With the development of China’s economy, the improvement of people’s living standard, mainly the change of residents’ diet structure and lifestyle, the prevalence of hypertension in China has shown a significant upward trend. 2002 China Population Nutrition and Health Survey results show that the prevalence of hypertension among Chinese adults is 18.8%, that is, there are about 160 million hypertensive patients nationwide, and one out of every five adults suffers from hypertension. Compared with 1991, the prevalence of hypertension in China increased by 31% in 2002, and the number of hypertensive patients increased by more than 70 million. Hypertension has become the most common cardiovascular disease in China.
I. What is hypertension
Hypertension refers to a sustained increase in arterial systolic and/or diastolic blood pressure. Whether it is a healthy person or a hypertensive patient, blood pressure is volatile, and blood pressure measured at different times often reads differently, and sometimes the difference is quite large. At present, China uses the international standard, if three consecutive non-same day blood pressure level systolic blood pressure ≥ 140mmHg, and (or) diastolic blood pressure ≥ 90mmHg that can be diagnosed as hypertension.
Second, the classification of hypertension
1, from the etiology of.
Primary hypertension: refers to the cause of unknown hypertension, accounting for more than 90%. The cause of primary hypertension is not clear, it is difficult to eradicate but can be controlled. Usually referred to as hypertensive disease is the primary hypertension.
Secondary hypertension: elevated blood pressure with a clear cause, accounting for 5-10%. It may be secondary to renal parenchymal disease, renal vascular disease, endocrine pathology, pregnancy or medication, and other causes. For secondary hypertension, treatment of the cause is more important, and part of it can be effectively controlled or even cured by surgical or interventional methods.
2. Classification according to blood pressure level.
Hypertension grade 1: systolic blood pressure 140-159, diastolic blood pressure 90-99; hypertension grade 2: systolic blood pressure 160-179, diastolic blood pressure 100-109; hypertension grade 3: systolic blood pressure over 180, diastolic blood pressure over 110.
Secondary hypertension includes primary aldosteronism, pheochromocytoma, renal artery stenosis, etc. Most hypertension is incurable and can only be controlled with medication for a long time.
Third, the cause of primary hypertension
The etiology of primary hypertension is not yet well understood. Epidemiological surveys and experimental studies show that its onset may be related to the following factors.
1, genetic factors: hypertension has a polygenic genetic characteristics, in the same family hypertension patients concentrated, not because they have a common lifestyle, mainly because of the presence of genetic factors. However, it is still very difficult to detect these genes clinically.
2, overweight: weight and blood pressure have a significant correlation. Epidemiological data show that obese people are 2 to 4 times more likely to suffer from hypertension than normal people, and with weight loss, blood pressure tends to fall with it.
3, dietary structure: too much sodium, a lot of alcohol, excessive intake of saturated fatty acids can make blood pressure rise; and if the diet is rich in sufficient potassium, calcium, high-quality protein, etc., can prevent the rise of blood pressure.
4, smoking: smoking can accelerate the process of atherosclerosis, the risk factors for hypertension.
5, mental, psychological and social factors: the prevalence of hypertension is higher in people engaged in highly stressful mental work than in physical work, indicating that hypertension is more likely to occur in people with long-term mental stress and lack of physical activity.
6, the impact of certain drugs: such as female contraceptives, hormones, anti-inflammatory painkillers, etc. can affect blood pressure.
Fourth, the symptoms and hazards of hypertension
Hypertension can lead to damage to the heart, brain, kidneys and other important organs and the occurrence of related diseases.
Most hypertension has an insidious onset and develops slowly. In the early stage, there is usually no symptom, occasionally headache and dizziness, palpitations, inattention, memory loss, fatigue, irritability and other symptoms; many patients are only found to have elevated blood pressure during physical examination. Hypertension can cause damage to target organs such as brain, heart, kidney and peripheral blood vessels. The early stage of target organ damage may be asymptomatic or have atypical symptoms, but the progression of the disease will result in organ failure. For example, brain damage caused by hypertension may result in increased headache and dizziness, loss of movement of half of the limbs, and even cerebral hemorrhage. In the case of heart, the heart gradually enlarges, and left heart failure may occur at a later stage, resulting in chest tightness, shortness of breath and cough. When the kidney function is impaired, there may be an increase in the amount of urine at night or an increase in the number of urination, and in severe cases, it may develop into renal failure, with symptoms such as little or no urine, loss of appetite and nausea.
V. Blood pressure control goals for hypertensive patients
Hypertension can cause damage to multiple organs, and antihypertensive treatment is more important to protect vital organs such as heart, brain and kidney. For different patients, the target blood pressure value to achieve the protection of vital organs varies. In general, blood pressure in hypertensive patients should be controlled at