Journal of Henan Medical College,2024,36(02):221-224.
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High blood pressure, also known as elevated blood pressure, is a condition in which blood flows through the blood vessels and the pressure on the blood vessel walls is continuously higher than normal. Because hypertension generally has no symptoms, many people do not know that their blood pressure is high, and by the time symptoms appear, cardiovascular and cerebrovascular lesions usually have appeared, so hypertension is also known as the "silent killer".
Uncle Zhang is 65 years old and a retired employee of a state-owned company. On June 12, 2021, Uncle Zhang went to Uncle Liu's house to play chess with him, but no matter how he knocked on the door, he did not reply. Instead, he heard a sound at the door and said that Uncle Liu was taken away by an ambulance last night, and I heard that it was a cerebral hemorrhage caused by high blood pressure.
After Uncle Liu was discharged from the hospital, Uncle Zhang came to visit him with fruits. I was surprised to find that the right half of Uncle Liu's body couldn't move at all, and he was all eating and drinking in the same bed, not to mention the quality of life, and his heart was also very painful. Unexpectedly, the seeds of high blood pressure causing cerebral hemorrhage were deeply rooted in Uncle Zhang's heart.
On September 11, 2021, the community organized all middle-aged and elderly people to have a physical examination, and Uncle Zhang, who met the conditions, naturally participated. According to the Chinese clinical practice guidelines for hypertension, the standard for hypertension in adults is systolic blood pressure (hypertension) greater than or equal to 140mmHg and/or diastolic blood pressure greater than or equal to 90mmHg. It is a grade 1 hypertension.
Depending on the level of elevated blood pressure, hypertension can be classified into 3 levels. Grade 1 hypertension is systolic blood pressure between 140 and 159 mmGh or diastolic blood pressure between 90 and 99 mmGh, while Grade 2 hypertension has systolic blood pressure between 160 mmGh and 179 mmGh or diastolic blood pressure between 100 and 109 mmGh, and Grade 3 hypertension is also severe hypertension with systolic blood pressure greater than or equal to 180 mmGh or diastolic blood pressure greater than 110 mmGh. The higher the level of high blood pressure, the higher the risk level.
Uncle Zhang was shocked when he heard that he had high blood pressure. With Uncle Liu's experience, Uncle Zhang is also afraid that he will become one of them. The doctor told Uncle Liu that there is no clinical cure for hypertension, but it can be kept stable by changing lifestyle and taking medicine.
The doctor told Uncle Zhang that the main reason why hypertension can cause cerebral hemorrhage is that long-term hypertension will cause damage to the intima of blood vessels, and lipids will be deposited in the intima of blood vessels, resulting in a decrease in the elasticity of blood vessels. But don't worry too much, as long as you control your high blood pressure, you won't necessarily get a cerebral hemorrhage.
After Uncle Zhang heard the doctor's inform, his heart relaxed a little. I found that exercise and diet can control blood pressure, but I still dare not relax, take medicine on time every day, insist on aerobic exercise 3 times a week, do not eat greasy and irritating food, and resolutely strangle the factors that cause blood pressure to rise in the cradle, so my blood pressure has been well controlled.
On January 12, 2022, Uncle Zhang caught a cold when he got up early for exercise, and when he returned home, he found that he began to clear his nose, coughed from time to time, coughed up white mucus and phlegm, and his head was also groggy, so he soaked himself in cold spirit granules. Remembering that I hadn't measured my blood pressure today, I took out a blood pressure monitor from the cabinet, but I heard a voice announcement that your blood pressure was 165/85mmHg, which was on the high side. The whole person was sober all at once.
You must know that his blood pressure has been controlled at about 130/80 before, why is his blood pressure so high? Cerebral hemorrhage caused by high blood pressure has always been Uncle Zhang's heart disease, so he took a long-term nifedipine sustained-release tablet orally.
Nifedipine sustained-release tablets are long-acting antihypertensive drugs, which are released slowly in the body and have a long duration of action, and can maintain blood concentration for 20 hours at a time when taken orally to maintain the stability of blood pressure. Short-acting antihypertensive drugs such as captopril often have a fast onset of action when hypertension is high and can lower blood pressure quickly. Therefore, Uncle Zhang retested his blood pressure 1 hour later, and saw that there was no sign of blood pressure dropping, and then he was finally scared, as if he saw a cerebral hemorrhage waiting for him not far away, and hurried to the hospital for treatment.
The doctor was understanding Uncle Zhang's condition and told Uncle Zhang not to worry too much, because cold medicine generally contains ephedra, which can also raise blood pressure, and you can change the cold medicine. In addition, viruses or bacteria cause inflammation in colds, which will stimulate blood vessel constriction, resulting in temporary constriction of blood vessels and an increase in blood pressure.
This sentence reminded Uncle Zhang of something, raised his eyes, and told the doctor a few times about the brief increase in blood pressure before. After hearing this, the doctor smiled with relief and explained that the causes of high blood pressure are different, not all high blood pressure needs to take medicine, in addition to high blood pressure caused by cold medicine, there are 4 situations that do not need to take medicine!
- Some secondary hypertension does not require antihypertensive drugs
Secondary hypertension refers to high blood pressure caused by other diseases, and the phenomenon of rising blood pressure will gradually disappear after systematic treatment of the original disease. For example, gestational hypertension increases during pregnancy due to the constriction of small blood vessels throughout the body, and generally within 12 weeks after the birth of the child, the blood pressure will gradually return to normal.
2. Some new-onset essential hypertension
There are many causes of essential hypertension in mainland China, and one of the important factors is excessive salt intake. The main ingredient of edible salt is sodium, and after excessive intake, the body will dilute the sodium concentration, and the amount of water left in the body will increase, resulting in an increase in blood volume, which will increase blood pressure, that is, water and sodium retention.
Some new-onset hypertension do not need to take antihypertensive drugs. If there is no damage to the heart, kidneys, and cerebrovascular blood vessels after diabetes, then you can temporarily skip taking antihypertensive drugs. First of all, blood pressure medicine is taken through a healthy life, that is, exercise, weight loss, salt reduction, regular work and rest, abstinence from alcohol, and so on. In about 3 months, if the blood pressure returns to normal, then continue to live a healthy life in the future and do not need to take antihypertensive drugs. But if it is still higher than 140/90 for 3 months, then you need to take blood pressure medication to lower blood pressure medicine.
3. For patients who have already taken antihypertensive drugs
For example, people who start taking antihypertensive drugs can consider reducing the dose if their blood pressure is controlled below 110/70mmHg by controlling their weight, insisting on exercise, eating a strict healthy diet, not staying up late, reducing stress, etc. However, if the blood pressure is close to 90/60 after taking antihypertensive drugs, and the symptoms of dizziness and weakness of the limbs appear, you should seek medical attention in time, reduce or stop the drug under the guidance of the doctor, so as to avoid falling due to hypotension, and even insufficient blood supply to the brain, causing cerebral infarction.
4. Pseudohypertension
Pseudohypertension is when blood pressure is measured in an incorrect posture, or when the cuff is too tight or too narrow, which can lead to a high measurement result. One or two increases in blood pressure are not diagnostic of hypertension, and taking multiple measurements at intervals can prevent the development of pseudohypertension. At the same time, it is recommended to measure blood pressure every morning, at this time the measurement will be more accurate, try to rest for 30 minutes before measuring blood pressure, and wait for the blood pressure to return to stability, and then start to measure blood pressure.
To sum up, we can know that not all high blood pressure must take antihypertensive drugs, and whether to take antihypertensive drugs or not depends on each person's situation. Therefore, when diagnosing high blood pressure, there is no need to worry excessively, relieve anxiety, release stress, maintain a healthy life, and improve blood pressure, even without taking blood pressure medication!