About the prevention and treatment of hypertension, I often hear some patients’ misunderstanding, and even some doctors have misunderstandings, I will put together these misunderstandings 9, I hope it can be helpful to all friends. 1, “no symptoms, no treatment” Generally speaking, about 50% of early hypertension patients can not have any symptoms, this kind of hypertension is actually potentially more dangerous! Because, people with symptoms, will prompt him to timely consultation, adjust the treatment plan, thus contributing to the control of the disease; while people without symptoms, just due to individual differences, hypertension is not sensitive, and thus neglected to treat, but the harm caused by high blood pressure continues, as a result, many people until the emergence of heart failure, brain hemorrhage and other serious complications before going to treatment, regret is too late. Therefore, as long as the diagnosis of hypertension, should be seriously treated. 2, “high blood pressure to take drugs, blood pressure is not high do not take drugs” Many patients always take medication intermittently, thinking that high blood pressure before the need to take drugs, the result is repeated blood pressure fluctuations, cardiovascular and cerebrovascular events continue unabated. There are many factors that cause interruptions in medication, one of the key factors is the lack of awareness of the need for long-term treatment of hypertension, the misconception that once the blood pressure has dropped you can stop taking the medication, worrying about the adverse effects caused by a long period of medication. This misconception is extremely harmful and should be eliminated. It is important to know that hypertension is not yet curable, and it is due to the role of drugs that blood pressure is reduced to normal, and once the drug is stopped, blood pressure will quickly return to its original level. Therefore, patients with hypertension generally require lifelong medication. However, recent medical information suggests that careful and gradual withdrawal of medications is possible in selective cases, in which patients generally do not have complications, do not have cardiovascular risk factors, have their hypertension under long-term control at normal levels, and preferably are taking a single blood pressure-lowering medication. But this is best done under the guidance of an experienced physician, never stop the drug on your own. 3, “blood pressure below 140/90mmHg can be” by the traditional concept of hypertension prevention and treatment, thought that blood pressure down to 140/90mmHg is enough. This perception is a misconception, according to the latest information from foreign studies, 90% of people with normal blood pressure at age 55 develop hypertension later in life. The relationship between blood pressure and cardiovascular disease events is continuous and independent of other risk factors. For the entire range of blood pressure from 115/75 to 185/115 mmHg in individuals aged 40-70 years, the risk of cardiovascular disease multiplies with each 20 mmHg increase in systolic blood pressure or 10 mmHg increase in diastolic blood pressure. The higher the blood pressure, the greater the risk of future myocardial infarction, heart failure, stroke and kidney disease. The new classification of JNC7, the U.S. guidelines for the prevention and treatment of hypertension, is based on this relationship and revises the blood pressure classification to list prehypertension states, moving prevention interventions forward and intensifying interventions. Therefore, it is now advocated that the lower the blood pressure in the ideal range, the better, of course, the patient should be tolerable, without any other discomfort performance, try to control below 135/85mmHg, for combined diabetes, kidney disease, blood pressure level should be below 130/80mmHg or less, which can help reduce the risk of cardiovascular and cerebrovascular events and delay the deterioration of renal function. 4, “hypertension only need to take drugs is enough” The prevention and treatment of hypertension should be based on non-drug therapy, such as adjusting lifestyle, low salt, low fat, quit smoking and limit alcohol and exercise, and on this basis take antihypertensive drugs to control blood pressure at the ideal or target level. However, in reality, many patients rely too much on drugs and do not pay enough attention to non-drug therapy, such as carrying antihypertensive drugs in their pockets, as usual, pushing glasses, big fish and meat, which not only affect the efficacy of antihypertensive drugs but also make the risk of cardiovascular and cerebrovascular events still exist, so hypertensive patients must pay attention to non-drug therapy. Form a good lifestyle, overcome bad habits and enhance exercise. 5, “the faster the blood pressure is lowered, the better” Many hypertensive patients believe that “since hypertension is so harmful, it should be brought down quickly, so the faster the blood pressure is lowered, the better”. These patients always want to lower their blood pressure within a day or two, and if their blood pressure does not drop to a normal level after a few days of medication, they change their medication. As a result, the drugs are changed frequently, and one drug is replaced by another before it takes effect, always “toiling without success”, and blood pressure fluctuates and becomes unstable. In addition, some patients prefer the faster action of short-acting antihypertensive drugs, while the long-acting antihypertensive drugs are skeptical, always feel that the effect comes slowly. In fact, these perceptions are wrong. Except for a few hypertensive emergencies, such as hypertensive encephalopathy, hypertensive crisis, etc., the patient’s blood pressure is very high, the symptoms are very serious, if not quickly bring down the blood pressure, may occur dangerous, such patients should quickly bring down the blood pressure. In general, hypertensive patients are chronic, treatment emphasizes regularity and individualization, and it is not advocated that the blood pressure should be lowered too fast or too low at once, but should be gradually reduced to the ideal or target level, and can be smoothly lowered throughout the day 24 hours to minimize fluctuations in blood pressure. In this regard, long-acting antihypertensive drugs can achieve this purpose, so elderly patients with hypertension should try to use once-daily long-acting antihypertensive drugs. Heartburn (commonly used in the past) is no longer advocated for long-term application because of its rapid action and short maintenance time, which can cause a sudden drop and rise in blood pressure. Of course, if the hypertensive patient’s blood pressure suddenly rises (such as emotional excitement, force) and there is obvious discomfort, the use of cardiac pain Ding 1 tablet sublingual is still a simple, practical method of lowering blood pressure. 6, “antihypertensive without drugs” This is a common phrase in the advertising of many health products and antihypertensive devices such as antihypertensive tables, antihypertensive caps, antihypertensive insoles, etc. In recent years, many patients tend to be overly enthusiastic, thinking that after using these devices will not need to take antihypertensive drugs, which is actually inappropriate. Objectively speaking, for patients with mild hypertension, pre-hypertension or occasional elevation of blood pressure, certain health care products and antihypertensive devices may play a role in stabilizing and lowering blood pressure by adjusting yin and yang, balancing the meridians, plus correcting unreasonable lifestyles, which can be applied at the discretion of the doctor’s advice, but should still be regularly monitored, and once the control effect is not good, should be immediately under the guidance of the doctor If the blood pressure is not well controlled, additional antihypertensive medication should be administered under the guidance of a physician. For the vast majority of hypertensive patients, antihypertensive drug therapy is the most effective method, many drugs have been confirmed by many large-scale research, antihypertensive effect, some of the heart, brain, kidney and other organs and protection, so most hypertensive patients should be under the guidance of doctors, long-term antihypertensive drugs to maintain stable blood pressure, reduce heart, brain and kidney complications, this is a wise approach. 7, “compound antihypertensive preparations should have been eliminated” compound antihypertensive preparations commonly used are antihypertensive zero, compound antihypertensive tablets, compound Robitussin, etc., the composition of which generally contains blood pressure, promethazine hydrochloride, dihydrocoumaric acid, Librium, etc., because of the exact antihypertensive effect of these drugs, cheap, early development, so until today is still many The drugs have been developed earlier and are still essential for many hypertensive patients. However, with the progress of medicine, the development of antihypertensive drugs is also changing day by day, and new drugs are emerging all the time. I believe that many patients taking the above-mentioned compounded antihypertensive preparations will often hear, especially from many doctors, that “compounded antihypertensive preparations have big side effects”, “can cause depression”, and “have long been eliminated “, making them also puzzled. In fact, no problem is absolute. Some of the drugs contained in these compound preparations do have side effects, such as reserpine with sedative and tranquilizing effects, causing drowsiness, fatigue, long-term can cause mental depression; diphenhydramine is prone to elevated blood sugar and lipids, increased blood uric acid, etc.. However, the advantage of compound drugs is that the combination of drugs with multiple mechanisms of action has a good antihypertensive effect, while the amount of each drug is very small, so the side effects are very mild. For example, BP Zero only needs to be taken once a day, or even only once a few days, to have a good effect on lowering blood pressure. Here is a good example of the relationship between the side effects of a drug and its dose. The diuretic diazepam is a kind of antihypertensive drug, which has adverse effects on blood lipids and blood glucose, and has experienced “favored” – “put into the cold” – “favored again”. First, most studies confirmed its definite antihypertensive effect, so it was listed as the first-line drug in the stepwise treatment of hypertension; then, its adverse effect on lipid and blood glucose metabolism was found, and its application in hypertension was greatly reduced; however, recently, the U.S. hypertension control However, recently, the U.S. guidelines JNC-7 again put diphenhydramine in a very important position, stating that the drug should be used in most uncomplicated hypertensive patients, and in patients who are initially treated with a combination of 2 drugs, one of the classes of drugs should be diphenhydramine. Moreover, it is noted that the drug has essentially no significant metabolic side effects when applied in small doses. It can be seen that the “right and wrong” of compounded antihypertensive agents should be evaluated objectively and not beaten to death with a stick. Personally, I believe that this drug can be considered for patients with no complications, not too old, with average economic status and no depression-related manifestations. If the same hypertensive patient, I give him to eat antihypertensive zero, the patient compliance is good, blood pressure control is also good; another doctor gave him to eat luohuaxi, the patient can not adhere to, three days to fish, two days to sunbathe, blood pressure control is not good, these two treatment options that effect is better? 8, “new drugs, expensive drugs is good drugs” “every penny counts”, the more expensive drugs are better, imported than domestic good, new drugs than old drugs, is this really the case? This is really a drug consumption misconception, there is no inevitable positive relationship between drug prices and drug effectiveness, the price of drugs is determined by many factors (such as tax rates, national price policy, etc.), especially imported drugs and new drugs. And is a new drug a good drug? The answer is “not necessarily”. Especially for some imported drugs, the number of cases used in China is much less than that of older drugs, so the potential side effects of the drugs are not easily detected. Many older drugs, however, have been used clinically for a longer period of time, and once side effects are detected, the national authorities will definitely introduce corresponding countermeasures. Therefore, in terms of safety, the use of older drugs is safer. At present, the development of new antihypertensive drugs is rapid, many varieties, often dazzling patients, and some patients are “three to four”, not waiting for a kind of antihypertensive drugs to take effect, think the effect is not good, hearsay, casually switch to other new drugs. This is a very wrong approach. The treatment of hypertension places great emphasis on individualized medication, i.e., choosing the appropriate medication according to the patient’s specific situation, rather than a generalization. So be sure to use the medication under the guidance of a doctor, do not blindly pursue new drugs, expensive drugs, thinking that new drugs, expensive drugs must mean “good drugs”. Some drugs, though newer, may be the same as those commonly used in the past, such as Asterix, Lortin, Mono, Pilipinas, and Kepone. Some drugs may be good for most people, but may be contraindicated for some people. For example, Yashida is a very good drug to protect the heart, brain and kidneys, but patients with severe kidney failure should never use it! 9, “according to the experience of others to take antihypertensive drugs” There is a hypertensive patient is more enthusiastic, their own use of Betalex effect is very good, immediately told his friends, friends are worried about finding the right antihypertensive drugs, immediately also take this drug, the results of eating once, the heart rate slowed to more than 50 times, uncomfortable. What is going on here? The cause of hypertension is complex, there are many clinical subtypes, each person’s responsiveness to drugs, adaptability and tolerance are different, and the performance of various antihypertensive drugs also varies, so you can not use the same fixed pattern of medication, but should adhere to the “individualized” principle of medication, such as betalac is suitable for patients with fast heart rate, no heart failure and conduction The drug should be contraindicated in patients with hypertension who have a slow heart rate, cardiac insufficiency or conduction block. In a study of 4,000 patients with mild to moderate hypertension in the United States, it was found that after taking the first antihypertensive drug, blood pressure was not controlled in about 40% of the patients, and after changing the drug, satisfactory results were gradually obtained. This shows that hypertensive patients should be under the guidance of a doctor, regular treatment, and not simply rely on the experience of others to take medication.