Adults with blood pressure ≥140 mmHg and/or 90 mmHg are considered hypertensive, regardless of age. The prevalence of hypertension among adults in China is as high as 25.2%, and the number of hypertensive patients nationwide is 270 million.
The prevalence of hypertension is 25.2% among Chinese adults, with 270 million people suffering from hypertension nationwide, making it the most prevalent chronic disease.
Hypertension is the most important risk factor for heart attack, brain attack and kidney failure. According to statistics, 2 million people die each year from diseases related to hypertension nationwide. Moreover, more than 60% of coronary heart patients, 80% of cerebral infarction patients, and 90% of kidney failure patients suffer from hypertension.
More than 60% of coronary heart patients, 80% of cerebral infarction patients, and 90% of cerebral hemorrhage patients have a history of hypertension. It can be said that hypertension is the most important “killer” of human health. Therefore, it is very important to understand hypertension correctly and control it strictly.
I. When to start blood pressure lowering treatment? What is the goal of blood pressure reduction?
The JNC8 (U.S. Hypertension Guidelines 8) released in early 2014 clearly states.
1. When to initiate antihypertensive therapy?
① Patients ≥ 60 years of age with hypertension, systolic blood pressure ≥ 150 mmHg and/or diastolic blood pressure ≥ 90 mmHg can initiate pharmacological antihypertensive therapy;
② Patients with hypertension < 60 years old, as long as the systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg that
2. Pharmacological antihypertensive treatment can be initiated. To what target blood pressure reduction?
① For hypertensive patients ≥60 years old, the target values for blood pressure lowering are <150 mmHg systolic and <90 mmHg diastolic;
② For hypertensive patients < 60 years of age, the targets are <140 mmHg systolic and <90 mmHg diastolic.
Of course, there are still different opinions on the target values for lowering blood pressure in patients with diabetes and renal disease, and the general trend is that the target values for lowering blood pressure in these two groups of patients should be more stringent. The occurrence of hypertension is associated with genetics and unhealthy lifestyles. To control hypertension, in addition to medication, lifestyle should be improved, but medication is undoubtedly the main measure. The starting medications for hypertension include ACEI class (Priligy class) drugs, ARB class (Satan class) drugs, CCB class (Diphenhydramine class), thiazide diuretics, beta-blockers, etc.
Second, common misconceptions in the treatment of hypertension
1, no feeling, there is no problem
Elevated blood pressure will feel headache, dizziness, tinnitus, insomnia, etc.. But some people feel nothing, which is like boiling a frog in warm water, slowly rising instead of uncomfortable. No feeling is not the same as no harm, and when you feel it after a heart attack, brain attack or brain hemorrhage, it may be too late. Therefore, elevated blood pressure, regardless of whether there is no feeling should be used drugs.
2, antihypertensive drugs can not just eat, once eaten can not be broken
Antihypertensive drugs are not addictive drugs, there is no dependence, can be stopped at any time. The problem is not to stop, once you stop the drug, blood pressure will rise again. Hypertension is a lifelong disease and needs to be controlled with medication for life. In this way, it is not the drug that is dependent, but the hypertension that is “dependent”. Of course, in the early stage of hypertension without family history, blood pressure can be normalized by improving lifestyle and can be treated without medication. Other than that, it should be treated with medication.
3. Not to use good drugs at the beginning
High-grade antimicrobial agents cannot be preferred for treating infections because once they are resistant, there is no medicine available. This is due to the ability of bacteria to fight against drugs. The antihypertensive drug acts not on the bacteria but on the receptor, and there will not be a situation similar to antimicrobial resistance. The so-called good drugs not only have good antihypertensive effect with few side effects, but also have protective effect on heart, brain, kidney and other organs. So choose antihypertensive drugs, which is good, choose which, and start with a good drug.
4, high blood pressure to eat drugs, blood pressure is normal to stop the drug
Normal blood pressure after medication is the result of the action of drugs, is the balance under drug control, the balance is broken after stopping the drug, blood pressure will rise again; high with the drug, normal on stopping the drug. This pattern of medication on demand will lead to blood pressure is always in fluctuation, and heart attack, brain infarction and other complications are in blood pressure fluctuations occur.
5, the lower the blood pressure the better
Systolic blood pressure is best maintained between 110-140 mmHg, too high or too low, complications and mortality will increase, this is the famous J curve of antihypertensive treatment. By the same token, diastolic blood pressure should ideally be maintained between 70-90
mmHg between.
6.Increased blood pressure is found, and it should be quickly lowered to normal
Blood pressure is gradually increased, and the blood pressure should be lowered gradually. In addition to hypertensive crisis and other emergencies, rapid and substantial lowering of blood pressure is not recommended, otherwise it will cause cerebral perfusion deficit and other unexpected situations. For hypertensive emergencies, a slow reduction of blood pressure to 160/100 within 24 to 48 hours
mmHg within 24-48 hours is sufficient, and intravenous medication is generally not required. The common clinical use of sublingual cardiac painkillers (nifedipine) for emergency blood pressure lowering is currently considered inappropriate. In addition to lowering blood pressure too quickly, but also can cause sympathetic excitation and induce cardiovascular disease.
7, antihypertensive drugs should be replaced every few years
If the correct choice of antihypertensive drugs, blood pressure control is very good, and there are no side effects, should continue to use, it is not recommended to change the drug regularly. Unless new varieties are listed, and the new drugs have great advantages in terms of efficacy and side effects, you can consider changing the drug.
8. Any drug has side effects, including antihypertensive drugs.
However, FDA-approved original drugs (imported drugs) are relatively safe. If the drug is used according to the instructions, the side effects will be very mild. Do not choke, and the harm of high blood pressure, compared to the side effects of antihypertensive drugs is minimal.
9, antihypertensive drugs hurt the kidneys
This argument has been around for a long time and is very stubborn, where the word “kidney” also implies male sexual function. The sartans, the priligy, the diphenhydramine class of antihypertensive drugs through the lowering of blood pressure has the role of kidney, especially the first two types of drugs is the first choice of drugs for chronic kidney disease, and improve the role of sexual function. Arteriosclerosis caused by hypertension is the main cause of erectile dysfunction in men, lowering blood pressure, treatment of arteriosclerosis is also the main measure to treat male sexual dysfunction. In short, it is high blood pressure that hurts the kidneys, not antihypertensive drugs.
10, health products can also lower blood pressure
In recent years, more and more antihypertensive health care products, such as antihypertensive pillows, antihypertensive watches, antihypertensive caps, antihypertensive insoles, etc., these health care products claim to have a good antihypertensive effect, but the results are not so. The antihypertensive efficacy of health care products is simply not clinically certified by science, and the use of such health care products to lower blood pressure can delay the treatment of hypertension, even if the health care products are not harmful.