What is hypertensive cerebral hemorrhage?

  According to statistics, the incidence of cerebral hemorrhage (also known as hemorrhagic stroke, called stroke in Chinese medicine) is 60-80 people/100,000/year, and about 95% of patients with cerebral hemorrhage have hypertension, and the mortality rate of cerebral hemorrhage takes the first place in the whole cerebrovascular disease. The most common site of hemorrhage is the nucleus accumbens in the basal ganglia of the cerebral hemispheres, accounting for about 50% to 60% of cerebral hemorrhage. The death rate in the acute phase of cerebral hemorrhage is about 30-40%. The increase of intracranial pressure caused by hematoma and the brain herniation of brain tissue by pressure displacement are the direct causes of death of patients. Early cerebral hemorrhage is characterized by sudden onset of hemiparesis, hemianesthesia, slurred speech, and even loss of consciousness. Studies have shown that reduced elasticity of cerebrovascular arterial wall and long-term hypertension are the endogenous and exogenous causes of cerebral hemorrhage; while diabetes, abnormal lipidemia, smoking and other factors can induce cerebral atherosclerosis, which is the main cause of reduced elasticity of cerebrovascular arterial wall. Hypertension is the most important extrinsic risk factor for hypertensive cerebral hemorrhage. Evidence-based medicine shows that after blood pressure is controlled to a satisfactory level by antihypertensive treatment in stroke patients, the risk of stroke is likely to be reduced to the same level as in patients without a history of hypertension. Therefore, both endogenous and exogenous factors should be used to effectively control hypertension and maintain long-term compliance, effectively control abnormal lipidemia and diabetes mellitus, and delay or prevent cerebral atherosclerosis, so as to maintain a strong resistance of the cerebrovascular arterial wall to counteract the impact damage effect of transient hypertension on cerebral vessels, and thus reduce the risk of cerebral hemorrhage.  First, blood lipids and blood cholesterol levels should be controlled: regardless of hypercholesterolemia, hypertriglyceridemia, high LDLemia and low HDLemia, all four are abnormal lipidemia and independent risk factors for the occurrence of atherosclerosis. The basic measure to correct abnormal lipidemia is to control 30 grams of edible fats, 200 grams of meat, poultry, fish and eggs, and 400 grams of pasta and other high-energy foods in the daily diet; if the diet cannot be controlled or is unsatisfactory, “statins, fibrates, bile acid chelators and fish oil” can be used alone or in combination according to the characteristics of abnormal lipidemia. In order to keep the lipid level in the normal range for a long time, it is necessary to conduct frequent tests.  Second, reasonable control of blood sugar, the incidence of atherosclerosis in diabetic patients is two to four times higher than in non-diabetic patients, and the disease is more serious, the age of onset is earlier, atherosclerotic disease often becomes the direct cause of death in diabetic patients. Diabetic patients are mostly associated with risk factors such as abnormal lipidemia, insulin resistance, and coagulation disorders. If the dietary control is not satisfactory, according to the different pathological states of diabetic patients, “insulin, insulin sensitizers, insulin secretagogues and biguanides” can be used alone or in combination to carry out standardized treatment, and frequent tests should be conducted to keep blood glucose and lipids in the normal range for a long time.  Finally, long-term effective control of hypertension and prevention of sudden and sharp rise in blood pressure are the keys to prevent cerebral artery rupture. Blood pressure should be lower than 140/90mmHg for general patients and 130/80mmHg for patients with coronary heart disease and diabetes. blood pressure should be measured once a day during the period when it is not up to standard so that medication can be adjusted until it is up to standard; after it is up to standard, blood pressure should be measured at least once a month to ensure that it is always controlled within the standard. The basic methods for effective control of hypertension are: “long-term adherence to standardized drug therapy, 24-hour stable antihypertensive (do not arbitrarily stop the drug and arbitrarily increase the dose); low salt and more vegetables; quit smoking and limit alcohol; control the ideal weight; appropriate physical activity and maintain a relaxed mood”. In short, that is, to achieve a reasonable diet, appropriate amount of exercise, psychological balance. Reasonable diet is summarized as “ten words”, namely, one, two, three, four, five, red, yellow, green, white and black. “One” refers to one bag of milk per day; “two” refers to about 250 grams of carbohydrates per day; “three” refers to three to four servings of high-protein foods per day; ” four” refers to four phrases, coarse and fine, not sweet and not salty, three, four, five meals, seven or eight minutes full; “five” refers to 500 grams of vegetables and fruits per day. The “red, yellow, green, white and black” refers to drinking red wine and green tea in moderation every day, eating some yellow vegetables, green vegetables, oatmeal and black fungus. Moderate exercise: every day according to their physical condition to do 40 minutes of brisk walking exercise, it is recommended to walk 120 steps per minute of brisk walking is appropriate. Mental balance refers to the correct treatment of themselves, others, and society, to help people in good times, to enjoy themselves in bad times, and to be content with what they have on a regular basis. Excited drinking at banquets and quarrels with others are most likely to induce cerebral hemorrhage. Don’t fight for a moment and leave a lifetime of regret.  In addition, season and climate are also related to cerebral hemorrhage. In winter, the prevalence of cerebral hemorrhage is high, and in summer, when the outside temperature is high, cerebral hemorrhage can also be triggered by the low temperature of indoor air conditioning. Therefore, proper warmth and avoiding sudden cold and heat are also effective measures to prevent cerebral hemorrhage.