In 2014, the World Health Organization updated the top 10 causes of human death worldwide, and ischemic heart disease (heart attack, heart failure) and stroke (stroke) continue to rank first and second. 2, disability and long-term bed rest after stroke are receiving increasing attention from society. 3, many risk factors can trigger cardiovascular disease, divided into controllable and uncontrollable factors, of which, among controllable factors, hypertension is on the top of the list. Shu Junlong, Department of Neurology, Peking University First Hospital, Beijing, China 4. Numerous large studies in recent decades have shown that controlling hypertension can reduce the onset and recurrence (re-occurrence) of cardiovascular and cerebrovascular diseases. 5. The control of hypertension in our population is very poor, with nearly half of the people not knowing they have hypertension before the onset (getting a heart attack or stroke), and less than 10% knowing they have hypertension but controlling it well. 6. ① Do not leave high blood pressure alone, cover your ears and deceive yourself, and then regret it when it is serious, people do not get heart attacks and strokes for no reason, the fruit of today is the cause of yesterday. For people with a family history of hypertension, it is recommended that their blood pressure should be monitored regularly after the age of 30, so that early detection and early treatment can lead to good results. ② Don’t put your expectations on drugs. The key to controlling hypertension is diet and lifestyle habits. A diet low in salt and high in potassium is thought to be beneficial in controlling hypertension. It is more difficult to change the diet in a short period of time, but a plan can be made for gradual progress. Bad habits should be eliminated, especially smoking; a single cigarette may cancel out the vast majority of the medication’s effectiveness. Good habits should be recommended, such as regular stress reduction, regular rest and regular exercise. ③ Regular blood pressure monitoring. After the improvement of diet and lifestyle habits, blood pressure is still not satisfactorily controlled, you need to consider adding drugs and need to monitor blood pressure regularly. The difference between taking medication without blood pressure measurement and not taking medication is not much. ④ Poorly controlled blood pressure is sometimes not only a problem of antihypertensive drugs. In addition to diet and lifestyle habits, the control of comorbidities is also important. For example, obesity, such as diabetes, to go hand in hand, multi-targeted comprehensive improvement, in order to achieve the desired results. ⑤ Don’t blindly believe in some health products under the banner of “Traditional Chinese Medicine”. Businessmen are only interested in profit and lack professional control. Patients spend time and money to seek the so-called “safe and effective” on TV or around unprofessional relatives and friends, resulting in delaying the disease, but also hurt the reputation of the motherland medicine. 7, some common questions and answers about hypertension drugs Q: high blood pressure must take antihypertensive drugs? A: There are two types of cases, one is a long-term high blood pressure, that is, repeatedly measured blood pressure at different times are high (systolic (high pressure) ≥ 140mmHg or diastolic (low pressure) ≥ 90mmHg), can be diagnosed as hypertensive disease, the need to control blood pressure, as previously mentioned, the first should be adjusted diet and lifestyle, and then add antihypertensive drugs; the second, a transient high blood pressure, this type of situation Unless the blood pressure is particularly high (>180/120mmHg or there is obvious discomfort, at this time should go to the emergency room), usually temporary no special treatment, the next few days in a quiet situation to retest several times to determine whether it is long-term hypertension. Q：How can I do if my blood pressure does not come down when I take antihypertensive medication? A: Several possibilities: ① irregular medication, many people take medication very randomly, want to get up to eat a piece, every other day to a piece, high blood pressure to eat a piece… This blood pressure is very difficult to control, the majority of hypertension drugs need to be taken every day, to adhere to, regular, on time. ②The drugs are not yet fully effective, the current drugs used for conventional blood pressure control are long-acting drugs, that is, they need to be taken continuously for a period of time (1 to 3 weeks) to fully take effect, just taking drugs during the blood pressure will fluctuate, sometimes higher than normal, unless particularly high, usually temporarily do not need to adjust, to adhere to take, in order to see the effect. ③ Other causes that can aggravate high blood pressure are not removed, such as smoking, obesity, persistent high blood sugar, high salt diet (eat very salty …) Sometimes the blood pressure can come down without the need for medication. ④If the medication is not effective enough, you should visit your doctor and consider whether to increase the dosage of the medication or combine it with other medications. Q: Are there a lot of side effects of antihypertensive drugs? Some people say that they hurt the liver and kidneys, so should I not take them for a long time and should I go to Chinese medicine to lower my blood pressure? A: Many people have a phobia of Western medicine, but in fact, it is not necessary. A basic principle, for the drugs that should be used, must be used, do not pay too much attention to the incredibly long list of adverse reactions, that is the doctor’s job, just keep a proper vigilance on the line, for the drugs that should not be used or are not very necessary, we need to increase the concern about adverse reactions, because there is not much benefit, so you can not take too much risk. For the vast majority of patients, antihypertensive drugs are basically mandatory and should be taken as the former. Most antihypertensive drugs are certified to be very safe, individuals may have some adverse reactions, but most are not too serious, and can be reversed after discontinuation or change of medication, especially a class of drugs if taken for several months without abnormal appearances, then basically can be considered safe, long-term use does not lead to accumulation of poisoning! On the contrary, Chinese medicine is not as safe and harmless as it is said to be, and some drugs may harbor serious toxin-causing ingredients that may be harmful if taken inappropriately. From clinical practice, the application of western medicine for blood pressure control is the current recommendation. Q: What should I do if my blood pressure goes up and down? A: Human blood pressure is not constant all the time, and a certain range of blood pressure fluctuations is normal. In patients with hypertension, the fluctuation of blood pressure will become more obvious due to the hardening of blood vessels caused by long-term hypertension, and some people may describe the blood pressure as a roller coaster ride, fluctuating very much. This is a late stage manifestation of hypertension, and there is no very effective means to reverse it. However, there are several recommendations for this type of phenomenon: ① Reduce non-vascular factors that cause blood pressure fluctuations, such as controlling anxiety, maintaining a calm state of mind, and avoiding excessive strenuous activity. Another point is that there may be patients who snore at night, causing hypoxia that can cause specific blood pressure fluctuations such as high blood pressure at night and early morning and low blood pressure during the day, and an active respiratory clinic visit may help. ②The timing of antihypertensive drugs can be adjusted slightly. Although we say that conventional antihypertensive drugs are long-acting and slow-release drugs, there is still a small peak in drug concentration after taking the drug that may help improve the rise in blood pressure at a fixed point in time. ③The blood pressure control target for such patients can be appropriately adjusted upwards, or that is, unless the blood pressure is exceptionally high and all are at little risk in the short term, but severe hypotension can be fatal. Q: What is the case that my blood pressure differential is unusually large? A: This type of patient usually has been suffering from hypertension for a long time, or the elderly, there is a hardening of the arteries, the elasticity of the blood vessels has changed, from a flexible and elastic hose into a rigid and perhaps even some rusty steel pipe, so when the heart contracted to pump blood is a high blood pressure, and when the heart diastolic is very low. There is no effective solution for this kind of vascular sclerosis due to long-term lesions, and as with blood pressure volatility, an appropriate increase in blood pressure control goals may reduce the occurrence of some adverse events. Of course, if high blood pressure can be well controlled at an early stage, the blood vessels will not harden so quickly and there will be no such trouble. Q: Can I stop taking my antihypertensive medication? A: Many times antihypertensive drugs need to be taken for a long time or even for life, but in some cases it is possible to stop taking them. For example, if you are obese, smoke, and have an irregular diet, you can stop taking your medication after you find out you have high blood pressure, and then gradually stop smoking, control your weight, and improve your diet and routine with the help of your doctor, and your blood pressure does not rise again after you stop taking your medication on a trial basis for a period of time. Another example: some elderly people, advanced hypertension, heart function degenerates, pumping function decreases resulting in the disappearance of hypertension, and even due to vascular sclerosis also repeatedly appear erectile hypotension, then this time should be discontinued. But it is important that the discontinuation of medication must be done under the guidance of a doctor! The biggest taboo for hypertension is to increase or stop the medication and increase or decrease the dosage on your own. Finally, may all my friends have a lifetime of normal blood pressure.