Cardiovascular disease is the main disease that threatens people’s health in the 21st century. It is mainly caused by psychological imbalance, unscientific lifestyle and unreasonable dietary structure, and it is sometimes difficult to rely on medication alone.
I. What is hypertension?
According to the World Health Organization and the Chinese Hypertension Alliance in 1999, the diagnostic criteria for hypertension are:
Systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg, are diagnosed as hypertension
Second, the epidemic characteristics of hypertension
Three high: incidence, prevalence, mortality
Three low: awareness rate treatment rate control rate
In 1991, the prevalence of hypertension among people aged 15 years or older in the whole gizzard was 11.26%, an increase of 25% from 1980. 160 million people were living in the whole country in 2004.
The national annual death of cerebrovascular disease more than 1 million, now surviving 5-6 million, of which 75% of the disease disability.
Third, who are vulnerable to hypertension
1, gender age
Both men and women, blood pressure increases with age. The prevalence is generally higher in young and middle-aged men than in women, and the rise in blood pressure is higher in women than in men before and after menopause.
2.Overweight and obesity
A simple formula can be used to calculate: height – 105 = standard weight. >10 for overweight, >20 for obese. Obesity has been listed by the W H O as one of the ten risk factors affecting a long and healthy life
3.Drinking alcohol
Long-term large amounts of alcohol (daily intake of alcohol 60g or more) of the prevalence of hypertension than those who do not drink alcohol is more than twice as high. Long-term heavy drinkers can also promote triglyceride synthesis, accelerating atherosclerosis, prone to cardiovascular accidents.
4, high salt
According to the survey, the average salt per 2g increase in systolic blood pressure increased by 2.0 mmHg, diastolic blood pressure increased by 1.2mmHg. 3 to 5 grams of salt per day, can make most hypertensive patients lower blood pressure.
5.Exercise
Most studies have shown that lack of physical activity is an independent risk factor for hypertension. Long-term regular exercise can reduce sympathetic nerve tension, so that the release of hypertensin is reduced and blood pressure decreases.
6, mental, emotional and psychological factors
High mental tension, emotional excitement, psychological imbalance, major trauma or grief, and type A personality, sympathetic nerve function is dominant, the level of pressor hormone is higher, small arteries contract, and blood pressure rises.
Fourth, the danger of hypertension to vital organs
1. Stroke
Large-scale studies in China have shown that blood pressure levels and stroke incidence are closely related, with a relative risk of stroke increasing by 49% for every 10 mmHg increase in systolic blood pressure at baseline (47% for ischemic stroke and 54% for hemorrhagic stroke) and by 46% for diastolic blood pressure.
2. Coronary heart disease
Especially when the risk factors increase, such as: smoking, obesity, diabetes, abnormal lipid metabolism, hypertension, etc., leading to angina pectoris, myocardial infarction.
3.Heart left ventricular hypertrophy (electrocardiogram, echocardiogram or X-ray changes), heart failure.
4, kidney
Hypertensive nephropathy, renal insufficiency and renal failure.
5.Aorta
Ultrasound or X-ray confirmed atheromatous plaque (carotid, iliac, femoral or aortic), entrapped aneurysm.
6.Pervasive or focal retinal arterial stenosis, fundus hemorrhage, blindness.
V. Principles of drug therapy for hypertension.
1, low toxicity, high efficiency, inexpensive, small doses ;
2, long-acting, slow release, controlled release, 1 tablet per day;
3, a single drug to achieve a certain dose of efficacy is not satisfactory, the combination of two or more drugs can be used to treat;
4, the first line of six types of recommended antihypertensive drugs
① Diuretics;
② β-blockers;
③ Angiotensin-converting enzyme inhibitors;
④ Calcium antagonists;
⑤ α-blockers;
(6) Angiotensin II receptor antagonists.
5.The selection of antihypertensive drugs should be based on the principle of individualization, different age, physical condition, disease and economic ability, and optimal selection.
6, after selecting an effective drug, generally must be long-term use, if there are no side effects, generally do not change the drug at will, let alone stop the drug at will.
7. Blood pressure should not be lowered abruptly, but within 2-4 weeks to the ideal level or to a level suitable for the patient, and to find a suitable dose for long-term maintenance.
Six, the preventive measures of hypertension
Healthy lifestyle
Scientific regulation of their lifestyles and behavior is the best remedy to prevent and treat hypertension.
Reasonable diet; moderate exercise;
Quit smoking and limit alcohol; psychological balance.
Healthy sleep
Specific measures: weight reduction, salt restriction: reduce the average daily salt intake per person to less than 8g, balanced diet, balanced nutrition, increase and maintain appropriate exercise, exercise should be consistent, orderly and moderate. The best exercise is walking. Maintain an optimistic mind, open-mindedness, light fame and fortune, benevolence, love and goodness. Improve stress capacity, improve personal health quotient, raise awareness of self-prevention of hypertension, and be able to actively seek medical attention once signs of hypertension appear. Quit smoking and limit alcohol consumption, with men drinking <20 to 30 g of alcohol per day and women <15 to 20 g. Pay attention to frequent blood pressure monitoring to keep blood pressure at the ideal level.
VII. Prognosis
For every 10/5 mmHg increase in blood pressure at baseline level, the risk of stroke increases by 48% and acute cardiovascular events by 20%-30%. If blood pressure can be maintained at the ideal or safe level, with reasonable diet, moderate exercise, smoking and alcohol cessation, psychological balance, healthy sleep, weight control, and good control of risk factors such as diabetes and abnormal lipid metabolism, the number of deaths due to cardiovascular and cerebrovascular diseases in China can be reduced by 300,000 to 400,000 each year, and we can all live a long and healthy life.