As a doctor who has been working in the cardiovascular department for a long time, I encounter many patients with high blood pressure every day. They came to my office with all kinds of questions and concerns, and one of the most common questions was, "Doctor, is my blood pressure as low as possible?" Hidden behind this question is a common misconception in hypertension treatment, which is that the goal of blood pressure control is "as low as possible". Through this article, I hope to be able to dispel these misconceptions and help patients understand and manage their blood pressure more scientifically. Let me share a practical example. Last week, a 65-year-old patient with high blood pressure, Mr. Zhang, came to my clinic. He prides himself on keeping his blood pressure below 120/80 mmHg, but lately he has been experiencing frequent dizziness and fatigue. After examination, I found that his blood pressure was actually too low and not suitable for his current physical condition. This condition is due to his excessive pursuit of low blood pressure, which causes the body to be unable to adapt to the low blood pressure level. From Mr. Zhang's example, we can see that when hypertensive patients pursue their blood pressure control goals, they need to adjust according to their specific individual circumstances, rather than blindly pursuing low values.
Hypertension control criteria
In the treatment and management of hypertension, it is important to understand the correct standard of blood pressure control. According to the latest medical guidelines and research, the goal of blood pressure control is not set in stone. In practice, this criterion is adjusted based on the patient's age, comorbidities, and overall health. 1. Goal of blood pressure control in young patients; For young, hypertensive people who don't have other serious health problems, doctors usually recommend keeping blood pressure below 130/80 mmHg. This goal helps reduce the risk of long-term cardiovascular disease. 2. Goal of blood pressure control in elderly patients; For hypertensive patients over 65 years of age, the goal of blood pressure control is somewhat relaxed, and maintenance below 140/90 mmHg is usually recommended. This is because low blood pressure may increase the risk of falls in older adults, as well as may lead to insufficient blood flow supply, affecting the function of various organs in the body. 3. Patients with concomitant diseases; If people with high blood pressure also have other medical conditions, such as diabetes, heart disease, or kidney disease, blood pressure control goals need to be more personalized. For example, people with diabetes may need to keep their blood pressure at a lower level to reduce the risk of kidney damage.
4. Medication and lifestyle modification: The management of hypertension does not rely solely on medication. Lifestyle changes, such as eating a balanced diet, exercising regularly, limiting sodium intake, quitting smoking, and limiting alcohol, are also important components of controlling blood pressure. Depending on the patient's specific situation, the doctor will recommend appropriate lifestyle modifications and medication regimens. In the treatment of high blood pressure, there is a widespread misconception that the lower the blood pressure control, the better. This view may stem from the quest for cardiovascular risk reduction, but in reality, too low blood pressure is not beneficial for everyone. This section will use medical data and clinical experience to dispel this common myth.
"The lower the better" for everyone
1. Risk of ultra-low blood pressure; For some people, especially older people, too low blood pressure can lead to reduced blood flow, which can affect the blood supply to the brain and other vital organs. This can cause symptoms such as dizziness, weakness and even loss of consciousness, and in severe cases, an increased risk of cardiovascular accidents. 2. Individual differences; The ideal blood pressure level for people with high blood pressure should be adjusted based on their age, overall health, and the presence of other medical conditions (e.g., diabetes, heart disease). For example, in young, healthy people with high blood pressure, a lower blood pressure target may help prevent long-term cardiovascular disease, while in older patients, a low blood pressure target may have more side effects.
Perspectives on medical research
3. Research-backed blood pressure ranges: Several studies have shown that controlling blood pressure within a certain range is safer and more effective for most people with high blood pressure. For example, one study showed that maintaining blood pressure between 130/80 mmHg and 140/90 mmHg was effective in reducing the risk of cardiovascular disease without having to lower blood pressure too low. 4. Adaptive treatment strategies: When treating hypertension, doctors will consider the patient's individual circumstances, including age, gender, disease history, and lifestyle habits. Adaptive treatment strategies aim to find the best blood pressure control goal for each patient to meet their individual needs, rather than "lower is better". practical advice for proper management of hypertension; Managing hypertension is a comprehensive process that involves multiple approaches and strategies. To help people with hypertension manage their blood pressure effectively, the following is a list of practical recommendations designed to achieve optimal blood pressure management through a combination of medication and lifestyle modifications. the correct application of drug therapy; Follow your doctor's instructions: Always follow your doctor's instructions for blood pressure medications. Don't increase or decrease your dose or stop taking it on your own, even if you feel well. Regular assessment: Discuss the effects of medication and any side effects with your doctor regularly, and adjust your treatment plan if necessary. Choice of medication: Choose the most appropriate type of medication based on the patient's age, complications, and other health conditions.
Key lifestyle adjustments: Eat wisely: Stick to a low-salt diet, increase your intake of vegetables and fruits, and reduce your consumption of high-fat and high-sugar foods. Regular exercise: Engage in at least 150 minutes of moderate-intensity exercise per week, such as brisk walking, swimming or cycling. Weight control: Maintain a healthy weight with a body mass index (BMI) at or near normal. Limit alcohol and quit smoking: Reduce alcohol intake, preferably quitting completely. Both tobacco and alcohol raise blood pressure and increase the risk of cardiovascular disease. Monitoring and self-management: Monitor your blood pressure regularly: Monitor your blood pressure regularly at home so that you can spot any abnormal changes in time. This can also help doctors better understand daily fluctuations in blood pressure and adjust treatment plans. Stress management: Learn effective stress management techniques, such as deep breathing, yoga or meditation, to help lower blood pressure. Engage in health education: Enhance your understanding and knowledge of hypertension management through reading, attending seminars, or talking to medical professionals.