Why can’t your blood pressure come down?

Hypertension and the comorbidities that come with it are a permanent pain for our government and our nation. Why? Because the prevalence of hypertension among adults in China is close to 30%, and the total number of hypertensive people is about 270 million; and the varieties of antihypertensive drugs in China are almost synchronized with developed countries abroad, and some even exceed those countries. However, China’s hypertension treatment control attainment rate is only 27.4%, which is significantly lower than that of developed Western countries, which cannot be said to be a sad. According to the 2015 survey study on the mortality rate of major diseases and causes of death of Chinese urban residents, cardiovascular and cerebrovascular diseases caused by hypertension ranked second and third in the mortality rate after tumors, and this conclusion is contrary to the medical investment of our government and the hard work of the majority of medical workers. The reasons for the low rate of hypertension control in China are multifaceted, though, mainly related to the public’s lack of awareness of the dangers of hypertension, poor lifestyle habits and the terror of medication to control hypertension, but also closely related to the professional medical profession’s lack of implementation of interventions to grasp the concept of hypertension management and treatment. The following unhealthy habits in daily life are often important triggers for hypertension 1, high sodium diet: sodium salt (sodium chloride) intake is positively correlated with blood pressure levels and the prevalence of hypertension, in most areas of China, per capita salt intake of 12-15 grams / day or more, significantly higher than the World Health Organization recommended 3-5 grams / day. 2, overweight and obesity: a large amount of clinical evidence shows that obese people have significantly higher hypertension than the general population: the general population body mass index (BMI) < 24, BMI ≥ 24 the risk of hypertension is 3 to 4 times the normal weight people, waist circumference of men ≥ 90cm or women ≥ 85cm, the risk of hypertension is more than 4 times the normal waist circumference people. According to a study by Imperial College of Science and Technology, the number of obese adults worldwide exceeds that of underweight people, and China has the highest number of obese people worldwide. The study found that China and the United States are the countries with the highest number of obese people in the world. Among them, China has the highest number of obese men at 43.2 million and women at 46.4 million. This is also one of the important factors for the high number of hypertension in China. 3, smoking, drinking a lot of alcohol, staying up late and other unhealthy habits are also important triggers of hypertension. Diabetes itself is a progressive vascular disease, the vast majority of diabetic patients are prone to combined hypertension. The number of diabetes cases in China has skyrocketed in recent decades, and they all have the potential to become part of the hypertensive army. The biggest problem in the diagnosis and treatment of hypertensive patients in China is the lack of effective supervision means, whether it is the patient's self-blood pressure management, or professional medical institutions to monitor the patient's blood pressure are in the stage of laissez-faire. At present, the Internet almost covers the cities and developed villages, and the current technical means can do a good job of monitoring blood pressure through mutual network and Internet of Things technology, but this work is still in a blank state. Therefore, the key to improve the control rate of hypertension also lies in improving the awareness of the danger of hypertension to the human body, lowering blood pressure itself is not the purpose, the ultimate goal of blood pressure control is to reduce and delay the damage to the heart, brain, kidneys and other important organs to improve their quality of life. The key aspects of good blood pressure management in 1, equipped with a reliable blood pressure monitor (recommended to use the international standard certified electronic blood pressure monitor can be connected with the Internet of Things); 2, the establishment of family blood pressure management plan, the implementation of family health workers, inspectors, liaison (with the doctor in charge) system; gradually regulate the diet, remove bad habits. 3.Learn to regularly analyze your blood pressure fluctuation curve and set warning signs. Antihypertensive treatment must master the following tips 1, control salt can improve the effectiveness of drugs Many hypertensive patients think that as long as I take drugs blood pressure should come down, do not pay attention to the diet of salt and other foods that have an impact on blood pressure control, the results of antihypertensive effect greatly reduced. As we all know, the human body's physiological need for salt is only 3-5 grams / day, while many areas of China (mostly in the north) up to 12-15 grams or more. Such a high salt load is very difficult to control blood pressure. 2, pay attention to the form, but also to care about the results Many people take hypertension drugs after a slight drop in blood pressure, or dizziness, chest tightness and other symptoms of hypertension slightly better thought that everything is fine, not at all concerned about whether the blood pressure down to the safe category. In fact, lowering blood pressure is only a form, its fundamental purpose is to protect the cardiovascular and cerebrovascular from harm. For this reason, the clinical standards for blood pressure control are as follows: in general hypertensive patients, blood pressure (systolic/diastolic) should be lowered to below 140/90 mmHg; in elderly people aged 65 and above, systolic blood pressure should be controlled to below 150 mmHg, and can be further reduced if tolerated; if there is renal disease, diabetes, stable coronary heart disease, cerebrovascular disease, then the goal of blood pressure reduction should be If accompanied by kidney disease, diabetes, stable coronary heart disease, cerebrovascular disease, then the goal of lowering blood pressure should be more individualized, generally can be lowered to 130/80 mmHg or less. Many people refuse to take medication after discovering hypertension, fearing that early use of medication will cause the antihypertensive effect of future medication. In fact, this mentality is more wrong than wrong. The antihypertensive drugs are not antibiotics and will not produce drug resistance. Long-term hypertension will cause the thickening of small blood vessels, when the blood vessels found so lesions, the effectiveness of antihypertensive drugs will instead be greatly affected. 4, a reasonable mix of medication Hypertension has many causes (neurological factors, vascular lesions, endocrine triggers, etc.), for different causes of hypertension patients should choose antihypertensive drugs in different categories. If you use drugs blindly, it will not only affect the antihypertensive effect, but also cause unnecessary comorbidities. 5, keep constant The process of antihypertensive treatment should not be a sudden drop in blood pressure, so doctors need to search for a reasonable dose in the process of medication. Since there are differences in the sensitivity of antihypertensive drugs between individuals, it may take some time to find the right type and dose of medication when you first start using it. Patients with hypertension should not be impatient to change their medication when the change in blood pressure is not obvious two to three days after taking it. The result is not only uncontrolled blood pressure, but also many side effects of the medication.