The n questions that hypertensive patients often ask doctors on national hypertension day, explain them clearly once.

Hypertension, as one of the most common chronic diseases, is the main risk factor of cardiovascular and cerebrovascular diseases, which can cause 7 million deaths worldwide every year. Existing hypertensive patients in ChinaIt has reached 300 million, with an annual increase of more than 3 million.

To this end, the Ministry of Health has decided that since 1998, the annualOctober 8th was designated as National Hypertension Day,It aims to arouse people’s attention to the prevention and treatment of hypertension. Today, let’s talk about high blood pressure.

Be good at fields

Diagnosis and treatment of acute and chronic heart failure, interventional therapy of coronary heart disease, diagnosis and treatment of primary and secondary hypertension.

1. What is the cause of hypertension?

About 95% patients with hypertension have unknown etiology, which is called primary hypertension. Although the cause is unknown, butOld age, obesity, diabetes, hyperlipidemia, high-salt diet, lack of physical laborAll of them are risk factors for hypertension. Therefore, in order to prevent hypertension, we should exercise more, eat lightly, control our weight, and have regular physical examinations to screen the "three highs".

Second, how to know if you have high blood pressure?

If the clinic blood pressure is greater than 3 times on different days140/90mmHg，It can be diagnosed as hypertension. However, some patients unconsciously raise their blood pressure as soon as they see a doctor in the clinic, leading to pseudo-hypertension, which we call "white coat hypertension". In order to avoid this phenomenon and lead to misdiagnosis, the guidelines in various countries are also very recommended now.24-hour continuous ambulatory blood pressure monitoring was used.Or home-based blood pressure monitoring to diagnose and find hypertension.

Third, "it’s a three-point poison, so my blood pressure is a little higher. Can I not take medicine?"
Many patients are always worried about taking antihypertensive drugs orally.side effectWorried that once antihypertensive drugs are taken, they will not stop, which is a misunderstanding of many patients.
The guideline suggests that for new-onset hypertensive patients with blood pressure greater than 140/90mmHg, after 3-6 months of healthy lifestyle improvement (such as low-salt and low-fat diet and exercise), if blood pressure is still high, it is appropriate.Start antihypertensive drug therapy.For example, patients with primary hypertension who have been complicated with heart, brain, kidney and other target organ injuries should be treated with antihypertensive drugs immediately.

Fourth, "I am taking antihypertensive drugs, and my blood pressure is controlled to 104mmHg. Is it too low?"

For the target value of blood pressure reduction, the national guidelines are slightly different. Generally, it is recommended to control it below 140/90mmHg, and it is best toReduce to less than 130/80mmHg.Especially in patients with complicated or chronic kidney disease, blood pressure reduction should be more strict. For the elderly over 80 years old, the target value of blood pressure reduction can be appropriately relaxed to below 150/90mmHg.

The ideal range of systolic blood pressure is controlled between 120-130mmHg. If the blood pressure of the elderly is lower than 110mmHg repeatedly, in order to avoid insufficient cerebral perfusion,The dosage of antihypertensive drugs can be appropriately reduced.

5. "There are many kinds of antihypertensive drugs. How should I choose?"

At present, commonly used antihypertensive drugs include ACEI/ARB (Puli/Sartans), β -blockers (such as metoprolol), calcium antagonists (horizon) and diuretics (furosemide, spironolactone, etc.). For stubborn hypertension,Combined medication is better than single medication., and to some extent offset the side effects.

For example, calcium antagonists can offset the side effects of β -blockers on increasing peripheral resistance, and bis-β-blockers can eliminate the side effects of calcium antagonists on increasing heart rate and cardiac output. European guidelines recommend the combination of two drugs for the initial treatment of primary hypertension, which is preferred.Monolithic compound preparation(SPC, that is, there are two antihypertensive components in a antihypertensive drug tablet).

Sixth, some suggestions

1. Blood pressureNot as fast as possible,We should master the principle of slowness and smoothness.

2. antihypertensive drugsDon’t stop eating or eat every other day., resulting in high and low blood pressure fluctuations.

3. Any drug may be intolerable to some people. Don’t refuse to use antihypertensive drugs because of the side effects listed in the instructions. If there are suspicious adverse reactions, see a doctor in time.Replace antihypertensive drugs that are more suitable for you.

4.　Don’t rely on feelings to evaluate whether there is high blood.Press,Many patients with hypertension have no symptoms.

Not only should we monitor blood pressure regularly, but we should also check it regularly.Whether there is target organ damage., such as blood sugar, liver and kidney function, echocardiography, electrocardiogram, vascular color Doppler ultrasound and other tests.

6. Put less oil and salt in cooking, eat more vegetables and fruits, and stretch your legs and move more.Quit smoking and limit alcohol.