1, what is hypertension Hypertension is a clinical syndrome characterized by abnormally elevated pressure in the body circulation, and the sustained elevation of blood pressure will lead to damage to the heart, kidneys, brain and blood vessels and result in a series of clinical diseases. The Chinese guidelines for the prevention and treatment of hypertension (October 1999) state that hypertension can be diagnosed in adults over 18 years of age with a systolic blood pressure ≥ 140 mmHg and/or a diastolic blood pressure ≥ 90 mmHg without taking blood pressure-lowering medication. Hypertension is divided into primary hypertension and secondary hypertension, the former is also called hypertensive disease, we usually refer to hypertension is usually primary hypertension, accounting for the vast majority of all hypertension; the latter is also known as symptomatic hypertension, is some specific disease caused by increased blood pressure, such as chronic nephritis, renal artery stenosis, adrenal cortical hyperplasia, pheochromocytoma, primary aldosteronism, etc., accounting for only hypertension less than 5%. 2, hypertension is already an epidemic in today’s human society Hypertension is the main cause of the current high incidence of cardiovascular and cerebrovascular diseases. In the western developed countries hypertension is already a common disease, epidemic, the incidence rate of up to 20%. In recent years, the incidence of hypertension in our country is increasing year by year, compared to 1980 and 1991, the incidence of hypertension in China has increased by 50%, at present, there are about 100 million hypertensive patients in China, with 3-4 million new patients every year, and with the accelerated pace of life and work in society, the incidence of hypertension is tending to the same as in developed countries, gradually entering the peak of hypertension. The incidence of hypertension is gradually entering the peak of hypertension. At present, the incidence of hypertension in China is higher in urban than rural areas, higher in the north than in the south, higher in the elderly than in other age groups, higher in the intellectual class than in the non-intellectual class, higher in the mentally stressed, high responsibility occupational groups than in other groups, police, accountants, medical and nursing staff, drivers, middle-level cadres of corporate organs, sales staff, etc., are the high incidence of hypertension. 3, hypertension is the result of genetic and environmental interactions The exact pathogenesis of hypertension has not been fully elucidated, but it has been basically clear that hypertension is due to genetic factors, environmental factors are extremely interactive results. Epidemiological studies have found that hypertension has obvious family heredity, accounting for 20%-40% of hypertension, of which the children of two parents without hypertension, one with hypertension and both parents with hypertension, the chances of their children suffering from hypertension are 3%, 28% and 46% respectively, while excessive obesity, overweight, high-salt diet, moderate alcohol consumption, and long-term mental stress, anxiety and depression. are all environmental factors that lead to hypertension, many of which are closely related to our own poor lifestyles. For example, for every 1 increase in body mass index BMI (weight (kg) divided by height (m) squared), the incidence of hypertension risk factors increases by 9% over 5 years. We physiologically need as little as 0.5g of salt per day, but in fact we greatly exceed the limit, and the average salt consumption of residents in northern China up to 12-18 grams, Shandong Province is the highest salt consumption in China, but also one of the highest incidence of hypertension in the country. 4, hypertension endangers the heart, brain, kidney, blood vessels Epidemiological data pointed out that hypertension is the first important risk factor for coronary heart disease. Hypertension causes heart changes mainly in the left ventricular hypertrophy, coronary atherosclerosis, which can lead to myocardial infarction and heart failure in serious cases; at the same time, hypertension is more closely related to stroke, more than 80% of cerebral hemorrhage and cerebral infarction is caused by hypertension; hypertension-induced renal arteriosclerosis can not only further increase blood pressure, but also lead to renal hypofunction, and is ultimately the second cause of uremia. Hypertension also leads to an increasing number of patients with extremely dangerous thoracic and abdominal aortic aneurysms. In short, the higher the blood pressure, the higher the incidence of myocardial infarction, heart failure, stroke and renal lesions. A recent large study published abroad with 1 million participants confirmed that for each 20 mmHg increase in systolic blood pressure or 10 mmHg increase in diastolic blood pressure at all blood pressure levels, the risk of cardiovascular disease doubled, even within the defined normal blood pressure range, in people aged 40-70 years with blood pressure ranging from 115/75 mmHg to 185/115 mmHg. Domestic studies have also confirmed that blood pressure levels are strongly associated with stroke, and that this relationship is stronger than in Western populations, and that the relative risk of hemorrhagic versus ischemic stroke is almost the same for elevated blood pressure. At the same time, epidemiological studies have also found that 80%-90% of patients with hypertension often have multiple cardiovascular and cerebrovascular risk factors other than elevated blood pressure, such as obesity, type 2 diabetes or hyperglycemia, hypercholesterolemia, and reduced HDL cholesterol, i.e., metabolic syndrome. For example, the risk of cardiovascular disease in patients with both hypertension and diabetes is two times higher than in patients without diabetic disease. The incidence of type 2 diabetes in hypertensive patients is 2.5 times higher than in normotensive controls, suggesting that the two diseases often coexist and that the pathological changes exacerbate each other. In a prospective British study, it has been shown that for every 10 mmHG reduction in systolic blood pressure, the risk of complications related to diabetes is reduced by 12%, diabetes-related mortality by 15%, myocardial infarction by 11%, and microvascular complications by 13%. Therefore, the control of hypertension often requires simultaneous control of blood lipids, blood sugar and weight, in order to ultimately reduce the incidence of heart, brain, kidney and other complications and mortality. 5, hypertension prevention and control must start with the youth Hypertension is the result of genetic and environmental interactions, we may not be able to change our genetic genes, but we can improve our environmental factors to achieve prevention and control of elevated blood pressure. Most of the environmental factors that cause elevated blood pressure are closely related to our poor lifestyle habits, which are generally developed as early as during adolescence and undergo a slow accumulation of years or even decades to cause elevated blood pressure, lipids and eventually damage our cardiovascular and cerebrovascular, a progressive pathophysiological process medically known as “cardiovascular This progressive pathophysiological process is medically known as “cardiovascular linkage”, during which we have many opportunities to stop the progression of its pathology, and active prevention and treatment of hypertension and hyperlipidemia, obesity, smoking cessation, and appropriate physical exercise are the basic aspects of our intervention. The post-war pandemic of coronary heart disease, stroke and other cardiovascular and cerebrovascular diseases broke out in Western countries in the 1960s and 1970s, seriously threatening people’s health and bringing about a serious social crisis. With the vigorous intervention of governments and relevant departments, the morbidity and mortality rates of cardiovascular diseases were greatly reduced through health education, increasing the rate of hypertension control, lipid reduction, smoking ban, and changing unreasonable diets and lifestyles. In the United States, the mortality rate of coronary heart disease decreased by 50% and stroke decreased by 70% from 1950 to 1995, which are the effects of adopting prevention-oriented intervention strategies. So what is the current situation of our domestic hypertension treatment? The reality is rather grim. At present, there are three low phenomena in the prevention and treatment of hypertension in China, namely low awareness rate, low treatment rate and low control rate (blood pressure <140/90mmHg). According to the recent data from a sample survey of hypertensive patients aged 35-74 in China, the awareness rate was 44.7%, the treatment rate was 28.2%, and the control rate was only 8.1%, which was much lower than the international level. What is even more worrying is that the age of onset of hypertension is also advancing. In the national perception, hypertension was originally a middle-aged and old-age disease far away from teenagers, but in hypertension clinics you can increasingly find the figure of young people in their twenties or even children in their teens, and it is no longer unusual for teenagers to get hypertension (excluding secondary hypertension). With the improvement of the pace of life and living standards, the westernization of the diet of domestic adolescents is becoming more and more obvious, and fast food such as McDonald's and Kentucky Fried Chicken, cola-type drinks with high sugar content, chocolate ice cream and other sweets are becoming the mainstream diet of many adolescents. Obesity, hypertension, and even induce diabetes, resulting in metabolic syndrome. In addition, nearly 2/3 of young people smoking habits, while the early arrival of social competition and pressure, so that some young people long-term mental tension, anxiety, depression, can make the cerebral cortex central dysfunction, sympathetic excitability increased, resulting in hypertension, so that cardiovascular and cerebrovascular diseases occur prematurely. According to the statistics of my hospital, the youngest patient with coronary artery stenosis confirmed by coronary angiography is only 18 years old, and the youngest age of 32 years old who had to undergo coronary stenting angioplasty due to serious coronary lesions, which is a bad phenomenon that we should worry about. The whole society should take action to change our own poor lifestyle and actively control hypertension and other cardiovascular risk factors, starting from the youth. If we do not intervene actively in this way, we may follow the footsteps of western countries, and it will be more than alarming that the peak of cardiovascular diseases that once claimed millions of lives in western countries will appear in our country earlier.