(A) Basic knowledge of hypertension
1, what is hypertension in the case of unmedicated, adults (age > 18 years) systolic blood pressure ≥ 140 mm Hg, diastolic blood pressure ≥ 90 mm Hg.
2, hypertension profile of more than 600 million people worldwide with hypertension, China currently has 160 million. Accounting for the top three causes of death (heart disease, malignant tumors, cerebrovascular disease), two of the diseases and hypertension are closely related. High prevalence, high disability and high mortality make hypertension the “number one killer” of Chinese people’s health.
3, suffering from hypertension is mainly related to seven factors genetics, excessive salt, mental stress, obesity, smoking, alcohol abuse, lack of exercise.
4, hypertension danger brain bleeding, cerebral infarction, coronary heart disease, renal insufficiency, fundus arteriosclerosis (bleeding).
5, hypertension main symptoms performance most hypertension no obvious symptoms; some patients performance: headache, dizziness, insomnia, tinnitus, finger numbness, neck and back muscle pain, tension.
6, the treatment goal of hypertension in general hypertensive patients <140/90 mmHg; diabetes or kidney disease patients <130/80 mmHg, if their urinary protein excretion reached 1g/24 hours, blood pressure control should be less than 125/75 mmHg; elderly patients SBP <150 mmhg, if tolerated can be further reduced.
(B) reasonable diet, moderate exercise
1, the concept of obesity abdominal obesity standards: Chinese waist circumference of men ≥ 2125px, women ≥ 2000px; Chinese normal adult body mass index (BMI, weight / height squared, kg/m2) for 19 ~ 24, body mass index ≥ 24 for overweight, ≥ 28 for obese.
2, limit the intake of salt diet should be light, eat less salty food, eat too much salt, will make the blood vessel sclerosis and blood pressure rise, salt should be eaten daily to 6 grams or less (2006 World Health Organization regulations: daily salt intake per person in 5 grams or less. (Salt tips: put 1/3 to 1/2 less than usual, put salt when you start the pot; buy high potassium and low sodium salt; use a salt spoon).
3, it is advisable to eat more potassium-containing food soybeans, pinto beans, tomatoes, zucchini, celery, fresh mushrooms and various green leafy vegetables; fruits such as oranges, apples, bananas, pears, kiwi, persimmons, pineapples, walnuts, watermelon, etc.
4.Learn to apply the “Chinese Residents’ Balanced Diet Pagoda (2007)
The first layer: 250-400g of cereals, potatoes and beans (50-60% of total calories), 1200ml of water; the second layer: 300-500g of vegetables, 200-400g of fruits; the third layer: 50-75g of animal and poultry meat, 50-100g of fish and shrimp, 25-50g of eggs; the fourth layer: 300g of milk and milk products, 30-50g of soybeans and nuts The fifth layer: 25-30g of oil, 6g of salt. hypertensive patients are basically suitable for the low limit of the above foods.
5, appropriate exercise, aerobic exercise to do aerobic exercise, should not be strenuous exercise, pay attention not to do the action of too Mongolian bending low, the amplitude of the change of position is too large and forceful breath-holding action. The most suitable aerobic exercise is walking, jogging, taijiquan, taiji sword, cycling, swimming, etc., the best is “walking”. A moderate amount of exercise can reduce the risk of hypertension by 30%. 20-60 minutes a day, 3-5 days a week (preferably every day). Self-judgment of the intensity of moderate exercise: heart rate control at “170-age”. Light sweating, relaxation, good appetite and sleep; slight fatigue, which disappears after rest. Indicators of diurnal blood rheology, especially the degree of blood attack, tend to rise in varying degrees from 20:00 pm to 6:00 am, with the most pronounced increase from 00:00 pm to 6:00 am. To avoid cardiovascular accidents, early morning exercise is not recommended. Scientific fitness, especially for cardiovascular patients, is best chosen at 9-10 am, or 4-6 pm or 30 minutes after dinner.
(C) Teach patients to self-monitor blood pressure
1, the choice of sphygmomanometer due to the application of mercury column sphygmomanometer process, the human operation of more influential factors, recommended the purchase of electronic sphygmomanometer in line with international standards.
2, blood pressure fluctuations in normal circumstances, blood pressure in the 24 hours around the clock is a cycle of rhythmic changes. Early in the morning, a wake-up call, blood pressure shows a continuous upward trend, reaching a peak at 9-11 a.m.; then gradually decline, to 3-6 p.m. again, as night falls, blood pressure again lower, after going to sleep is a continuous downward trend, the lowest at midnight. This “two highs and one low” time is the risk period for hypertension. It is important to note that the time of peak blood pressure is not the same for every patient, and in practice, self-monitoring should be used to find out the summary.
3, blood pressure measurement precautions
(1) The person to be measured should rest quietly for at least 5 minutes, refrain from smoking, drinking tea, coffee and alcohol, and emptying the bladder within 30 minutes before the measurement.
(2) Stay relaxed before the blood pressure measurement.
(3) The patient is seated, removes the upper arm clothing, places the upper arm on a cushion and table, and measures the blood pressure of the right arm with the arm band of the electronic sphygmomanometer and the heart placed at the same level.
(4) No talking during the blood pressure measurement.
(5) Repeat measurements should be taken 2 minutes apart, and the average of the two readings should be recorded. If the difference between the SB and DB readings of the two remeasurements is >5 mmHg, measure again after a 2-minute interval and take the average of the three readings.
(6) It is best to measure blood pressure at a fixed time every day and register it well.
(4) Make the patient aware of the treatment strategy for hypertension
(1) Most patients with hypertension (but not all) should gradually lower their blood pressure to the target level within a few weeks.
(2) To achieve these goals, most patients will need to take more than one antihypertensive medication.
(3) Depending on the baseline blood pressure level and the presence or absence of complications, low-dose monotherapy or low-dose combinations of two drugs should be used at the start of therapy.
(4) The use of long-acting agents, which can act for up to 24 hours and be taken once daily, is recommended to reduce fluctuations in blood pressure, reduce the risk of major cardiovascular events and prevent target organ damage, and improve medication adherence. Emphasis is placed on long-term regular antihypertensive therapy to achieve effective, smooth, long-term control.
(5) Hypertension is a lifelong disease, and once diagnosed, lifelong treatment should be adhered to. This is especially true when antihypertensive medication is applied.
(6) Patients are advised to follow up regularly at the hospital (1-3 months) and to have a comprehensive physical examination at least once a year.