Some patients with hypertension tend to be satisfied with the effect of lowering their blood pressure values after taking medication, but not reaching their target values.
One of the misconceptions: a little high blood pressure is not relevant, no need to make a fuss. Wang Tao, Department of Cardiac Surgery, Qilu Hospital, Shandong University
In fact, a large number of observational studies have confirmed that blood pressure even a little higher cardiovascular disease risk will increase significantly, for high blood pressure must not take a carefree attitude must be taken seriously.
Myth No. 2: There is no harm in having a high systolic blood pressure, as long as the diastolic blood pressure is normal.
The long-held view that the danger of hypertension lies mainly in the increased diastolic blood pressure level should be corrected. Because, the latest clinical research confirms that the danger of increased systolic blood pressure is much greater than that of increased diastolic blood pressure.
Myth No. 3: Increased blood pressure in the elderly is a physiological phenomenon.
Increased blood pressure in the elderly is not a physiological phenomenon, and the diagnostic criteria for hypertension in the elderly are the same as those for young people. The Chinese guidelines for the prevention and treatment of hypertension state that the goal of hypertension in the elderly is to reduce systolic blood pressure to <150 mm Hg. The guidelines also state that it can be further reduced if tolerated. However, this is a point of disagreement internationally, because the heart and blood vessels are already aging and need more protection, and older people need to have the same blood pressure levels as younger people. The same level of high blood pressure is more harmful to the elderly than to the young.
Myth No. 4: Patients whose heart, brain and kidney functions are already impaired should not have their blood pressure lowered.
In the past, it was thought that in patients who had damage to the heart, brain and kidney, blood pressure should be higher to maintain the blood supply to the organs, and that lowering blood pressure would aggravate ischemia. The current view is that hypertensive and diabetic patients with damage to the target organs of the heart, brain, and kidneys need more aggressive blood pressure lowering in order to protect the damaged organs and avoid further deterioration due to increased blood pressure.
Myth No. 5: Antihypertensive drugs stop and eat, can not adhere to.
Hypertension is a chronic disease, only long-term adherence to medication, in order to effectively reduce its harm. Stop eating to eat, easy to cause blood pressure fluctuations, not only not beneficial but harmful.
Myth No. 6: Blood pressure down to normal should be stopped, wait until the high up and then take drugs.
Blood pressure down to normal, can only explain the effect of drugs, can not indicate that high blood pressure has been cured. Hypertension usually requires lifelong adherence to medication. After the blood pressure has stabilized and normalized, it is sometimes possible to reduce the medication in small amounts under close observation, but it is not advisable to stop taking the medication. Otherwise, blood pressure will rebound in most cases.
Myth No. 7: The demand for rapid reduction of the increased blood pressure to the normal ideal level.
It is unrealistic and harmful to ask for a rapid reduction of the increased blood pressure to the normal ideal level, especially in patients with high blood pressure above 180 mmHa. Because the body has already adapted to the high level of blood pressure, if it drops too quickly, it will cause the body not to adapt to the new symptoms, organ blood supply will be damaged. Treatment should start with small doses of antihypertensive drugs, so that the blood pressure drops slowly and steadily, allowing the body to get a new adaptation and balance, is reasonable. In fact, some antihypertensive drug effects, too, do not occur immediately and require patience. Of course, there is an exception, that is, only acute hypertensive patients (including hypertensive crisis with acute target organ damage, hypertensive encephalopathy and other acute hypertensive patients) must be hospitalized as soon as possible to suddenly and sharply increased blood pressure control.
Myth No. 8: Constantly change the variety of drugs.
“Don’t take the same medication all the time to avoid failure.” Patients with this view often take the initiative to constantly change the variety of antihypertensive drugs. In fact, this is not true. Choose certain antihypertensive drugs, after obtaining satisfactory results should continue to adhere to take, generally will not fail, such as blood pressure fluctuations occur, should look for other reasons, including colds, fever, mood swings, stay up late, overexertion, etc. can lead to blood pressure fluctuations.
Myth No. 9: Try not to eat or take less medicine, because “medicine is three points of poison” well.
Indeed, drugs are a double-edged sword, incorrect use of drugs can bring problems. But please rest assured that after the strict approval of the listed drugs, basically safe and effective, do not worry about. Taking medication is like getting sick, it is not based on one’s subjective desire, but rather an objective existence, all based on the need to decide. As long as it is needed, we should take medicine under the guidance of a physician.
Myth No. 10: Chinese medicine is safer than Western medicine, so we refuse to take Western medicine.
This view needs to be corrected. Since all medicines can have toxic side effects, there are reports of disabilities and deaths caused by the toxic side effects of Chinese medicine. We advocate taking drugs that have been scientifically proven to be effective and safe.
Myth No. 11: Antihypertensive drugs should not be taken at night or before bedtime.
Because it is clinically observed that some patients have high blood pressure mainly in the morning or at night, it is reasonable to take medication at night or before bedtime for such patients, and the time to take medication should vary from person to person.
Myth No. 12: Medication should be stopped or reduced in summer.
This can only apply to some patients and is limited to a small, cautious trial reduction under close observation; discontinuation is often inappropriate.
Myth #13: Treated but blood pressure is not up to standard.
Some hypertensive patients tend to be satisfied with the effect of lowering blood pressure values after taking medication, but not reaching the target value. Hypertension guidelines put forward the target value of blood pressure reduction is ordinary hypertensive patients to 140/90mmHg or less. The word “below” is very important here. Because there is no specific lower limit for the target value. However, it is worth noting that the guidelines also suggest that “blood pressure levels start at 110/75 mmHg, and the risk of cardiovascular morbidity continues to increase as blood pressure levels rise. 94 mmHg, the risk of cardiovascular morbidity increases twofold.” From this passage, we understand that the ideal blood pressure value should be 110/75mmHg. If the blood pressure is lowered to below 140/90mmHg, such as 139/89mmHg level, it is just a barely passable level of the upper target value, should try to lower the blood pressure, the benefit will be greater. Blood pressure 120-139/80-89mmHg level, the United States is considered to be “pre-hypertension”, China’s guidelines are considered to be “normal high value”, in short, are considered to be non-normal range.
Myth No. 14: The misconception that the target value for lowering blood pressure is 140/90 mmHg.
We can see from the above, “compared with blood pressure <110/75mmHg, blood pressure 140/90mmHg increases the risk of cardiovascular morbidity by a factor of 2." Setting a target value of 140/90 mmHg for lowering blood pressure is certainly a misconception. To date, there are still many people who prefer to think that 140/90mmHg is a normal level of blood pressure value. In fact, a blood pressure of 140/90 mmHg has met the diagnostic criteria for hypertension. Based on the available evidence, the Chinese Guidelines for the Prevention of Hypertension (2005) recommend that blood pressure in patients with common hypertension should be strictly controlled to below 140/90 mmHg; in patients with diabetes and kidney disease, blood pressure should be reduced to below 130/80 mmHg; and in the elderly, systolic blood pressure should be reduced to below 150 mmHg, or further reduced if tolerated.
Myth No. 15: Judging the effect of treatment based on occasional blood pressure values.
Generally, blood pressure values fluctuate within 24 hours, and incidental blood pressure values (usually the office blood pressure values measured by a physician) can often lead to misdiagnosis (white coat hypertension, i.e., pseudohypertension as hypertension) and omission (a normal blood pressure that omits the presence of hidden hypertension), and often do not truly reflect the true overall blood pressure situation and the efficacy of antihypertensive treatment. At present, we advocate and encourage hypertensive patients to bring their own blood pressure monitor, just like diabetic patients monitor their own blood sugar, to understand the fluctuation of blood pressure around the clock by monitoring their own blood pressure. Most patients have the highest blood pressure in the early morning, but there are also patients with increased blood pressure at night. If possible, 24-hour blood pressure monitoring should be accepted, which will be very helpful in determining the effect of blood pressure lowering and formulating treatment plans.
Myth #16: Take medication based on symptoms.
Some people feel dizzy, headache and other uncomfortable symptoms when the temporary take some antihypertensive drugs, no symptoms when they believe that their blood pressure is normal, usually do not take drugs, which is not true. Because some hypertensive patients will have no symptoms even if their blood pressure is above 200 mmHg, these patients are called adaptive hypertension. Patients with hypertension are often asymptomatic, if at all. The only basis for taking medication should be the measured blood.