Myths of hypertension.
1, hypertension to dizziness.
2, hypertension is not considered a disease, not uncomfortable without treatment.
3, hypertension after taking drugs that blood pressure is normal that can stop the drug.
4, pick the cheapest drugs, can bring down blood pressure to normal on it.
I. Hypertension epidemiology
The incidence of hypertension is increasing year by year. 5% (30 million) in 1959 and 18.8% (1 million) in 2001.
In 2001, 18.8% (160 million, 1 in 5), more men than women, higher in the north than in the south, and higher in urban than in rural areas. The onset of hypertension is influenced by various factors: lifestyle, dietary structure, mental factors (stress), and one’s own physique (genetics).
Second, the diagnostic criteria of hypertension
Blood pressure should be measured in the morning and at bedtime. Any time three times blood pressure is higher than normal.
Hypertension criteria: systolic blood pressure ≥ 140, diastolic blood pressure ≥ 90 mmHg.
Ideal blood pressure: systolic blood pressure ≤ 120 mmHg, diastolic blood pressure ≤ 80 mmHg.
Normal high value: systolic blood pressure 130-139 mmHg, diastolic blood pressure 80-89 mmHg.
Three, hypertension risk factors
1, overweight obesity. bmi (body mass index) every increase of 1, 5 years the chance of hypertension increased by 9%; increase 3, the chance of hypertension more than 50%. bmi = weight Kg / (height m) 2, normal value of men < 25, women < 24, > 30, 29 obese.
2, alcohol consumption: men who continue to drink alcohol than non-drinkers, the risk of hypertension increased by 40% within 4 years.
3, diet: high salt (North 12-18g, South 7-8g), low potassium, low calcium diet, low animal protein diet.
4, other: mental factors, genetics, smoking, occupation (mental > physical labor), age (> 40 years), diabetes, dyslipidemia, environmental pollution (urban > rural).
Fourth, the harm of hypertension
Increased blood pressure can cause damage to blood vessels and organs (heart, brain, kidney, retina) throughout the body, and it is in the subtle, they do not feel, the damage has already occurred, when the real performance is irreversible. For example, heart enlargement, cardiovascular atherosclerosis, angina, heart attack; brain infarction; blood vessel narrowing, peripheral vascular atherosclerosis; kidney atrophy, kidney failure; retinal degeneration, detachment, cataract, blurred vision. Long-term hypertension predisposes to increased blood glucose.
Therefore, for the first consultation of patients with long-term hypertension, they should lower blood pressure on the one hand, and check for complications on the other hand, (cardiac and carotid ultrasound, renal function, blood glucose and lipid tests, examination of fundus, and if necessary, cranial MRA), and after examination, treatment of related complications and prevention of cardiovascular disease.
V. Treatment of hypertension
1.Non-pharmacological treatment
① weight loss: reduce total caloric intake (fat, grain, increase high quality protein – soy products, fish).
②Salt restriction.
③ potassium and calcium supplementation: fresh milk, soybean products, fresh vegetables.
④ quitting smoking and limiting alcohol to <1 tael/day.
⑤ increase physical activity, 3-5 times a week for 20-30 minutes each time.
⑥reduce mental stress.
2.Drug treatment
(1) Five major classes of drugs.
The choice of drugs: according to the patient’s high or low blood pressure, economic conditions, sensitivity to different drugs, and other diseases of the body selection.
(2) Medication attention.
① Regardless of the drug, lowering blood pressure is the main purpose.
(2) Combination of drugs, compounded formulations – convenient.
(3) long-term medication.
④Stable blood pressure, with long-acting drugs.
⑤ the speed of lowering blood pressure, moderate.
⑥No use of cardiac painkillers and reserpine.
⑦ Pay attention to the side effects of different drugs.
⑧ Pay attention to the monitoring of blood pressure and the examination of complications.
⑨ Diuretic use should tell patients the risk of low potassium and regular checkups.
(3) Systolic hypertension in the elderly.
①Diuretics or calcium antagonists, lifestyle changes.
(2) Note the occurrence of postural hypotension and slow movement.