Today (17 May) is World Hypertension Day, and this year's theme is "Accurate Measurement, Effective Control, Healthy and Longevity".
According to statistics, the prevalence of hypertension among adults (≥ 18 years old) in mainland China is 27.9%, about 245 million people. In other words, almost 1 in 4 adults has high blood pressure. Hypertension is more than simply high blood pressure, it is an important risk factor for stroke, coronary heart disease, kidney disease, hardening of the lower extremities, and death.
01
Why are there more and more young and middle-aged patients with hypertension?
Can losing weight lower blood pressure?
Nowadays, there are more and more young people with high pressure, and there may be several factors:
01
lifestyle
Most of today's young people are heavier, less physically active, less exercised, stay up late or eat unhealthy diets, such as ordering takeout and eating fast food.
02
High pressure at work
Because young people are now more competitive and stressed, the sympathetic nervous system is in a state of high excitement for a long time, resulting in the inhibition and excitatory process of the cerebral cortex is out of balance.
For this part of the patients, a term has gradually formed: hypertension in young and middle-aged people. Their blood pressure has a characteristic, the elasticity of blood vessels is better, systolic blood pressure is often not particularly high, but diastolic blood pressure is high, for example, the patient's blood pressure is often 130, 100.
Treatment is preferred by suppression of sympathetic excitation, and β blockers are preferred, which can lower diastolic blood pressure and return blood pressure to normal. Of course, the choice of this drug should be carried out under the guidance of a professional doctor. For example, some young people are very fat, have a short neck, and may have sleep apnea, in this case, β blockers may not be suitable, and some other drugs can be selected.
For young people with high blood pressure, such as obesity, weight loss is the best way to do it. This kind of patient is often accompanied by high blood sugar and high blood lipids, that is, there are three highs, in this case, weight loss is the most important, after losing weight, it is possible not to take medicine, or to take a small amount of medicine, on the contrary, if you do not lose weight, you may take a lot of medicine, and the effect of lowering blood pressure is not ideal.
In terms of exercise, walking 6,000 steps a day is considered a moderate-intensity exercise, 30-40 minutes. The World Health Organization recommends 150 minutes of moderate-intensity exercise a week, which means walking 6,000 steps a day, or five days a week, even if you have completed moderate-intensity exercise.
02
How do I self-check my blood pressure at home?
In general, there are three ways to measure blood pressure:
Clinical blood pressure
In the doctor's office, blood pressure is measured by a doctor.
Ambulatory blood pressure monitoring
In the hospital, carry a small box, the same as the Holter ECG, called ambulatory blood pressure monitoring.
Home self-blood pressure monitoring
For ordinary patients, the most important of the three blood pressure monitoring is home self-measurement.
If the patient is confirmed to have high blood pressure and comes to the hospital to prescribe medicine, the medicine is generally prescribed for a week to see if there are any side effects when taking it, whether the body reacts to the medicine, and how effective it is.
During this period, patients are generally required to measure their blood pressure twice a day, once in the morning, once in the evening, and twice at a time, that is, twice in the morning and twice in the afternoon, and take the average of these two values as the blood pressure in the morning and the blood pressure in the afternoon. Write it down in a notebook every day and show it to the doctor for seven days. The next step is that the patient can take the drug for a long time.
In the case of long-term medication, it is enough to insist on it once or twice a week, and there is no need to test it every day.
03
What are the treatments for high blood pressure?
Treatment of hypertension can currently be divided into three categories:
Non-pharmacological therapies
In terms of beneficial lifestyles, such as practicing tai chi and practicing calligraphy, it is especially helpful to lower blood pressure. At the same time, it is necessary to change some unhealthy lifestyles.
First, control salt intake. The World Health Organization recommends no more than 5 grams of salt a day, but we often eat more salt in our lives. If you have high blood pressure, be sure to limit your salt intake.
Second, smokers and drinkers should quit smoking and drinking.
Third, strengthen exercise, through which the imbalance between sympathetic and parasympathetic of the autonomic nerve can be adjusted, that is, the excitatory and inhibitory processes are out of balance, which helps to control blood pressure.
Fourth, weight control, obesity is a very important aspect of causing high blood pressure.
Fifth, adjust your mentality, let your mentality be in a balanced state, don't be too anxious and anxious in life or work, or be too anxious and anxious for a little thing, so that you are in a state of uncalm mood, which is not conducive to the control of blood pressure.
drug therapy
There are several classes of drugs commonly used in clinical practice, such as vasodilators, diuretics, and ACE inhibitors, sartans. Medication is currently one of the most basic and common ways to treat hypertension. Medications used in the context of lifestyle changes tend to work particularly well.
Surgical treatment
Surgical treatment is now mainly through transcatheter or transductal ultrasound to remove the sympathetic nerve innervation of the blood vessels of the kidney, which is called transcatheter renal sympathetic nerve denervation. However, the scope of application is not yet the mainstream clinical treatment, and it is only suitable for some refractory hypertension.
At present, the mainstream treatment for hypertension is medication and lifestyle changes.
Editor-in-charge: Dong Xiaoxian