After entering the summer, many patients with high blood pressure will find that their blood pressure during the day is much lower than before, even to the "normal value".
Some patients found that they could maintain normal blood pressure during the day without taking medicine after monitoring their blood pressure, and happily believed that high blood pressure was cured and gradually stopped taking it.
In fact, "high blood pressure cure" in the summer is an illusion, self-reduction and discontinuation, which is even more dangerous behavior for hypertensive patients.
Experts interviewed
Liu Jian, Chief Physician, Department of Cardiology, Peking University People's Hospital
Liu Ming, Executive Director and Deputy Chief Physician of Institute of Hypertension, Jiangsu Provincial Hospital of Traditional Chinese Medicine
"High blood pressure cured" in the summer is an illusion
A large cohort study of continental populations showed seasonal fluctuations in blood pressure as the months changed, with systolic blood pressure reducing systolic blood pressure by an average of 10 mm Hg in summer compared to winter.
On high temperature days, due to the principle of thermal expansion and contraction, the blood vessels of the human body will expand, the resistance of blood vessels will decrease, and blood pressure will drop accordingly.
At the same time, the human body sweats a lot in summer, and the salt is excreted with sweat, just like taking diuretics, resulting in a decrease in blood volume and a decrease in blood pressure.
As a result, some patients will have low blood pressure, and some patients find that they can maintain normal blood pressure during the day without taking medicine, thinking that high blood pressure is "cured".
However, a recent study by the Shanghai Institute of Hypertension found that blood pressure at night showed the characteristics of "high summer and low winter".
The increase in blood pressure at night has a hidden risk, which will increase the risk of damage to target organs such as heart, brain, and kidney, and it is necessary to strengthen monitoring and attract attention.
Blood pressure fluctuates, and blood vessels are prone to accidents
The weather is hot, and although the outdoor temperature is high, the indoor temperature may be lower due to the air conditioning.
Frequent alternation of cold and heat can easily lead to vasoconstriction, increased blood pressure, and may fluctuate 10~20 mm Hg in a short period of time, which may make hypertensive patients "recurrence of old diseases", and severe cases will also cause cardiovascular and cerebrovascular accidents.
In summer, the sympathetic excitability increases, the basal metabolic rate increases, the heart rate is fast, and the heart is also prone to "heat stroke" due to increased burden, and dangerous events such as myocardial ischemia, angina, and sudden cardiac death occur.
In summer, there is a lot of body fluid loss, which will also cause a decrease in circulating blood volume, slow blood flow, and an increase in blood viscosity, which will bring opportunities for thrombosis.
What happens if you reduce or stop taking your medication on your own
Leads to increased blood pressure fluctuations and increased risk of cardiovascular and cerebrovascular events.
It may bring about a "retaliatory rebound" of blood pressure, and blood pressure will rise again after stopping the drug for a period of time, and it is difficult to maintain stable blood pressure after taking the original dose.
Therefore, patients must reasonably adjust the type and dose of medication under the guidance of a doctor in summer.
Stabilize blood pressure that fluctuates with the seasons
In 2020, the European Society of Hypertension made 7 recommendations for seasonal fluctuations in blood pressure.
1. Confirm whether seasonal blood pressure changes occur by repeatedly measuring blood pressure in the clinic or outside the clinic to avoid unnecessary drug adjustment due to transient blood pressure fluctuations.
2. Exclude changes in blood pressure caused by other causes, such as dehydration, weight loss, poor adherence to treatment, taking foods or drugs that affect blood pressure, alcohol consumption, etc., and then attribute them to seasonal changes.
3. The summer blood pressure of hypertensive patients should be controlled between 120~130/70~79 mmHg.
4. When the blood pressure value is lower than the guideline recommended target value, especially when symptoms related to hypotension occur, the type and dose of antihypertensive drugs should be considered according to the doctor's advice.
5. Daytime systolic blood pressure in office blood pressure, home self-measured blood pressure, or ambulatory blood pressure
6. When reducing the dose of antihypertensive drugs, it should be carried out gradually according to the patient's health status, starting with drugs with weak indications and strong contraindications, and ensuring adequate control of blood pressure throughout the day.
7. After adjusting the drug, patients should regularly carry out home blood pressure monitoring or regular ambulatory blood pressure monitoring.
In life, in order to prevent discomfort caused by summer blood pressure fluctuations, it is recommended to do the following.
Replenish water intake appropriately
In summer, the temperature is high, visible and invisible perspiration will increase, so to ensure water intake, if there is no combined heart failure, renal insufficiency and other diseases, you should ensure to drink 2000 ml of water per day.
If acute watery diarrhea (strained) occurs, light salt water should be supplemented appropriately and antidiarrheal drugs should be taken.
Don't move too hard
Slow movements when getting up or getting up from a chair, it is best to sit or stand up for 3 minutes before walking.
Take medication as directed by your doctor
Patients with hypertension have large individual differences, do not increase the dose or combine drugs without authorization, pay attention to the use of antihypertensive drugs.
The elderly generally do not advocate taking a variety of antihypertensive drugs before going to bed, unless the doctor has a special explanation; Try to choose long-acting preparations, long-acting dosage forms that need to be swallowed whole, can not be broken open and eaten.
Stabilize your mind and sleep
Ensuring adequate sleep, keeping a relaxed mind and avoiding large mood ups and downs as much as possible can help maintain stable blood pressure.
Seek medical attention promptly if you feel unwell
If symptoms such as dizziness, chest tightness, and fatigue occur, hypotension should be suspected and seen as soon as possible. ▲
Editor of this issue: Xu Menglian