A patient with hypertension often comes to the doctor asking the following questions.
1. How did my hypertension come about?
2. Am I having “primary hypertension” or “secondary hypertension”?
3.The doctor said I have high blood pressure, but I have no symptoms, can I not take the medicine?
4. Western medicine has side effects, but Chinese medicine has no side effects, can I take Chinese medicine?
5. I just started to have high blood pressure, so I should take something cheap.
6. My blood pressure is very inaccurate.
Let me tell you one by one.
1, the cause of hypertension
First of all, hypertension has a certain degree of heredity, if both parents have high blood pressure, children who usually live unhealthy, such as like smoking, alcohol, high sugar and high fat diet, do not pay attention to sports, coupled with the tension of life, work pressure and often stay up late, it is also easy to get high blood pressure at a young age. That is to say, if both parents have high blood pressure, it is best to be good at moderation in their own lives, do not envy others to eat and drink, blood pressure is normal as usual.
2, primary hypertension or secondary hypertension.
Most of the hypertension is “primary hypertension”, that is, no other diseases that cause high blood pressure, and only about 10% of patients with hypertension can find the cause, such as kidney disease such as chronic nephritis, nephrotic syndrome and other renal diseases, renal vascular stenosis leading to rapid fluctuations in blood pressure hypertension, adrenal tumors, etc. If these secondary factors are corrected, the blood pressure can return to normal and there is no need to take antihypertensive drugs in the future, while “primary hypertension”, which does not lead to increased blood pressure, can be found. “Oral antihypertensive drugs must be taken to maintain blood pressure.
3, on the question of whether to take drugs for hypertension.
This depends on the situation, if the blood pressure is only mildly elevated, in the absence of complications, the first found elevated blood pressure, blood pressure in 150/100mmHg below, you can first by improving lifestyle, observe 1-3 months, if the blood pressure can be to 140/90mmHg below, you can temporarily do not take antihypertensive drugs. However, if the blood pressure is higher than 150/100mmHg, or if heart, brain, kidney and vascular complications have developed, oral antihypertensive medication must be started immediately. I often talk to patients about the normalcy of blood pressure control. Hypertension is different from diabetes. In diabetes, even if the blood sugar is controlled normally, many complications are still developing, while in hypertension, as long as the blood pressure is controlled in the normal range, the quality of life and life expectancy of hypertensive patients is the same as that of people with normal blood pressure. renal and vascular complications.
I remember a patient with a high blood pressure of 200/110 mmHg and no symptoms. The doctor told the patient to take antihypertensive medication, but the patient refused, saying that a surgeon he knew told him that he could not take medication if he had no symptoms. We had no choice but to give up because of various persuasions. The patient came back to me a few days later and asked me to prescribe him antihypertensive drugs to eat. He said that the surgeon he knew had died suddenly of a brain hemorrhage due to his high blood pressure, and he was afraid, so he wanted to take antihypertensive drugs.
4. “Lowering blood pressure is the hard way”
No matter what method is used, as long as the blood pressure is lowered to normal, it is mostly successful, whether it is with Chinese medicine or Western medicine. But from the point of view of Western medicine, I recommend the current antihypertensive drugs with evidence-based medical evidence, such as the use of angiotensin-converting enzyme inhibitors (or angiotensin receptor antagonists) doubling other receptor blockers recommended for combined cardiac hypertrophy and heart failure, calcium antagonists recommended for combined stroke, diuretics can be considered for simple systolic hypertension in the elderly, and the use of proteinuria recommended for combined Use of angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists. Individualized programs are important.
5, from the price consideration; currently on the market can be divided into three kinds.
(1) Inexpensive domestic short-acting drugs (a few dollars a month), such as nifedipine, Beijing antihypertensive 0, etc.
(2) medium-priced (1 day cost 2 yuan/tablet) domestic long-acting drugs, such as pressurized, Landi, etc.
(3) expensive (costing more than 4 yuan a day): imported or joint venture drugs: such as Dextran, Boeotin, etc..
I personally think that according to their own affordability to choose. Of course there are expensive reasons for expensive.
6.How to measure blood pressure? There are three methods of measuring blood pressure.
(1) Clinic blood pressure, that is, to the hospital, the doctor to measure blood pressure, this blood pressure is susceptible to environmental and mental stress led to high blood pressure, performance of “white coat hypertension”, as the name suggests, see the doctor in a white coat, blood pressure will rise.
(2) 24-hour ambulatory blood pressure, which monitors blood pressure fluctuations over a 24-hour period and can detect nocturnal hypertension and early morning hypertension.
(3) is also my personal recommendation is the home self-measurement blood pressure, recommended automatic upper arm blood pressure machine. Some people say my own blood pressure measurement is not allowed, in fact, as long as the method is correct, home self-measurement blood pressure is still very accurate.
How to use: quiet, empty the bladder, rest 5-10 minutes, sit back chair; at least twice, sometimes need to measure multiple times, the 2 times the closest number of average (difference < 8 mmHg), such as the first 150/90, the second 140/88, the third 138/86, the latter 2 times the average, that is, the current blood pressure; morning, or afternoon, or evening; hypertensive people, before or after taking medication. Finally, again: hypertension, as long as the blood pressure is controlled in the normal range, the quality of life and life expectancy of patients with hypertension is the same as that of people with normal blood pressure, while on the contrary, if the blood pressure is not controlled, serious complications of heart, brain, kidney and blood vessels will occur in 5-10 years.