May 17 is the 20th World Hypertension Day. According to data from the National Center for Cardiovascular Diseases, the prevalence of hypertension among residents aged 18 and above in mainland China is 27.5%, that is, about 1 in 4 adults is a hypertensive patient, and the number of people affected is about 245 million.
Hypertension will lead to atherosclerosis throughout the body, causing the blood supply and oxygen supply to various important organs to be affected, resulting in damage to the heart, brain, kidneys, eyes and other organs, and the high incidence of hypertension-related complications will further push up the treatment cost of related cardiovascular and cerebrovascular diseases, which will become a huge burden on society and families.
The stereotype that hypertension is a disease of old age, but the reality is that hypertension is gradually getting younger. In 2020, a survey covering 890,000 young and middle-aged people (35~49 years old) in mainland China showed that 26.2% of them had different types of hypertension. Therefore, young people should not take high blood pressure lightly.
Hypertension is the core of the prevention and treatment of cardiovascular and cerebrovascular diseases in mainland China
There is a clear genetic predisposition to hypertension, and if parents have hypertension, the incidence of high blood pressure passed on to their children will also increase significantly. In addition, long-term mental stress, irregular life and diet are the reasons for the younger age of hypertensive patients.
Zhang Long, deputy chief physician of the Department of Cardiovascular Medicine of Peking University First Hospital, introduced that blood pressure refers to the pressure of blood in the blood vessels on the blood vessel wall, and usually the blood pressure we say refers to the arterial pressure. When the heart contracts, a large amount of blood enters the arteries, and the pressure on the walls of the blood vessels is the highest, resulting in systolic blood pressure, also known as high pressure. When the heart is diastolic, the amount of blood in the arteries is the lowest, and the pressure on the blood vessel walls is the lowest, and diastolic blood pressure, also called low pressure, is generated. The difference between systolic and diastolic blood pressure is called the pulse pressure difference.
Hypertension is diagnosed when systolic blood pressure > 140 mmHg and/or diastolic blood pressure > 90 mmHg measured not on three consecutive visits on the same day without the use of antihypertensive drugs. If the family continuously measures blood pressure for 5~7 days, and the average blood pressure > 135/85mmHg, it can be considered as a diagnosis of hypertension.
Detailed division of blood pressure standards: < 120 >
Most patients with hypertension have no obvious symptoms and discomfort, which leads to a lack of self-awareness and attention, so that the awareness rate, treatment rate and compliance rate of hypertension are relatively low. Hypertension is the main risk factor for cardiovascular and cerebrovascular diseases, which can lead to coronary heart disease, angina, myocardial infarction, heart failure, stroke hemiplegia, acute cerebral hemorrhage, renal failure, proteinuria, etc., and the effective control rate is only 16.8%, so hypertension is the core of the prevention and treatment of cardiovascular and cerebrovascular diseases in mainland China.
Long Deyong, a doctor at Beijing Anzhen Hospital affiliated to Capital Medical University, said that hypertension and atrial fibrillation are the most common diseases in the cardiovascular system, and the two are very strongly related. According to statistics, more than 50% of patients with atrial fibrillation suffer from high blood pressure. Previous studies have shown that for every 10 mmHg increase in blood pressure, the incidence of atrial fibrillation increases by about 6%, and the risk of stroke and fatal myocardial infarction increases by 53% and 31%, respectively.
Many studies have found that the vast majority of patients with atrial fibrillation have high blood pressure. Both hypertension and atrial fibrillation can lead to stroke and heart failure, and the harm of hypertension combined with atrial fibrillation has a superimposed effect. Studies have shown that 70% of ischemic stroke patients have hypertension, and hypertension combined with atrial fibrillation can also significantly increase the risk of adverse events such as heart failure, renal dysfunction and death, and the disability and mortality rates are high.
There are 3 major misunderstandings about hypertension
The common symptoms of hypertension are dizziness, headache, fatigue, palpitations, etc., but there are many people who have no special symptoms in the early stage of hypertension, and may find out that they have hypertension by chance during a physical examination, but the damage has been quietly occurring, so hypertension is also known as the "silent killer".
The doctor reminded that many people have misunderstandings about hypertension, which is easy to delay the condition and cause irreversible consequences.
Myth 1: If you don't have symptoms, you don't have high blood pressure. Hypertension is measured by blood pressure, not by feeling, and there is no clear relationship between the level of blood pressure and the severity of symptoms.
The absence of discomfort does not mean that the blood pressure is not high, and most people with high blood pressure have no symptoms. Some patients do not feel any significant discomfort despite elevated blood pressure, because they have adapted to high blood pressure levels over time and may not "feel" until a cerebral hemorrhage occurs.
Myth 2: No feeling is the same as no harm. The blood vessel wall is easily damaged under high pressure, so that the cholesterol in the blood has the opportunity to be deposited on the blood vessel wall, which promotes the formation of plaque in the blood vessel and accelerates the process of atherosclerosis. In addition, in order to combat the abnormally high pressure of the blood, the blood vessel wall will become thicker, the blood vessel lumen will be narrowed, and if plaque is combined, the blood vessel will be too narrow or blocked, resulting in a long-term shortage of nutrients and oxygen to some organs, and in severe cases, it will cause serious complications such as thrombosis and cerebral infarction.
Myth 3: Drugs to improve symptoms can replace antihypertensive drugs. When hypertensive patients have symptoms such as headache and dizziness, they are accustomed to using painkillers and anti-dizziness drugs, which cannot replace antihypertensive drugs.
Scientific use of medicine, prevention starts from daily life
For the health of yourself and your family, it is very important to monitor your blood pressure regularly to help achieve early detection and prevention of high blood pressure. The 2019 Chinese Family Blood Pressure Monitoring Guidelines recommend that people over the age of 18 measure their blood pressure at least once a year and pay attention to changes in blood pressure.
Know how your blood pressure changes. A person's blood pressure level varies throughout the day. Normal people's blood pressure will show an obvious circadian rhythm, that is, 6~10 o'clock in the morning and 4~8 o'clock in the afternoon are the two peak stages of blood pressure in a day, and the early morning is often a trough period of blood pressure, which is the so-called "double peak and one valley".
Studies have shown that the risk of stroke is 4 times higher in the early morning hours than at other times. In addition, Asian populations are relatively more likely to develop early morning hypertension than Europeans. Early morning hypertension is an important risk factor for cardiovascular and cerebrovascular accidents, which needs to be paid special attention.
For people with diagnosed hypertension, doctors recommend that blood pressure should be monitored every day within 1 hour of waking up, before taking antihypertensive drugs, before breakfast, and after emptying the bladder. After remaining at least 5 minutes, self-check your blood pressure at home in a sitting position.
Patients with high blood pressure, whether they feel it or not, should follow the doctor's instructions and continue to take medication. For the vast majority of patients diagnosed with hypertension, it is often necessary to take medication regularly on time for a long time to stabilize blood pressure and prevent hypertension-related complications. Therefore, patients should not stop treatment at will or change treatment regimens frequently. Because the blood pressure will rise again after the sudden withdrawal of the drug, it is easy to cause excessive fluctuations in blood pressure, causing more serious damage to the heart, brain, kidney and other organs, and even becoming the fuse of stroke and myocardial infarction. Dose reduction should be performed as directed by a physician and blood pressure should be closely monitored during this time.
Some patients worry that antihypertensive drugs will become "resistant" and they will not be able to stop taking them, which is a very wrong and dangerous concept. Because antihypertensive drugs are not antibiotics, they do not develop "drug resistance". The earlier the blood pressure is controlled, the better the effect of preventing heart, brain, and kidney dysfunction, and if you wait until the organ function has been damaged before taking the drug, the best treatment time will be lost.
Lifestyle changes should be made even if medication is adhered to. Non-pharmacological measures are the cornerstone of choice for the treatment of hypertension, and weight control, salt restriction, smoking cessation, mood swing avoidance, and reasonable exercise are all indispensable.
Reduce sodium intake. Sodium intake is positively correlated with blood pressure levels and the prevalence of hypertension, and salt restriction is a key point in dietary therapy. Sodium can significantly increase blood pressure, while potassium can counteract the blood pressure-raising effect of sodium salt. It is recommended that the daily sodium intake should be less than 6 grams.
Reduce sugar intake. High blood sugar can damage the walls of blood vessels, which in turn secrete too much insulin, which stimulates blood vessels to constrict and cause high blood pressure. Therefore, patients with high blood pressure should pay attention to reducing sugar intake.
Control your weight. Weight loss is beneficial to lower blood pressure in hypertensive patients, and systolic blood pressure can be reduced by 4mmHg for every 1000g of body weight lost. Weight loss should not be too fast, and it is advisable to lose 10% of the original body weight within one year.
Control alcohol intake. The prevalence of clinical hypertension increases with alcohol consumption. The higher the amount of alcohol consumed, the higher the systolic and diastolic blood pressure, and there is also a risk of hypotensive shock.
Stay in a good mood. When a person is in a bad mood, adrenaline levels rise, and blood pressure rises.
Improves sleep. The quality of sleep of a hypertensive patient on the previous day affects the fluctuation of blood pressure that day, and if you do not sleep well, your blood pressure will inevitably increase. Therefore, patients with high blood pressure should have a good attitude and a good sleep. (All-media reporter Zhang Zheng)
Source: China Women's Daily