The number of patients with hypertension is increasing, and there are often some interesting points raised by patients, such as “it’s fine if you don’t use antihypertensive medication, but once you use it, you can’t get rid of it”, “how long do you take the medication for hypertension before it stops?” “I can stop taking blood pressure medication after using blood pressure lowering therapy device” “I am anemic, how can I get high blood pressure?” “What kind of antihypertensive drugs are best?” And so on.
Over time, it has been found that many hypertensive patients have similar questions in their hearts, and there is a lump in their throats, so it is not painful to not understand. Here, we might as well summarize these common interesting views to analyze carefully to see whether it is reasonable.
First, can hypertension be cured?
Hypertension can be divided into secondary hypertension and primary hypertension. Secondary hypertension refers to hypertension caused by kidney disease, renal artery stenosis, adrenal tumors, etc. Some of this hypertension can be normalized by dealing with the underlying disease, for example, renal artery stenosis can be eliminated by placing a stent in the narrowed blood vessel, and adrenal tumors can be removed surgically, etc. After the underlying disease is removed, blood pressure will drop to After the underlying disease is removed, blood pressure will drop to normal.
However, there are not many patients with this type of secondary hypertension, and more hypertension (more than 95%) is primary hypertension, and what we usually call hypertension is generally referred to as primary hypertension. This type of hypertension is caused by a combination of factors, rather than which is the cause alone. Once this type of hypertension occurs, it cannot be completely eradicated in most cases unless strict lifestyle changes are made.
Radiofrequency ablation of the renal sympathetic nerve, which has been explored in recent years for severe and intractable hypertension, seems to have a positive effect on lowering blood pressure and may provide a surgical method to “cure” hypertension in the future, but So far, there is no definitive cure for essential hypertension by drug or single means. Therefore, long-term lifestyle adjustments and effective antihypertensive medications are needed.
Here we have to mention those who blow the mysterious “antihypertensive recipe” “antihypertensive device”, these products almost all boast that they can cure hypertension, is there really such a miracle? If there is, there is still a need for so many people in the medical and pharmacy fields to work hard for hypertension? The facts are clear, those are just money tricks. The author, an old patient, because of listening to the magic of the “antihypertensive device”, stop taking antihypertensive drugs, the result was a stroke.
Second, the antihypertensive drugs will be dependent?
Many patients mistakenly believe that once they start taking blood pressure lowering drugs, they will become dependent on them and have to take them for life. I have heard some patients describe the feeling of concern to me as if they were worried about drug dependence. Is this really the case? No, absolutely not. All blood pressure medications do not make a person dependent on them, and it is not the blood pressure that becomes dependent on them.
The reason why lifelong medication is needed is because primary hypertension, as explained in the first article, is generally difficult to cure, and if medication is not used to lower blood pressure, blood pressure will remain at a high level for the rest of your life, and this will continue to cause cardiovascular damage. In order to lower blood pressure and reduce the risk of cardiovascular damage, it is necessary to take medication for life to continuously control blood pressure.
Therefore, it is not the blood pressure or the person who will become dependent on the medication, but the high blood pressure itself needs to be controlled with medication for life. So, once you have high blood pressure and still can’t return to normal through lifestyle adjustments, then, boldly choose antihypertensive drugs, because, that is the need to lower blood pressure.
Third, is there the best antihypertensive drug?
At present, there are 6 major classes of drugs used to lower blood pressure, and there are many varieties. The antihypertensive mechanism of each type of drug is different, and the side effects are also different; different varieties of the same class of drugs, the intensity and duration of antihypertensive also have differences. Because hypertension itself is caused by a variety of factors and mechanisms, the combination of multiple classes of drugs is needed to achieve good antihypertensive effect. It is very interesting that the combination of different classes of drugs not only enhances the effect of lowering blood pressure, but also counteracts or diminishes the side effects of each other.
In addition, the causes of hypertension are not identical in different people, and other physiological indicators of the body are also different and respond differently to drugs. Therefore, the choice of hypertension drugs is generally recommended in combination with medium- and long-acting drugs (that is, once-a-day, which is good for blood pressure stability), and emphasizes individualization (that is, different drugs are chosen according to the different physical conditions and antihypertensive responses of different individuals);
Overall, it is not possible to talk about which antihypertensive drug is the best, for a specific patient, as long as a certain drug regimen can steadily lower blood pressure, and does not lead to significant side effects, then for him (or her) is a good drug program.
Fourth, does anemia prevent hypertension?
Is there any relationship between anemia and blood pressure? Let’s make a less appropriate analogy and think of human blood as a grainy orange drink. Anemia refers to a decrease in hemoglobin content in the blood, which is less than the normal level, just like a grainy orange drink with too few orange meat particles, which does not meet the standard requirements. The high blood pressure refers to the pressure caused by the blood flowing in the arterial blood vessels, just like the pressure caused by the drink rushing into the bottle when filling the grainy orange, which has nothing to do with the amount of orange meat particles.
Therefore, anemia is not related to hypertension. Unless it is acute anemia caused by acute hemorrhage, that may be accompanied by low blood pressure or even shock, but that is also not caused by anemia natively, but by overall loss of blood. Therefore, anemic people can have high blood pressure as usual.
Fifth, there is no need to take medicine for high blood pressure without discomfort?
Often asked by patients, high blood pressure does not feel uncomfortable, but once you take antihypertensive drugs but uncomfortable, does it mean that such high blood pressure does not need to take drugs? The answer is: No! Most high blood pressure does not cause significant discomfort because the human blood vessels do have a strong ability to regulate blood flow according to blood pressure.
However, as long as blood pressure continues to operate at a high level, then damage to blood vessels, and to target organs such as the heart, brain, and kidneys, continues to progress and sooner or later will cause major problems, even catastrophic consequences. Therefore, regardless of whether there is discomfort, as long as the blood pressure is high and cannot be restored to normal levels through lifestyle adjustments, you should take antihypertensive drugs, as for the discomfort of taking drugs, you need to analyze the specific situation, adjust the drug regimen and find the right drug.
There are many other seemingly reasonable, but actually unreasonable views, most of which are caused by a lack of understanding of hypertension, concerns about drug side effects and other factors, and it is recommended that patients with hypertension discuss more boldly with a professional cardiovascular physician. The most taboo is to easily believe in all kinds of word-of-mouth gossip, fear of medication or random drug changes, stopping medication, that often brings some avoidable adverse consequences.