Patients with hypertension should pay attention to lowering blood lipids.
However, how to judge whether your blood lipids are high? Do I want to take medication? How much is it reduced?
Of course, the final judgment needs to be determined by the doctor. But as a patient, it's also good to know about it.
As we have said, you cannot use the normal values on the lipid test to determine whether to lower blood lipids. Because the normal value of the lipid test is for normal people, if you have already had high blood pressure, it is a patient, and if you are sick, you can't follow the standards of normal people.
This refers to patients with hypertension and risk factors, not counting those who have already suffered from cardiovascular diseases such as coronary heart disease, stroke, or diabetes, or patients with particularly high blood lipids, total cholesterol ≧ (greater than or equal to) 7.2 mmol/L, or LDL cholesterol ≧ 4.9 mmol/L. Those patients themselves are extremely high-risk, high-risk, and must be treated with lipid-lowering drugs.
Let's say that the general hypertension patients lower blood lipids judgment.
Is the blood lipid of hypertensive patients high, should it be lowered, and how much? These are determined based on the patient's own cardiovascular risk. Cardiovascular risk has a method of assessment, different guidelines are slightly different, we will see the doctor's commonly used hypertension, hyperlipidemia related guidelines.
Guidelines for assessment of hypertension:
Look at blood pressure levels and risk factors, target organ damage.
Blood pressure levels.
If the blood pressure is very high, to the level of tertiary hypertension, that is, the level of ≧ 180/110mmHg, it is also high risk.
If it is secondary hypertension, that is, blood pressure is 160 to 179/100 to 109 mmHg, then there are two risk factors that are high risk.
Even if it is first-degree hypertension, that is, blood pressure ≧ 140/90mmHg, but there are 3 or more risk factors, it is high risk; if there is target organ damage, such as atherosclerosis, myocardial hypertrophy, or poor kidney function, or diabetes, it is high risk.
What are the risk factors? In addition to blood pressure, there are 7 more.
Age: 55 years ≧ males and 65 years ≧ females.
Smoking: Whether you smoke yourself or those around you.
Abnormally high blood glucose, high fasting, and high after-meal meals are counted.
Dyslipidemia: According to the normal value of blood lipids, HDL cholesterol is low, and total cholesterol and LDL cholesterol are high.
Family history: To have an early onset of cardiovascular disease, the parents, siblings have cardiovascular disease before the age of 50.
Abdominal obesity, the kind of obesity with a large belly.
Blood homocysteine is elevated, ≧ 15 mol/L.
Target organ damage mainly depends on the function of the heart, blood vessels and kidneys.
Heart: That is, ecglyctic or ultrasonography with ventricular hypertrophy.
Vascular: Mainly to see whether the carotid arteries have hardening, or whether there is any hardening of other arterial vascular arteries, there are examination items.
Renal: microalbuminuria, or decreased renal function. Microalbuminuria is not something that can be seen by the usual physical examination of the urine routine, and should be specially tested. Kidney function depends on the level of blood creatinine, but also to estimate the glomerular filtration rate, the doctor will see.
Methods of assessment of hyperlipidemia guidelines.
It is dedicated to the evaluation of patients with hypertension, based on blood pressure and lipid levels as well as risk factors. Lipids refer to cholesterol.
Grade III hypertension is already high-risk, and here we are talking about grade I and II hypertension.
Blood lipids are particularly high-risk, and what is said here is that blood lipids are at normal levels or have not yet increased to the level of high-risk.
Blood lipid cholesterol levels are divided into three levels.
Total cholesterol and LDL cholesterol are higher than the normal value of the first grade; total cholesterol in 4.1 ~ 5.2mmol / L, low density within 2.6 ~ 3.4mmol / L is counted as a grade; total cholesterol in 3.1 ~ 4.1mmol / L, low density of 1.8 ~ 2.6mmol / L within a file, even if it is high, medium and low.
There are 3 risk factors: smoking, decreased HDL cholesterol, age: male ≥ 45 years, or female ≥ 55 years.
Let's say high risk, because the treatment is up, low/medium risk is a grade.
In patients with hypertension, 3 risk factors are available, no matter what level of blood lipids are high risk; with 2 risk factors, even if the blood lipid level is at the mid-range level, it is also a high risk.
How do young people count?
Young people are less risky of age, can not be rated as high-risk, but also to evaluate, called "risk for the rest of life".
The risk factors for young people have changed: high-density reduction, smoking is not counted; increased obesity, that is, body mass index ≥ 28kg/m2; and non-HDL cholesterol reduction, ≥ 5.2mmol/L, which is calculated, total cholesterol minus HDL cholesterol; secondary hypertension, that is, blood pressure ≧ 160/100mmHg.
The high-risk young people are not counted in the front, and if there are two here, they are also high-risk.
After assessing the risk, it is time to lower blood lipids.
High-risk patients, don't wait, take medicine plus improve your lifestyle.
Patients with first-degree hypertension, low and moderate risk can first improve lifestyle observation, and if they can't get down in 3 to 6 months, then take medicine.
What are the standards for lowering lipid cholesterol?
In low- and moderate-risk patients, the "low density" drops below 3.4 mmol/L, which is within the normal range, or the "non-high density" drops below 4.1 mmol/L.
In high-risk patients, the "low density" drops below 2.6 mmol/L; or the "non-high density" drops below 3.4 mmol/L.
If the original blood cholesterol level is relatively low, it is 30% lower than the original level.
Eat hypolipidemic drugs, you must see that it is not up to standard, and it is up to standard!
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