Hello! I am Liu Jian
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The "China Cardiovascular Health and Disease Report 2020" pointed out that the number of hypertension patients in China has reached 245 million [1]. You should understand that hypertension can cause serious complications such as stroke, coronary heart disease, heart failure, kidney disease, etc., and at the same time, by controlling blood pressure, the risk of complications can be significantly reduced, so patients with hypertension must take measures to control blood pressure.
However, many patients with hypertension are worried about the side effects of long-term medication and hope to delay the start of antihypertensive drugs as much as possible. So, when exactly should I start taking antihypertensive medications?
3 red lines for blood pressure values
The ultimate goal of antihypertensive therapy is to reduce the overall risk of complications and death, so when to start antihypertensive drug therapy, can not only look at the patient's personal wishes, nor can it only look at the level of blood pressure value, but also should be combined with the patient's cardiovascular risk assessment level to consider comprehensively. Let's combine the 3 red lines of blood pressure values to see when to start antihypertensive drug therapy.
Red line 1: 120/80mmHg
If your blood pressure is below this red line, then congratulations, your blood pressure is normal and you should continue to maintain it.
Red line 2: 140/90mmHg
If your blood pressure value is between the first red line and the second red line, you should be vigilant, this is a normal high blood pressure value, and the blood pressure begins to be a little abnormal.
If the blood pressure value has crossed the second red line, then you need to measure the blood pressure in the hospital on another day, and in the absence of antihypertensive drugs, instead of the 3 clinic blood pressure measured on the same day, the systolic blood pressure ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg are diagnosed as hypertension. Here, as long as one of the systolic and diastolic blood pressure reaches or exceeds the limit, it is hypertension. It should be noted that at this time, it should be examined in the cardiology clinic to assess whether there are other cardiovascular risk factors, such as blood glucose, blood lipids, renal abnormalities, as well as obesity, snoring, etc.
Red Line 3: 160/100mmHg
This red line is the dividing line for determining whether to start drug therapy immediately.
If blood pressure values are already above the first red line, but are still below the third red line, and if there are no chronic diseases or risk factors (e.g., coronary heart disease, heart failure, stroke, peripheral atherosclerosis, kidney disease, diabetes, dyslipidemia, etc.) under the evaluation of a physician, lifestyle interventions should be undertaken to lower blood pressure first, including reducing sodium intake, weight loss, regular exercise, smoking and alcohol cessation, and psychological balance [2].
Lifestyle interventions can be continued after 3 months of lifestyle intervention alone, and if blood pressure can be reduced below the standard of 140/90 mmHg, follow-up every 3 months; if the blood pressure is not met after lifestyle intervention alone, antihypertensive drugs need to be taken under the guidance of a doctor at the same time as the lifestyle intervention.
If the patient has chronic disease or cardiovascular risk factors, or blood pressure ≥ 160/100 mmHg, your doctor will recommend that you initiate antihypertensive medications immediately after the diagnosis of hypertension in addition to lifestyle improvements.
Speaking of which, you should understand the timing of antihypertensive drugs, in order to make you more intuitive, we summarize into the following table for your reference.
A combination of blood pressure levels and cardiovascular risks determines whether to use antihypertensive drugs
Brother Jian said
The fundamental goal of antihypertensive therapy is to reduce the overall risk of cardiac, cerebral, renal, and vascular complications and death.
Initiation of antihypertensive pharmacotherapy requires a combination of patient preference, blood pressure levels, and cardiovascular risk.
Blood pressure levels above the normal blood pressure high value, need to go to the cardiology department for cardiovascular disease risk assessment, if there is no other risk factors, you can first carry out lifestyle intervention, if the risk of cardiovascular disease is high, should be based on lifestyle intervention to use antihypertensive drugs.
Most patients with confirmed hypertension need to take antihypertensive drugs and follow the doctor's instructions to "treat" long-term peace of mind.
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bibliography
China Cardiovascular Health and Disease Report Writing Group. Overview of China Cardiovascular Health and Disease Report 2020. China Cycle Journal.2021,36(6):521-545.
National Cardiovascular Disease Center, National Basic Public Health Service Project Grassroots Hypertension Management Office, National Grassroots Hypertension Management Expert Committee. National Guidelines for the Prevention and Management of Hypertension at the Grassroots Level 2020 Edition. Chinese Journal of Recycling.2021,36(3):209-220.
Speaker: Liu Jian
Editor-in-Charge: Tan Suzhen