The prevention and treatment of hypertension has long been an important issue in chronic disease management. Some developed countries have also started the research on the prevention and treatment of hypertension early, mainly through health education, non-pharmacological treatment, drug treatment, lifestyle intervention and community management measures to reduce the risk of hypertension and cardiovascular disease, and thus reduce the morbidity and mortality of cardiovascular disease in the population. In China, with the recent improvement of social and economic living standards and the arrival of aging, the number of hypertensive patients is also increasing, and is now close to 300 million people, which will seriously threaten the lives and health of the people. Therefore, good prevention and treatment of hypertension, especially how hypertensive patients do their own management, will have an important impact on the occurrence of cardiovascular and cerebrovascular diseases.
First, the current situation of hypertension in China
1, the characteristics of hypertension in China.
①High incidence of stroke areas, stroke/infarction = 5:1
②High sodium and low potassium diet
(3) More abnormal glucose and lipid metabolism, overweight and obesity
④Low awareness, treatment and control rate of hypertensive patients
⑤Most people do not take blood pressure for a long time, and most hypertensive patients do not
⑥Take blood pressure regularly, many hypertensive people do not know they are hypertensive
(7) 330 million hypertensive patients nationwide (current prevalence rate 25-30%)
⑧3.5 million people die of cardiovascular disease in China every year, half of which are related to hypertension
⑨Cohort shows that 66% of cardiovascular disease occurrence is related to hypertension
⑩ Hypertension accounts for 41% of the number of chronic disease outpatient visits, accounting for the first
2. Hypertension is the first risk factor for cardiovascular disease
CHD Ischemic stroke Hemorrhagic stroke CVD
Hypertension 20% 39% 54% 35%
Smoking 20% 9% 4% 13%
Hyperlipidemia 6 % 3 % 2 % 4 %
Low HLD 7% 4% 3% 4% 4%
Diabetes 4 % 3 % 2 %
Obesity 3% 6% 7% 4%
3. Risk factors for the development of hypertension in China
Non-variable Variable
Age Diets high in salt, low in potassium
Gender Overweight, obesity
Genetic factors Long-term excessive alcohol consumption
Long-term mental stress
Lack of physical activity
Second, the standard measurement of blood pressure
1. Problems of blood pressure measurement
Do not pay attention to the quality of blood pressure measurement
Use of unqualified blood pressure monitor
Electronic sphygmomanometer without clinical validation
Blood pressure measurement is not standardized
Incorrect blood pressure recording
2. Ambulatory blood pressure measurement (ABPM)
Automatic intermittent timing measurement of blood pressure in the 24-hour daily life state, more objective response to the 24-hour blood pressure, blood pressure rhythm, fluctuations.
Application object: diagnosis and assessment of hypertension, white coat hypertension, hidden hypertension, assessment of refractory hypertension, assessment of morning peak blood pressure, assessment of antihypertensive efficacy
3. Blood pressure measurement specifications
Practice specification for blood pressure measurement in the consultation room
Conditionally carry out ambulatory blood pressure measurement
Actively recommend home self-testing for hypertensive patients
Recommend internationally certified upper arm blood pressure monitor
HBPM, ABPM to assess white coat hypertension, covert hypertension, and early morning hypertension