Because most patients with hypertension do not have obvious conscious symptoms, and complications appear slowly, so that patients do not see the serious consequences of the disease in a short period of time, therefore, hypertension is often referred to as a “silent killer” “time bomb”. Hypertension is the total bane of arteriosclerosis, cerebrovascular, coronary heart disease, and heart failure. Studies have proven that a 10 mmHg reduction in systolic blood pressure reduces the risk of stroke by 53% and the risk of coronary heart disease by 31%. Hypertension such as untreated survival 19 years, the average life expectancy of 51 years.
If treated with effective antihypertensive treatment, it is necessary to live 10-20 years longer than untreated people. However, in recent years, the control rate of hypertension in China is only 6.1%; hypertension caused by the above-mentioned complications not only not reduced, but also increased year by year. What is the reason for this? It is the misconceptions on the prevention and treatment of hypertension are at fault.
Myth 1: People are old, blood vessels are stiff, blood pressure is naturally higher than young people, no need to control blood pressure.
As we age, the blood vessels in the human body will have varying degrees of elasticity decline (or called atherosclerosis). Usually, systolic blood pressure continues to rise after middle age, while diastolic blood pressure stops rising or even declines as we enter old age due to atherosclerosis of the large arteries. Some people take for granted that increased blood pressure with age is natural and does not need to be treated with medication.
It is a pathological phenomenon with very serious consequences. The characteristic of hypertension in the elderly is that some of them only have elevated systolic blood pressure, while the diastolic blood pressure is normal, which is called simple systolic hypertension. Both elderly patients with simple systolic hypertension or those with both systolic and diastolic hypertension should have their blood pressure actively controlled.
This is beneficial in reducing their rate of cardiovascular disease episodes and mortality. Moreover, many elderly patients suffering from hypertension accompanied by hyperlipidemia, diabetes, heart failure, renal insufficiency and other diseases, if the blood pressure is not well controlled, blood pressure will “help the enemy to abuse”, so that these diseases greatly increase the damage to the human body.
Myth 2: Mildly elevated blood pressure, do not need to take drugs, or blood pressure rises again, there is no medicine to cure.
A study of high risk factors in 340,000 men, the results after 15 years of follow-up showed that of the total number of additional deaths from coronary heart disease due to elevated blood pressure, systolic blood pressure in the 120-139mmHg accounted for 31.6%, 140-159mmHg accounted for 42.9%, in > 160mmHg accounted for only 24.1%. This shows that mild hypertension can increase the incidence of coronary heart disease. From the study data, the largest proportion of mild hypertension was found, suggesting that mild hypertension should not be taken lightly! Unlike antibiotics, anti-hypertensive drugs do not generally produce resistance. If effective can be taken for a long time.
Misconception 3: What drugs others take, we also follow what drugs.
Hypertensive patients are often combined with coronary heart disease, angina pectoris, myocardial infarction, stroke, heart failure, kidney failure, diabetes, etc., take this antihypertensive drugs, but also need to take into account the treatment of these diseases, which is the basic principle of the choice of antihypertensive drugs (a drug for multiple uses).
Each patient’s comorbidities are different, of course, the use of different drugs, such as hypertension combined with coronary heart disease, no cardiac insufficiency, the first choice of beta-blockers, calcium antagonists; such as hypertension combined with cardiac insufficiency, the first choice of “Pulley” class or “Satan” class and If hypertension is combined with cardiac insufficiency, “Priligy” or “Sartan” and diuretics are preferred; different coexisting diseases, as well as according to the patient’s age and gender, should be used differently. For different groups of people, especially when accompanied by heart, brain, kidney, diabetes and other diseases, these require individualized medication under the guidance of a professional doctor.
Myth 4: High blood pressure without dizziness, headache and other uncomfortable symptoms, can not use drugs.
Most elderly patients with hypertension do not have obvious discomfort, and only when their blood pressure is very high will they have symptoms such as dizziness and headache. Some patients mistakenly believe that it is okay to have high blood pressure without symptoms, so they do not need medication. The first thing that should be clear is that hypertension is a disease that can be asymptomatic and that the risks and complications associated with hypertension are not caused by clinical symptoms, but by elevated blood pressure. The only basis for taking medication should be the measured blood pressure value. Normally, even if there are no symptoms, the decision to take antihypertensive medication and the dose must be based on the monitored blood pressure level.
Myth #5: Stop taking your medication once your blood pressure is normal.
Primary hypertension is a lifelong disease, incurable, and most people need to take medication for life, do not eat and stop. Blood pressure fluctuates from high to low, damaging to the heart, brain, kidneys and other organs, is very harmful! Even if blood pressure is controlled, it still needs to be maintained for a long time. Look for a minimum effective maintenance amount, and insist on taking it for a long time, so as to achieve a “long-term cure” for hypertension.
Some patients see advertisements and think that hypertension can be “cured” after treatment. The cause of primary hypertension is unknown, and so far it cannot be cured. Therefore, at this stage of science, if you say that you can cure hypertension, it is certainly a lie.
Some hypertensive patients think that their blood pressure is already normal, or taking antihypertensive drugs every day will make their blood pressure lower and lower, which is not scientific. This is not scientific. Because taking antihypertensive drugs every day to maintain normal blood pressure is like eating every day to maintain life, drugs and food are metabolized, and the maintenance dose taken every day is to supplement the drugs that are metabolized and excreted every day, so taking the maintenance dose will not make the blood pressure lower and lower. For hypertensive patients, there is a very important saying, that is, “rather forget a meal, not forget a medicine”.
Misconception six: “medicine is three parts poison” fear of side effects of antihypertensive drugs.
Some people believe that “medicine is three parts poisonous”, antihypertensive drugs can not eat as much as possible, must eat as little as possible. In fact, the drugs approved by the state are listed, are through a strict evaluation of the effectiveness and safety. Therefore, within the recommended dose, these drugs are usually very safe. Scientific studies have confirmed that antihypertensive drugs can effectively lower blood pressure and significantly reduce the risk of serious cardiovascular diseases such as stroke and myocardial infarction.
Therefore, one should not skip or take less or even refuse to take antihypertensive drugs because of the fear of adverse effects of antihypertensive drugs. In fact, it is very safe to take antihypertensive drugs under the guidance of an experienced doctor.
Myth 7: Antihypertensive drugs think that the fewer types you take, the better.
For many hypertensive patients, a single drug does not bring blood pressure down to the ideal level. generally speaking, a single antihypertensive drug can lower blood pressure by 10 to 20 mmHg. if a single drug does not bring blood pressure under good control, it is advisable to use 2 or more antihypertensive drugs in combination, rather than increasing the dose of a single drug. More than 70% of hypertensive patients need two or more antihypertensive drugs to achieve the blood pressure standard. The combination of drugs can reduce the dosage of each drug, reduce side effects and improve efficacy, and have a synergistic protective effect on target organs. Doubling one drug is better than pairing two or three drugs.
Myth #8: It’s OK for older adults to lower their blood pressure to 140/90
The guidelines require that all hypertensive patients have a blood pressure target of 140/90 mmHg or less. The word “below” is very important here. Because there is no specific lower limit for the target value. To date, many people still prefer to think that 140/90 mm Hg is a normal level of blood pressure. In fact, a blood pressure of 140/90 mmHg has already met the diagnostic criteria for hypertension. And coronary heart disease, diabetes to be lowered to <130/80mmHg. have a lot of proteinuria blood pressure down to <125/75mmHg. take antihypertensive drugs, blood pressure must reach the standard to be effective, above this value, its harmfulness is not really lifted.
Myth nine: health care products and antihypertensive apparatus can replace antihypertensive drugs
In recent years many health care products and antihypertensive apparatus such as antihypertensive pillows, antihypertensive table, antihypertensive cap, insoles and other advertising commonly used in the phrase, “no drugs can also lower blood pressure. After the use of these things, not only can not treat hypertension, but will be because of this “health care antihypertensive” and delay the time of treatment. For the vast majority of hypertensive patients, antihypertensive drug therapy is the most effective and beneficial.
Some patients, although found to have suffered from hypertension, but gullible untrue propaganda, gullible advertising and folk “prescriptions, prescriptions”, health care products as treatment drugs, often lead to patients can not be timely formal treatment, so that the target organ damage is increasingly aggravated, and even into a big mistake. The most sensible thing to do is to go to a regular hospital to receive treatment for hypertension in a timely manner.
Myth 10: Once you have taken anti-hypertensive drugs, you cannot stop using them.
The main reason for this misconception is the lack of understanding of the development and pathological process of hypertension. The reality is that if untreated hypertension is left untreated, the blood pressure will remain at a high level for a long time. Not only does this make comorbidities occur one after another, but it also makes subsequent treatment more difficult and makes it difficult to meet safety standards. Hypertension, like diabetes, mostly requires lifelong treatment. Only a very small number of patients with mild cases can stop taking their medication for a short time or temporarily.
Furthermore, the decision on the duration of medication and whether it can be stopped depends mainly on the condition itself, not on whether the antihypertensive medication is used in a timely manner. The antihypertensive drug itself is not dependent and not addictive. Therefore, there is no need to “talk about drugs”. Hypertension drugs are not impossible to stop, but should not be stopped.
Myth 11: See a doctor once, buy the medication as prescribed, and not follow up for a long time.
The treatment plan for each person is not set in stone. For various reasons, blood pressure fluctuates. For example, in winter, due to the cold weather, blood pressure will be a little higher, and in summer, blood pressure will be more stable, then you can increase or decrease the amount of medication under the guidance of your doctor. It is difficult to detect adverse reactions to medication by purchasing medication on your own for a long time without going to the hospital for examination. It is also difficult to achieve the purpose of antihypertensive treatment. It is perfectly possible to buy drugs from pharmacies, but be sure to review them at the hospital so as to better control blood pressure and effectively reduce cardiovascular and cerebrovascular complications.
Myth 12: “Flush” blood vessels twice a year to lower blood pressure and prevent hemiplegia.
Some people like to “flush” the blood vessels twice a year (intravenous drip with Chinese medicine) to lower blood pressure and prevent hemiplegia and heart disease, which is wrong. The drugs that “flush” the blood vessels are mostly Chinese medicines that activate the blood and dilate the blood vessels, which generally have a very small range of blood pressure reduction and a very short duration of effect. For a patient with chronic hypertension, a momentary intravenous infusion will not achieve the purpose of long-term hypotension and stabilization of blood pressure. Only standardized and reasonable oral antihypertensive drugs can bring blood pressure up to standard and reduce the ultimate goal of cardiovascular and cerebrovascular diseases.
Misconception 13: Treating Salvia tablets and heart pills as “antihypertensive drugs”
Danshen tablets, heart pills and other drugs are beneficial for the treatment of coronary heart disease, but they do not have the exact antihypertensive effect. It is very scary for hypertensive patients to take these drugs as antihypertensive drugs. If the blood pressure is very high and not well controlled, and taking these drugs to activate blood circulation, but will increase the risk of cerebral hemorrhage.
Myth 14: Chinese medicine has fewer side effects to lower blood pressure.
Some people think that Chinese medicine has fewer side effects, but in fact all drugs have certain side effects, and cases of disability and death caused by the toxic side effects of Chinese medicine are often reported. The Chinese patent medicine antihypertensive drugs such as Zhenju antihypertensive tablets and compound rooibos tablets are short-acting antihypertensive drugs. They must be taken three times a day on time. If you take it only once a day, or not strictly on time, not only can not maintain the antihypertensive effect, but also make the blood pressure fluctuate greatly.
The side effects may be more than the long-acting antihypertensive drugs. In addition, look at the side effects of drugs can not be subject to the manual, the regular production of Western medicine instructions for use is very comprehensive and detailed, even if the occurrence of very low adverse reactions are also listed in detail. Some proprietary Chinese medicines have very simple instructions, but the side effects may not be less than it. The viewpoint of refusing to take western medicine needs to be corrected, advocating the use of drugs that have been scientifically proven to be effective and safe. At present, the five major types of first-line antihypertensive drugs widely used around the world have been confirmed to be safe and effective through years of large-scale research and clinical observation.
Myth 15: The more expensive the drug, the better it is.
Some patients believe that the more expensive the drug is, the better, but in fact the most suitable drug for the characteristics of the patient is the best drug. The price of drugs is affected by many factors, for example, the high cost of research and development of drugs, but also in the patent period, the drug is very expensive. It is also an extremely common misconception that the more expensive a drug is, the better it is. Some antihypertensive drugs are very expensive, but the range of blood pressure reduction is very small, and they are only suitable for mild and moderate hypertension, while the treatment effect on patients with severe hypertension is not ideal.
In contrast, hydrochlorothiazide is very cheap, costing only 1.5 cents per day, but the treatment of hypertension is very effective, especially for the treatment of senior hypertension, no drug can be comparable to it. Therefore, the price of drugs and the effect is not necessarily proportional, not to mention the pursuit, blindly favor the so-called those new and expensive drugs. Generally speaking, new drugs need to undergo long-term, extensive clinical practice before their efficacy can be determined. Patients with hypertension should choose their drugs according to their specific conditions.
Myth 16: Blood pressure is very high, immediately sublingual short-acting strong antihypertensive drugs.
It is true that sublingual nifedipine, captopril and other short-acting strong antihypertensive drugs can quickly lower the blood pressure. However, too rapid a reduction in blood pressure can lead to inadequate blood supply to vital organs, especially in elderly hypertensive patients with combined coronary heart disease and stroke, many of whom suffer from myocardial infarction or cerebral thrombosis as a result. It is not advisable to lower the blood pressure too fast or too low at once, but to lower it slowly and steadily to the desired or target level gradually. Long-acting antihypertensive drugs can be used for this purpose, therefore, elderly patients with hypertension should try to use once-daily long-acting antihypertensive drugs.
Myth 17: Constantly changing medications.
There are two types of people who keep changing their medications. One is that when starting medication, they always want to bring down their blood pressure within a day or two, and if their blood pressure fails to drop to a normal level after a few days of medication, they change their medication. The result is frequent drug changes, a drug has not yet taken effect before the switch to another drug, always “labor without success”, resulting in blood pressure fluctuations and instability. In fact, long-acting antihypertensive drugs can only take effect in 1 week, and it takes 4 weeks or more to achieve the full effect of antihypertensive.
Another situation is that “don’t take the same drugs all the time to avoid failure.” Patients with such a view often take the initiative to constantly change the variety of antihypertensive drugs, but this is actually not true. If you choose certain antihypertensive drugs, you should continue to take them after obtaining satisfactory results, and they will not fail. Frequent drug changes can lead to blood pressure fluctuations, but is not good for the body.
Myth 18: One hand holds a bottle of wine, one hand holds a bottle of medicine, the same eating two.
High blood pressure medication is important, but non-pharmacological treatment also directly affects the effect of lowering blood pressure, a good lifestyle is the cornerstone of the treatment of hypertension, only focus on taking medication is not enough. For example, excessive alcohol consumption can cause blood pressure to rise. Other non-pharmacological treatments, including weight loss, salt restriction, proper diet, smoking cessation, aerobic exercise, adequate sleep, a happy mood, and smooth bowel movements, are also important. Hypertension is caused by a combination of factors, including a poor lifestyle. Therefore, it is necessary to take comprehensive measures along with drug treatment, otherwise it is impossible to achieve the ideal treatment.