outweigh the disadvantages. In the process of use, especially after the first month of use, monitor liver function and creatine kinase, if they are normal, you can use them without worry, if there are obvious symptoms such as muscle pain and muscle weakness, promptly seek medical advice. If liver function abnormalities are more than 3 times normal and creatine kinase abnormalities are more than 5 times normal, they can usually return to normal after stopping the drug. After normalization, consider switching to other statins, or statin tapering, or switching to a cholesterol absorption inhibitor (ezetimibe) on the advice of your doctor.
We hope that the elderly will maintain a stable and positive mood throughout the winter, quit smoking, maintain good lifestyle habits, eat a low-salt and low-fat diet, do not overeat, do not stay up late, and control blood pressure, blood sugar and blood lipids. It is also important to keep the room temperature stable, not to feel cold on the body surface, and to monitor blood pressure in the early morning and avoid risking strenuous exercise with morning peak blood pressure. Prevention of disease is important, and the successful use of statins is also an important target for reducing cardiovascular disease risk in patients who require statin lipid-lowering medications. Drugs that must be taken must be taken, with less concern, and increased monitoring of adverse drug effects, as well as increased monitoring of self-symptoms, such as angina and discomfort such as headache and dizziness and numbness in the extremities, and prompt consultation.