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Why do smokers get high blood pressure easily

 Why does smoking cause high blood pressure? At present, it is believed that it is mainly caused by nicotine, a highly toxic substance in tobacco. Nicotine can stimulate the heart and adrenal gland to release a large amount of catecholamine, make the heart beat faster, vasoconstriction, blood pressure rise. Some scholars have found that smoking an ordinary cigarette can increase the systolic blood pressure by 1.3-3.3kpa (10-30mmhg). Smoking a large amount of cigarettes for a long time, that is to say, smoking 30-40 cigarettes a day can cause the continuous contraction of small arteries. Over time, the smooth muscle of small artery wall degenerates, the intima of blood vessels gradually thickens and arteriosclerosis forms. Smoking also has an impact on blood lipid metabolism, can make blood cholesterol, low-density lipoprotein increased, high-density lipoprotein decreased, therefore, the process of atherosclerosis is accelerated, prone to rapid malignant hypertension, subarachnoid hemorrhage and coronary heart disease, myocardial infarction, etc., in addition, there are data show that smoking habits in patients with hypertension, due to reduced sensitivity to antihypertensive drugs Low, antihypertensive treatment is not easy to obtain satisfactory results, and even have to increase the dose.

It can be seen that smoking has a great influence on high blood pressure. Therefore, it is advised that smokers, especially patients with high blood pressure, should give up this bad habit in time.

Prevention and treatment of hypertension is the key, and regular physical examination is very important

 Every patient with hypertension should initially master the basic knowledge of judging the severity of the disease, which is very helpful to improve the cure rate and prognosis. Regular monitoring of blood pressure to understand the changes in blood pressure, do a healthy physical examination is necessary

According to the stage, hypertension can be divided into three stages. The first stage refers to those who have reached the level of diagnosis of hypertension and have no clinical manifestations of heart, brain and kidney complications. The second stage refers to those who have reached the level of confirmed hypertension and have one of the following items: 1. Physical examination, X-ray, ECG or ultrasound examination show left ventricular hypertrophy; 2. Fundus examination show fundus artery narrowing; 3. Proteinuria and (or) elevated plasma creatinine concentration. The third stage refers to those whose blood pressure reaches the level of confirmed hypertension and has one of the following items: 1. Cerebrovascular accident or hypertensive encephalopathy; 2. Left heart failure; 3. Renal failure; 4. Fundus hemorrhage, exudation or papilledema. In the first stage, the disease was mild without organic injury; in the second stage, the disease was severe with organic injury, but its function was normal; in the third stage, the organ function was decompensated, indicating that the disease was serious.

Look at the diastolic blood pressure

Mild: diastolic blood pressure was 95-104mmhg

Moderate: diastolic blood pressure was 105-114mmhg

Severe: diastolic blood pressure > 115mmhg

According to the course of disease, therefore, the general course of disease less than 10 years (except for a small number of acute type) can be regarded as mild, if the disease is more than 20 years, the disease is more serious, especially found late diagnosis, has not been reasonable treatment.

Looking at the family history, if the patient's lineal blood relatives (especially parents and siblings) suffer from hypertension and die of stroke or other complications of hypertension in middle age or before middle age, they should be particularly vigilant.

If hypertension patients have coronary heart disease, diabetes, hyperlipidemia, hyperuricemia and other diseases, it can accelerate the development of the disease, make the damage of important organs more obvious, and affect the choice of drugs for the treatment of hypertension, so it should be taken seriously. Under the guidance of the doctor, if the antihypertensive effect is still not ideal after the correct application of antihypertensive drugs, the blood pressure remains high, or sometimes high and low, and the blood pressure fluctuates greatly, this situation is prone to accidents, so we should take it seriously and ask the doctor to find out the reasons and adjust the drugs, so as to achieve satisfactory curative effect.

Several good ways of high blood pressure diet

 Hypertension should be paid attention to from the daily drops, and the people should take food as the day. Therefore, we should pay attention to the prevention and treatment of hypertension from the basic point of view:

1. Three meals

The diet should be arranged with a small amount of meals to avoid overeating; the patients with hypertension are often obese, and they must eat low-energy food. The total heat should be controlled at about 8.36 megajoules per day, the main food is 150-250 g a day, and animal protein and plant protein account for 50%. If there is no kidney disease or gout disease, the patients with hypertension may eat more soybean, peanut, black fungus or white fungus and fruit. Dinner should be less and light, and excessive greasy food can cause stroke. Edible oil should be made of vitamin E and linoleic acid; no sweet food. Eat more high cellulose foods, such as bamboo shoots, vegetables, cabbage, winter melon, tomato, eggplant, bean sprouts, jellyfish, kelp, onion, etc., as well as a small amount of fish, shrimp, poultry meat, skimmed milk powder, egg white, etc.

2. low salt

The amount of salt per person per day should be strictly controlled at 2-5g, or about a spoon. The salt content should also be reduced from the sodium contained in the cooking soy sauce, which is equivalent to 1 g of salt in 3 ml. Salty (sauce) vegetables, carrion, salted meat (eggs), pickled products, clam shellfish, shrimp, egg, and chrysanthemum, grass head, cabbage and other vegetables contain higher sodium, so they should be eaten as little as possible or not.

3. high potassium

Potassium rich food can be used to resist the pressure and vascular damage caused by sodium, and can be used in recipes. Such foods include beans, mushrooms, dates, almonds, walnuts, peanuts, potatoes, bamboo shoots, lean meat, fish, poultry meat, rhizome vegetables such as amaranth, rape and scallion, and fruits such as bananas, dates, peaches, oranges, etc. Fish are preferred for any type of hypertension, because epidemiological studies have found that the mortality rate of heart disease is significantly lower in those who eat fish once a week than those who do not.

4. fruits and vegetables

Every day, the body needs B vitamins and vitamin C, which can be satisfied by eating more fresh vegetables and fruits. Some people advocate that eating 1-2 apples a day is good for health. Fruits can also supplement calcium, potassium, iron and magnesium.

5. calcium supplement

People had hypertension take 1g of calcium a day and blood pressure was found to drop after eight weeks. Therefore, we should eat more calcium rich foods, such as soybeans, sunflower seeds, walnuts, milk, peanuts, fish and shrimp, red dates, fresh mustard, garlic seedlings, and purple vegetables.

6. iron mending

The results show that iron in the plasma of elderly patients with hypertension is lower than normal, so eating more iron rich foods such as peas and auricles can not only reduce blood pressure, but also prevent anemia in the elderly

7. drinking water

The natural mineral water contains the essential trace elements such as lithium, strontium, zinc, selenium and iodine. The boiled water will have precipitation, which will reduce the calcium, magnesium, iron and zinc which are beneficial to human body, so it is suitable for drinking water that meets the standard. Tea contains tea polyphenols, and the content of green tea is higher than that of black tea. It can prevent vitamin C oxidation, help the use of vitamin C in vivo, and eliminate harmful chromium ions. In addition, it also contains trace elements such as potassium, calcium, magnesium, zinc, fluorine, etc. Therefore, it is beneficial to human body to use 4-6 g tea (equivalent to 2-3 cups of bag tea) every day to brew and take it for a long time.

Above diet principle, hypertension patients if they can be implemented, persevered, will be beneficial to health.

Prevention of breast feeding hypertension in infants

 Breastfed infants prevent high blood pressure, which is lower in adults than in bottle fed infants. This means that they are at relatively reduced risk of heart disease, which is known as the number one killer in developed countries.

For a three-month-old, breastfeeding baby, his systolic pressure will drop by 0.2 percent. However, the time of breastfeeding had no significant effect on diastolic pressure of the heart.

"Although blood pressure has dropped only a little bit, it may be important for public health," experts said. The systolic pressure of the heart is reduced by 1 percentage point and the mortality rate due to various reasons will be reduced by 1.5% People with lower blood pressure are less at risk of heart disease, stroke, kidney disease and other related diseases. There are other benefits of breastfeeding, such as the fact that babies are not prone to obesity, are less likely to have behavioral problems, and are different intellectually from other babies. Therefore, experts suggest that all mothers should try to breastfed their babies in the first year, and if possible, the following year.

Experts believe that the nutritional components in human milk may be the main cause of blood pressure reduction. Breastfed children absorb relatively little sodium, which can affect blood pressure. In addition, there are more unsaturated fatty acids in breast milk, which can affect the development of blood vessels in infants. Experts point out that obesity is also related to hypertension, obesity also promotes the production of insulin antibodies, and it is easy to cause diabetes in adulthood.

Experts conducted a long-term follow-up study of 4763 children, and found that breastfed children grew up with lower blood pressure than those who grew up on milk powder. Despite factors such as the education level of mothers, socio-economic status and birth weight, experts still found that breastfed children were less likely to have high blood pressure.

Snoring and high blood pressure in women

 Women's parties often hear their complaints about their husband snoring. In fact, snoring is not only for men, but also for women. The latest research report points out that women who are slim, hate smoking and have a normal life will have latent high blood pressure and heart disease if they snore regularly.

40% of middle-aged men and 30% of middle-aged women snore frequently. Due to unknown reasons, the air supply is not smooth enough, resulting in respiratory tract stenosis, lack of oxygen in brain and body, low sleep quality and other problems. In the long run, it will not only affect the individual's sleep, but also cause the sequelae such as inattention, poor work efficiency, and even harm health.

The researchers tracked and interviewed tens of thousands of middle-aged women. Data show that people who are overweight, old and have smoking habits will certainly have snoring problems, but young, slim and non-smoking women will also have snoring symptoms. What's more worrying is that women's snoring sounds high blood pressure, but they don't know that there is a potential correlation between snoring and high blood pressure. Therefore, once you find that your partner has snoring problems, you should not be careless. You should accompany her to the hospital as soon as possible to find out the chronic diseases that hurt her body, so as to cure snoring thoroughly.

Reasonable exercise is necessary to control hypertension

 Having high blood pressure, reasonable exercise is essential

1. take a walk. All kinds of hypertension patients can be used. After a long walk, diastolic pressure can be decreased obviously and symptoms can be improved accordingly. Walking can be carried out in the morning, evening or before sleeping. The time is generally 15-50 minutes, once a day, and the speed can be determined by the physical condition of each person. It is a simple and easy exercise method to go for a walk in the fresh air area.

2. jogging or long run. Jogging and long-distance running are more exercise than walking, and are suitable for patients with light illness. The highest heart rate of patients with hypertension can reach 120-136 times per minute when jogging. Long-term exercise can make blood pressure steadily decrease, pulse is stable, digestive function is enhanced and symptoms are reduced. Running time can be increased gradually from less to 15-30 minutes. Slow down, don't run fast. If you have coronary heart disease, you should not run long, so as to avoid accidents.

3. Taijiquan. It is suitable for patients with hypertension in all stages. Taijiquan has a significant effect on the prevention and treatment of hypertension. According to the survey in Beijing, the average blood pressure of the elderly aged 50-89 who practiced Taijiquan for a long time was 134.1/80.8 mm Hg. The results showed that the level of mercury was significantly lower than that of the same age group (154.5/82.7 mm Hg). Taijiquan is three advantages for hypertension.

First, Taijiquan is soft in action, and the relaxation of the whole body muscles can relax the blood vessels and promote the blood pressure to drop.

Second, Taijiquan with the idea guidance movement, concentrated thinking, quiet mood, helps to eliminate the mental tension factors to the human body stimulation, conducive to blood pressure drop.

Third, Taijiquan contains balanced and coordinated actions, which helps to improve the balance and coordination of the action of patients with hypertension. Taijiquan is a variety of types, with simple and complicated, and can be selected according to each individual's condition.

But when exercising, the hypertension patients should not do the action of too strong bow, too large range of body position change and forced breath holding, so as to avoid accidents. The elderly often suffer from many chronic diseases, and should be paid more attention to during physical exercise, and it is better to exercise under the guidance of doctors. Hypertension patients should not take part in winter swimming.

Eat your blood pressure

 For patients with hypertension, the dietary requirements are very strict, especially the foods with high fat content, and should be respected. According to the research results of hypertension control in some countries in the world, some nutrition experts have proposed the method of "eating" blood pressure to the patients with hypertension

Eating 2-3 cloves of garlic a day is the easiest way to reduce blood pressure. The results showed that the average blood pressure of garlic paste was 11 mm Hg.

Melon and yogurt have a high mineral potassium content, and eating such food at breakfast helps to control blood pressure. A follow-up study of 2600 people showed that blood pressure could drop by 4 mmHg in five weeks after eating a diet containing 1 g of potassium in six days, such as a potato, a big banana or 226 grams of milk.

Orange juice is rich in vitamin C, while the higher the vitamin C content in blood, it helps to expand blood vessels, and the lower the arterial blood pressure. Therefore, drinking more orange juice is also beneficial to reduce blood pressure. Taking 60 mg vitamin C tablets a day, or eating more vegetables, lemons and other sour fruits, can do the same.

Experts wake you up, this article only provides some dietary suggestions for hypertension patients, but if the patients with hypertension, it is better to get medical advice!

Five points for attention in the morning of hypertensive elderly

 Most of the old people have the habit of getting up early. Fresh air in the morning is conducive to the discharge of harmful substances deposited in the respiratory tract at night and promote metabolism. However, due to the degradation of organs in the elderly, if we do not pay attention to health care, getting up early may also be harmful to health. Generally, the elderly should pay attention to five measures to get up early. Especially for the elderly with high blood pressure, we suggest you pay more attention to some points

Get up slowly: do not get up immediately after waking up in the morning, because the intervertebral disc of the elderly is relatively loose. If you suddenly change from lying position to standing position, it is not only easy to sprain your back, but also may affect the nervous system. People with high blood pressure and heart disease may have accidents if they suddenly change their position. When the elderly wake up, they can stretch on the bed, stretch their limbs and joints, lie on the bed and rest for a while before getting out of bed.

Water should be warm: cold water face washing has a strong stimulation to the facial skin of the elderly. In addition to those who insist on taking a cold bath for many years and have a healthy constitution, it is better for the elderly not to wash cold water. The water temperature of face washing should be controlled at about 10-15 ℃, not too hot or too cold. The direction of the towel is best from back to front, from bottom to top. In this way, washing the face in accordance with the direction of blood flow is conducive to promoting blood circulation and delaying facial skin aging. After washing the face, wipe the face with palms of both hands until the face is hot. It can also improve blood circulation and prevent colds.

Clothing should be warm: the clothing of the elderly should be added or reduced in time according to climate change. Due to the reduced ability of the elderly to defend against diseases, they are susceptible to wind and cold when they get up early, so it is better to wear warm clothes. When you get up in summer, open the window immediately to make the air circulate. But in winter, you should get up after a while, let the body adapt to the outdoor temperature and then open the window, so as to avoid catching cold after being blown by the wind and affecting your health.

Exercise should be appropriate: after getting up early, the amount of activity should not be too large and the time should not be too long. Taijiquan, qigong, jogging, unarmed exercise and other soft and slow activities are most suitable for the elderly to get up early. Activities should be a little faster heartbeat, a little shortness of breath for the degree, must not be able to show off. Avoid excessive movement that is fast, rotating or lowering your head. For the elderly with emphysema, arteriosclerosis, coronary heart disease, diabetes and other diseases, it is better to take a walk, and it is not suitable to walk too far away from home to avoid accidents.

Tea should be light: some old people like to get up early and drink a cup of strong tea slowly. This habit is actually not good for their health. In the morning, the stomach is basically empty. Drinking strong tea on an empty stomach will not only cause gastrointestinal discomfort, loss of appetite, but also damage the normal function of the nervous system. Therefore, it is generally not suitable to drink strong tea in the morning. When the old people drink tea in the morning, they can pour the first course of tea and drink the second course of tea. If you can add a little sugar and the right amount of white chrysanthemum in the tea, it will be better. Hypertension elderly can get up in the morning to drink water

Drinking tea can treat hypertension

 Hypertension is a common disease in the elderly. Besides the drug treatment, the patients can also play a good role in auxiliary treatment by drinking tea with traditional Chinese medicine.

Hawthorn tea: Hawthorn contains ingredients that can help digest, expand blood vessels, reduce blood sugar and reduce blood pressure. At the same time, hawthorn tea is often used, which has obvious auxiliary effect on the treatment of hypertension. The drinking method is to drink 1-2 fresh hawthorn fruit in a few times a day.

Chrysanthemum tea: all chrysanthemums should be chamomile, which has no bitter taste, especially the big white chrysanthemum or small chrysanthemum produced in the Suzhou Hangzhou area is the best. It is used to make tea about 3 grams each time, and it can be drunk three times a day. It can also be used to add honeysuckle and licorice to the same time for tea drinking. It has the effects of clearing liver and clearing the eyes and detoxifying heat. It has significant effect on hypertension and arteriosclerosis.

Lotus leaf tea: the practice of traditional Chinese medicine shows that the extract and decoction of lotus leaf have the effects of expanding blood vessels, clearing heat and relieving heat and reducing blood pressure. At the same time, lotus leaves are also a good medicine for fat reduction and fertilizer reduction. The drinking method of hypertension treatment is: wash and cut half of lotus leaves, add appropriate amount of water, boil and put the tea of cool offspring for drinking.

Sophora flower tea: after the buds of the Sophora tree are picked and dried, soaked in boiled water, they are used as tea for drinking several times a day, which has a unique therapeutic effect on hypertension patients. At the same time, sophora flower also has the function of constricting blood vessels and hemostasis.

Shouwu tea: it has the effect of reducing blood lipid and reducing thrombosis. If the blood lipid is increased, the effect of drinking Shouwu tea is very obvious. The method is to take 20-30g of the head black, add water to boil for 30 minutes, and drink it when it is warm and cool, and drink it every day.

Lotus seed heart tea: the so-called lotus seed heart refers to the green green embryo in the middle of the lotus seed, which tastes very bitter, but it has excellent effect of reducing blood pressure and removing fat. Use 12 grams of lotus heart, boiling water to brew tea for future generations. Drink it once a day, morning and night. Besides reducing blood pressure, it also has the special effects of clearing heat, calming mind and strengthening heart.

Cassia cassia tea: Cassia Cassia has the functions of lowering blood pressure, lowering blood lipid, clearing liver and bright eyes. Drinking cassia seed tea often has the effect of treating hypertension. It is a good product for treating hypertension, dizziness and unclear vision by drinking 15-20 g cassia seed in water for tea several times a day.

Corn mustard tea: corn whisker not only has a good effect of reducing blood pressure, but also has the efficacy of stopping diarrhea, hemostasis, diuresis and nourishing stomach. Make tea several times a day, 25-30 g each time. In clinical application corn whisker treatment for edema and hypertension caused by nephritis is particularly obvious.

Pueraria tea: Pueraria has the effect of improving blood circulation in the brain, and has a better effect on relieving headache, dizziness, tinnitus and lumbago leg pain caused by hypertension. Regular drinking of Pueraria tea has obvious effect on hypertension. The method of making it is to wash and slice Pueraria, 30g a day, add water and boil it to boil, and then drink it when tea is consumed.

Mulberry parasitic tea: Chinese herbal medicine mulberry parasitism is essential for tonifying kidney and blood. The clinical results of traditional Chinese medicine show that the use of San parasitic Decoction for tea has a significant auxiliary effect on the treatment of hypertension. The method of making mulberry parasitic tea is to take 15 grams of dried mulberry parasitic products, cook for 15 minutes, and drink it once a day, morning and evening.

Effect of propolis on hypertension

 Clinical practice and research have proved that taking propolis, which is rich in flavonoids and has strong antioxidant effect, can not only reduce the harm of lipid peroxide to blood vessels and prevent vascular sclerosis, but also effectively reduce triglyceride content, reduce platelet aggregation and improve microcirculation, so as to reduce high blood pressure, which has therapeutic effect on patients with hypertension.

Nikolov et al. Reported clinical observation on 100 million patients with hypertension. The patients were 45-72 years old and had a history of 4-15 years. They belonged to stage II and III hypertension. They took 30% propolis ethanol extract, 40 drops each time, three times a day, one hour before meals. After 20 days, the main symptoms of 37 patients (88%) were significantly improved, headache, dizziness and tinnitus disappeared, no precordial pain was found, and the heart function was improved Palpitation and pressure were relieved in 5 cases. Among them, 35 cases (83.4%) had decreased blood pressure, systolic blood pressure decreased by 20-40 mmHg on average, diastolic blood pressure decreased by 10 mmHg on average.

The latest standard and stage of hypertension

 When blood flows in blood vessels, it puts pressure on the wall of blood vessels, which is called blood pressure. It includes systolic pressure and diastolic pressure: systolic pressure refers to the pressure of blood on the wall of blood vessels when the heart is contracting; diastolic pressure refers to the pressure of blood on the wall of blood vessels when the heart is relaxing. Many factors will make blood pressure rise, reaching a certain standard is hypertension. The harm of hypertension lies in the damage to the heart, brain, kidney and other important organs of patients, resulting in serious lesions, and even stroke, myocardial infarction, renal failure and other disability, fatal accidents. On the division of normal blood pressure and hypertension, the latest regulations of the World Health Organization are: adult systolic blood pressure < 140 mmHg and diastolic blood pressure < 90 mmHg is normal blood pressure; systolic blood pressure ≥ 140 mmHg and / or diastolic blood pressure ≥ 90 mmHg is hypertension. If your blood pressure exceeds the normal standard three times in a row (not in the same day), you may have hypertension. At this time, you should go to the hospital in time.

Hypertension is divided into primary and secondary. Secondary hypertension is caused by some specific diseases such as acute and chronic nephritis, which only accounts for a small number of patients with hypertension (about 5-10%). And we usually say hypertension refers to primary hypertension, accounting for more than 90% of patients with hypertension. The etiology of essential hypertension has not been completely clear. It is generally believed that it is related to many factors, such as heredity, bad living habits and so on. The stage of hypertension is based on the level of blood pressure and the damage of target organs (heart, brain and kidney). Recently, the sixth report of the Joint Committee on the prevention, evaluation and treatment of hypertension in the United States classified adult hypertension as follows:

Staged systolic blood pressure (high pressure) (mmHg), diastolic blood pressure (low pressure) (mmHg)

Ideal blood pressure < 120 and < 80

Normal blood pressure < 130 and < 85

Normal high limit 130-139 and / or 85-89

hypertension

Stage1 140-159 and / or 90-99

Stage 2 160-179 and / or 100-109

Stage 3 ≥ 180 and / or ≥ 110

According to the degree of damage to heart, brain and kidney, hypertension can be divided into three stages: stage I without heart, brain and kidney damage; stage II with heart, brain and kidney damage, but the function is still compensatory; stage III with cerebral hemorrhage, heart failure, renal failure, etc.

Isolated systolic hypertension

 The so-called simple systolic hypertension, as the name suggests, refers to a person's diastolic blood pressure is not high, only systolic blood pressure exceeds the normal range. In March 1993, the World Health Organization re defined the standard of systolic hypertension above 21.3kpa (160mmhg) and diastolic blood pressure below 12.0kpa (90mmHg). If the systolic blood pressure is between 18.7kpa and 21.3kpa (140-160mmhg), it is called critical isolated systolic hypertension. At present, this diagnostic standard is widely used, but some diseases with increased output, such as aortic insufficiency, patent ductus arteriosus, systemic arteriovenous fistula, hyperthyroidism, severe anemia, etc., often appear simple systolic hypertension, which is not included in the scope of simple systolic hypertension. Because simple systolic hypertension occurs more in the elderly over 60 years old, so it is also called senile simple systolic hypertension, referred to as senile systolic hypertension, a small part occurs in young people with high dynamic circulation.

The incidence rate of these patients is very high. According to the sampling survey of hypertension in 30 provinces, municipalities and autonomous regions in 1993, more than 950 thousand people were investigated. The prevalence of isolated systolic hypertension was 1.25%, that is to say, 15 million of the patients with isolated systolic hypertension in the whole country, 60% of whom were elderly, about 13000000, accounting for 86.6%.

Many people don't know whether simple systolic hypertension needs treatment or not, and even mistakenly believe that high systolic blood pressure is a natural phenomenon, especially in the elderly. Is this really the case? Foreign scholars have followed up 5727 people for 20 years and found that the relationship between coronary heart disease and systolic blood pressure is significantly higher than that of diastolic blood pressure, and the relationship between stroke, left ventricular hypertrophy, congestive heart failure and systolic blood pressure is more closely than that of diastolic blood pressure. Fuwai Hospital in Beijing reported 117 cases of isolated systolic hypertension in the elderly, including 41.9% of them, 32.5% of heart failure, 28.2% of heart failure, and 57.3% of renal insufficiency. The incidence rate of hypertension was higher than that of other types of hypertension. There are also some reports that several complications of elderly hypertension, the most common in patients with systolic hypertension, especially prone to ischemic stroke. It can be seen that simple systolic hypertension must not be taken lightly.

A recent international study also pointed out that the treatment of elderly patients with simple hypertension is safe and effective, which can reduce cerebrovascular disease by 36% and cardiovascular disease by 32%. Therefore, it is suggested that simple systolic hypertension should be treated in time.

The treatment of simple systolic hypertension includes non drug treatment and drug treatment. Non drug treatment refers to life intervention measures, including regulating the law of life, reducing emotional stimulation, reducing excessive weight, limiting excessive nutrition, insisting on sports, limiting salt, quitting smoking, avoiding drinking, etc., which is an indispensable basic treatment for any patient with hypertension. The principle of drug therapy is to emphasize individualized treatment, pay attention to blood pressure fluctuation, target organ damage, complications and other risk factors. First, choose a single antihypertensive drug, start from a small dose, do not sharply reduce blood pressure, especially for the elderly, should pay special attention to, under the guidance of doctors, according to blood pressure monitoring, timely adjust the medication and dosage.

What is borderline hypertension?

 Borderline hypertension is also called borderline hypertension. Its systolic blood pressure is 18.6-21.3kpa (140-160mmhg), diastolic blood pressure is 12.0-12.6kpa (90-95mmhg). This disease is characterized by slightly higher blood pressure, no organic damage to the important organs, such as heart, brain and kidney, but it is easy to develop into hypertension. Clinical observation showed that 71.5% of borderline hypertension patients were easy to develop hypertension, while only 11.1% of normal people. The incidence of cerebral hemorrhage, cerebral thrombosis, coronary heart disease, and the mortality were similar to those of patients with hypertension, and significantly higher than those of normal people. Because it has no organic damage in the early stage, and lacks specific symptoms and signs, it is easy to be ignored. The prevention of this kind of hypertension is the same as that of general hypertension. However, the key is to control sodium intake, preferably less than 5g per day, and increase potassium intake, such as eating more fruits and vegetables. In addition, we should insist on sports and take calcium antagonists for a long time if necessary.

Hypertension and its treatment progress

 Hypertension can increase the risk of some cardiovascular complications, such as stroke, coronary heart disease and congestive heart failure. Effective treatment of hypertension can significantly reduce the incidence of cardiovascular events, complications and mortality. But the treatment of hypertension is a complex task, and it is also very difficult to make clear what is hypertension. In recent years, more and more evidence shows that lower blood pressure is also dangerous, which changes our understanding of optimal blood pressure.

Existing studies have shown that diastolic blood pressure is no longer the main determinant of blood pressure, systolic blood pressure and pulse pressure have replaced diastolic blood pressure as the main determinant of blood pressure. Evidence suggests that systolic blood pressure, pulse pressure and diastolic blood pressure are all part of the blood pressure characteristics of patients, and the age of patients determines the relative importance of these three measurements. Recent analysis shows that diastolic blood pressure is still the strongest predictor of cardiovascular events in people younger than 50 years old; in people younger than 60 years old, systolic blood pressure and diastolic blood pressure have the same predictive value for cardiovascular events, but ≥ Systolic pressure and pulse pressure are the most important predictors of mortality and complications of cardiovascular disease in people aged 60. In this age group, increased pulse pressure is the most important risk factor, but it is almost always accompanied by systolic hypertension. If systolic blood pressure > 120 mmHg and remains unchanged, the risk increases with the increase of pulse pressure (at this time, diastolic blood pressure decreases). In patients over 60 years old, systolic blood pressure was positively correlated with risk, while diastolic blood pressure was negatively correlated with risk. At a certain systolic blood pressure, the lower the diastolic blood pressure, the greater the risk of cardiovascular disease. The reason why diastolic blood pressure is negatively correlated with the risk of cardiovascular disease is that the physiology of cardiovascular system changes with age. From middle age, the aorta gradually becomes stiff, systolic blood pressure increases and diastolic blood pressure decreases. The parallel increase of systolic and diastolic blood pressure can reflect the increase of peripheral vascular resistance.

Prevention is the most effective way to deal with hypertension. In general, about 41% of the people whose blood pressure is higher than the normal high limit (systolic blood pressure 130-139 mmHg or diastolic blood pressure 85-89 mmHg) will develop into long-term hypertension within four years. Therefore, people with blood pressure higher than the normal high limit should also receive antihypertensive treatment.

Lifestyle change is an appropriate way to reduce the risk of blood pressure related cardiovascular events. Regular exercise (at least 3 times a week, 30 minutes each time), low-fat, high fiber diet, especially more fruits and vegetables, can reduce systolic blood pressure by 8 mmHg and diastolic blood pressure by 3 mmHg. Reducing sodium intake by 44 mmol every 24 hours can reduce diastolic blood pressure by 0.9 mmHg and systolic blood pressure by 1.7 mmHg.

The best treatment for hypertension (hot) studies have shown that although diastolic pressure drop to ≤ 80 mmHg does not further reduce the risk of cardiovascular events. However, severe cardiovascular events (myocardial infarction, stroke or death due to cardiovascular disease) did not increase, even when diastolic pressure drop reached 70 mmHg. Its clinical significance is that if active treatment of systolic hypertension leads to a decrease in diastolic blood pressure, even if the diastolic blood pressure drops to 70 mmHg is safe.

Studies have shown that systolic blood pressure should be reduced to < 150 mmHg and diastolic blood pressure should be reduced to < 90 mmHg for patients with hypertension at all stages. JNC VI suggested that most patients with stage 1 systolic hypertension should start drug therapy if the change of lifestyle can not reduce the systolic blood pressure below 140 mmHg. Patients with stage 2 and stage 3 hypertension should start drug therapy immediately. JNC IV suggested that SBP should be maintained at < 140 mmHg and DBP should be maintained at < 90 mmHg.

For patients with diabetes, blood pressure should be strictly controlled. UK Prospective Diabetes Study (UKPDS) and hot study pointed out that systolic blood pressure should be reduced to 140 mmHg and diastolic blood pressure should be reduced to 80 mmHg. Strict control of blood pressure can reduce diabetes related complications and mortality. Whether lower blood pressure is suitable for patients with type 2 diabetes remains to be further studied.

Previous studies have shown that diuretics and beta blockers can reduce the incidence of cardiovascular events and mortality in patients with diastolic hypertension. JNC Ⅳ suggests that the elderly should not use beta blockers alone, unless the comorbidity requires beta blockers. The elderly can be treated with diuretics first, and they can also choose dihydropyridine calcium antagonists for isolated systolic hypertension. The captopril prevention study (CAPPP) showed that captopril seems to be as effective in reducing the incidence of cardiovascular events as diuretics and beta blockers. However, this study also showed that captopril seems to increase the risk of stroke, while other studies have not reported that angiotensin-converting enzyme inhibitors increase the risk of stroke.

Nine ways to prevent hypertension

 Hypertension is a common cardiovascular disease, is the number one killer of human health. So how to prevent hypertension?

The public health examination center tells you that the following nine methods can help you to reduce blood pressure more smoothly and prevent hypertension:

1. Quit smoking;

2. In order to lose weight, women with lower weight should limit their daily drinking;

3. Reduce the intake of sodium (no more than 6 grams of salt per day);

4. Increase exercise (30-40 minutes of walking and other activities every day);

5. Eat more fruits and vegetables;

6. Eat more potassium food every day (the recommended intake of potassium is 3.5G per day, about 3 bananas per day, and drink three cups of orange juice);

7. The diet contains enough calcium (about 1300mg of calcium should be taken every day);

8. Limit the intake of saturated fat;

9. Limit cholesterol intake.

Cardiovascular experts from the public health examination center remind the majority of patients with hypertension to have regular physical examination, timely understand the condition and take care of their health. In addition, for people with high blood pressure, the Center specially launched three blood pressure packages: high blood pressure meal a, high blood pressure meal C, high blood pressure meal B. in addition, there are also health care packages to facilitate your physical examination.

Common symptoms and signs of hypertension

 Because of the different types of hypertension and different stages of the development of the disease, there are different severity and complex clinical manifestations.

The clinical symptoms of early patients are often not obvious, and hypertension is only found during physical examination. The blood pressure of the first patients increased at the same time, and the fluctuation of most patients was large, and it was often affected by mental and tired factors, and could be recovered to normal range after proper rest. The common clinical symptoms are headache, dizziness, tinnitus, forgetfulness, insomnia, fatigue, palpitation and other neurological disorders. The severity of symptoms is not proportional to the level of blood pressure.

When the condition develops continuously, the blood pressure increases in the middle and late stage, and it tends to be stable in a certain range, especially the increase of diastolic pressure is more obvious. Because of the long-term spasm of the whole body fine artery and the deposition of lipid in the wall of the tube, the wall hardening can cause ischemic lesions of the heart, brain, kidney and other important organs. Due to the different degree of damage and compensatory function of these organs, in addition to the above early general symptoms, the following clinical manifestations of one or several organs can also appear.

Heart: the blood pressure increases for a long time, and the left ventricular is compensatory. When the hypertension heart disease develops further, it may lead to the insufficiency of left heart function, and even the right heart hypertrophy and right heart dysfunction.

Kidney: it is mainly because of arteriosclerosis, which gradually reduces renal function, and there are many urine and nocturia. During urine examination, there are a small amount of red blood cells, tubular type and protein, and the proportion of urine is reduced. With the development of the disease, it can eventually lead to renal failure, and azotemia or uremia.

Brain: if the cerebral vessels have sclerotic or spastic space, it often leads to cerebral ischemia and hypoxia, and produces headache, dizziness, eye flower, numbness of limbs or temporary aphasia and paralysis. The cerebral vessels can be further developed and cause stroke on the basis of the above pathology, among which cerebral hemorrhage and cerebral artery thrombosis are the most common.

Fundus: in the early stage, the small retinal artery spasm or mild and moderate sclerosis can be seen, and in the late stage, there are bleeding and exudates, and optic nerve papilla edema can be seen.

Most of the patients with hypertension are developing slowly, and they are called slow-moving (benign) hypertension.

In a few patients, sudden hypertension may occur, especially diastolic pressure lasting from 17.33 to 18.66kpa or higher. The disease develops rapidly. Due to the severe spasm of the whole body arterioles, cellulose like necrosis of the wall of multiple organs of fine arteries may occur in a short time, or elastic fibers and collagen fibers proliferate, which may cause the obstruction of the lumen and the organic lesions of the heart, brain, kidney and other organs, which may lead to the heart and kidney dysfunction and even failure. Or the hypertension, stroke, prognosis is poor, need to be actively treated or rescue. This part of the patients are clinically called acute (malignant) hypertension.

The systemic fine artery is temporarily strong convulsion, and the blood pressure rises sharply, accompanied by severe headache, dizziness, nausea, palpitation, vision disorder, even coma, convulsion, etc., which is called hypertension crisis.

If the arterioles are severe and persistent spasm, they can cause stenosis of cerebral artery, cerebral thrombosis and small embolism, cerebral blood circulation disorder, and lead to cerebral ischemia, hypoxia, brain edema and intracranial pressure increase. The clinical manifestations are sudden onset, such as high blood pressure, severe headache, dizziness, vomiting, palpitation, vision disorder, unconsciousness, coma, convulsion, temporary hemiplegia, bleeding and exudates in retinal vessels, optic nerve papilledema, unequal size and round pupil on the second side, which is called hypertensive encephalopathy.

Nervous system and hypertension

 There is a lot of evidence that hyperactivity of sympathetic nervous system is the main factor in the formation and maintenance of hypertension. The increase of sympathetic activity increased the levels of renin and noradrenaline in these patients, and the stress response of blood vessels increased, which led to the enhancement of myocardial contractility, acceleration of heart rate, increase of blood volume of the heart, and contraction and spasm of peripheral resistance arterioles, which led to the increase of blood pressure. The patients with essential hypertension have excessive pressure-up and hypotension reactions in stress and relaxation. The degree of blood pressure drop in meditation or other relaxing state of the body, and the increase of blood pressure during mental calculation or emotional excitement are higher than that of normal people. These phenomena verify why the patients with hypertension often have tragedy on mahjong table and why the patients with hypertension are more grumpy than normal people. A large population survey found that the incidence rate of hypertension in city was significantly higher than that in rural area. During the World Cup football match, the rate of visiting patients with hypertension was significantly higher than usual, indicating that adverse environmental factors and stress reactions could also raise blood pressure. Stress plays a role in the sympathetic nervous system. Some antihypertensive drugs achieve the goal of reducing blood pressure by inhibiting the stimulation of sympathetic nervous system.

Age and hypertension

 In one's life, the blood pressure value is not constant. In normal physiological conditions, the blood pressure value varies with age, sex and other factors. The increase of systolic pressure was more significant than that of diastolic pressure, which was manifested by the increase of pulse pressure difference. This is due to the increase of age, the proliferation of collagen fibers, gradually replacing smooth muscle and elastic fibers, resulting in the decrease of vascular wall elasticity. The increase of blood pressure in men was higher than that of women, but after menopause, the difference between men and women decreased.

Nearly 30% of people over 15 years old have hypertension

 The reporter learned from the provincial CDC that the number of hypertensive patients in China has reached 160 million. According to the population of our province in 2000, the number of patients with hypertension in our province is as high as 1975 million.

On the morning of the 8th National Hypertension Publicity Day, the provincial CDC organized relevant departments to hold a free consultation on hypertension in Hualian square, the provincial capital. According to the staff of the Institute of chronic diseases of Shandong Center for disease control, the results of the survey on nutrition and health status of residents in seven counties and districts of Shandong Province in 2002 showed that the prevalence rate of hypertension among residents over 15 years old was 27.49%, higher than the national average level. According to the population of our province in 2000, the number of patients with hypertension in our province is 19.75 million. In the past few decades, the estimated number of adults with high blood pressure in China has increased from 30 million in 1960 to 160 million at present, and another 1.5 million people die of stroke and other diseases caused by high blood pressure every year. Among them, smoking, drinking and other bad habits become the "culprit".

According to Liu, director of Cardiology Department of provincial hospital, in addition to genetic reasons, long-term drinking, smoking, mental stress, lack of exercise, intake of salt and animal fat are the main causes of hypertension. Hypertension, which usually seems to be "not in the way of the overall situation", will lead to cerebrovascular, heart, kidney and other major diseases if it is allowed to develop without treatment.

In the interview, the reporter also found that many patients with high blood pressure are very "resistant" to antihypertensive drugs. They don't take antihypertensive drugs when their blood pressure is not high or they don't feel comfortable, but take excessive drugs once they feel uncomfortable. Experts remind that the current hypertension can not be cured, can only be controlled, such medication can only cause greater hidden danger. The main cause of blood pressure fluctuation is not taking medicine on time or forgetting to take medicine. High and low blood pressure is more likely to cause vascular disease, blood vessel rupture and bleeding, leading to acute heart disease, stroke and even sudden death. Therefore, the prevention and treatment of hypertension must ensure a healthy lifestyle, and patients with hypertension should regularly take drugs to treat hypertension, in order to achieve the purpose of controlling blood pressure.

Young people alert to asymptomatic hypertension

 The diagnostic criteria for hypertension in adults are the same. The normal blood pressure category is that systolic blood pressure (upper pressure) is less than 140 mmHg and diastolic blood pressure (lower pressure) is less than 90 mmHg. If the upper pressure is higher than 140 mmHg and the lower pressure is higher than 90 mmHg, it is called hypertension. Generally speaking, the older people, the higher the risk of hypertension.

To investigate the causes of hypertension in young adults, we can roughly list the following incentives: excessive nutrition, too little activity, too much mental pressure in daily work and life, overweight, and so on. Most people know that hypertension, diabetes and other life-long diseases, once the disease is difficult to "take off the hat.". However, hypertension in young adults is different: they are not as persistent as the elderly, but their blood pressure is unstable and sometimes increases. Such intermittent hypertension, in fact, can be completely cured through intervention.

As we all know, the formation of hypertension needs a gradual process, sometimes the human body continues to tension, blood vessels contraction, will produce intermittent hypertension; after this stage, the mood gradually relaxed, blood pressure will return to normal. Some young people are diagnosed with high blood pressure as soon as they find high blood pressure, and then take medicine for treatment. This practice is not scientific. Because intermittent hypertension is not equal to lifelong hypertension, patients do not have to take medicine for life.

Generally speaking, patients with hypertension will appear dizziness, irritability, tinnitus, fatigue, insomnia and other symptoms. However, some patients with high blood pressure do not have the symptoms mentioned above. In young people, the potential risk of asymptomatic hypertension is greater, especially need to be vigilant.

Clinically, we often find that some young people don't feel much, diastolic blood pressure (lower pressure) is too high. This is probably secondary hypertension. The so-called secondary hypertension, is in some diseases in the process of secondary blood pressure rise, hypertension is only one of the clinical manifestations of this disease. To deal with secondary hypertension, the most important thing is to find the root and have a definite aim. For example, due to endocrine system diseases secondary to hypertension, it is certainly useless to take antihypertensive drugs alone. Only after starting to treat endocrine system diseases can hypertension be alleviated.

Hypertension in children

At 12, chubby Dun was suffering from "three high", and he had all the "old age diseases" such as hyperglycemia, hypertension and hyperlipidemia. Such a special "small disease" surprised experts, "such a big child is type 1 diabetes, that is, genetic factors, but this small fat pier is actually type 2, that is to say, excluding genetic factors, the culprit is obesity." Jiangsu Provincial People's hospital endocrine experts told reporters, before really did not meet such a patient.

[case] the child has adult diabetes hypertension

Daming (pseudonym) is 12 years old, 1 m 65, but the body has been a little different, weight has reached 90 kg, more than an adult, according to family, as long as walking a little faster, children can not breathe, in recent times the child's head is a little dizzy, to the hospital examination found that diabetes.

Professor Liu Chao of Jiangsu People's hospital told reporters: the children were transferred from other hospitals to the hospital for a second visit. It was found that the children had diabetes, but also hypertension and hyperlipidemia. It was a typical "three high" patient, and the child actually had type 2 diabetes, which was caused by obesity alone.

No one is alone. The affiliated middle hospital of Southeast University has also received a small medical number recently. The 15-year-old boy Mingming (pseudonym), weight has reached 70 kg, according to the children's family, children have been feeling dizziness and insomnia in recent years, occasionally headache, results to the school medical room a blood pressure, even 170/110, is a typical hypertension patient. The family of the child has never had a history of hypertension, which basically excludes genetic factors. Experts in the hospital told reporters that children were treated early and high blood pressure could be controlled.

The harm of obesity is not only "three high". The people's Hospital of Jiangsu Province found that obesity leads to more and more patients who snore maliciously, and there are some patients with younger age. [status quo]

The detection rate of obese children increased 5 times in 10 years

The average rate of obesity children in China is increasing at an average rate of nearly 10% per year. The prevalence of obese children in cities such as Shanghai and Nanjing with rapid economic development has increased by about 5 times compared with that of 10 years ago. Experts from Nanjing Maternal and child health hospital told reporters that at present, the proportion of obese children in the country is 7.06%, while Nanjing has increased by 467.7% in the past ten years, and the incidence of obesity in the 6-7-year-old group has risen from 0.84% to 4.17%.

Another data shows that the prevalence of overweight and obesity among students in Jiangsu Province has reached 10%, the obesity rate of urban students is significantly higher than that of rural students, and the prevalence of overweight and obesity in Nanjing students is 19%. Experts in Provincial People's hospital told reporters that students pay more attention to eyesight in physical examination. Those with better conditions may also pay attention to the ears, nose and throat. Although they also weigh weight, they seldom give a reasonable suggestion and reminder. Even if they find that children are overweight, they do not point out the effect of overweight on children's health.

[effect] obesity also affects children's psychology and intelligence

Experts from Nanjing Children's Hospital said that obesity has physiological effects on children and adolescents, and has a great impact on psychology. The impression of "bloated, lazy, clumsy" caused by obesity is often regarded as clumsy, backward and ridiculed object, which makes obese children feel inferiority and mental pressure. Many children and adolescents obese students are not flexible in their movements and participate in collective activities, which makes their personality seem isolated. Some obese children and adolescents form "autism" who are unwilling to communicate with others, and their mental health level is declining, which has strong resistance to participate in collective activities or communicate with others.

In addition, the imbalance of amino acid metabolism in the food of obese children makes a large number of amino acids accumulate in brain cells, which affects the activity of brain cells. In the long run, intelligence will be behind the same age. Fat children have too much fat, oxygen consumption is 30% - 40% higher than that of normal people. Oxygen in the body "cannot be paid for", and often appear listless, easy to fatigue, sleepiness, and mental difficulty.

[reminder] the "face changing" of the students with low age disease

In recent years, the physical examination items of primary and secondary school students seem to have no change, mainly including examination of five official, color discrimination, vision, height, weight, blood pressure, internal medicine, blood test, chest permeability, vital capacity, etc. In recent years, with the changes of living conditions and living environment, diabetes, hypertension and other adult diseases have appeared the trend of low age. Experts suggest that students can increase their physical examination items when they are taking physical examinations, especially those with high incidence rate of teenagers. For example, children aged 1 to 3 need a medical examination once a year, and adolescents aged 3 to 18 should have a physical examination every year. In addition to physical examination and physical test, the routine physical examination of teenagers should also be regularly checked for blood routine and urine routine. Children with dysplasia should be tested for trace elements, and children with obesity and chest depression should be examined for blood lipid and blood glucose.

"Silent killer" hypertension

 Hypertension is not only a common cardiovascular disease, but also a vicious "killer" endangering human health. With the improvement of people's living standard, the incidence rate of hypertension is also increased. Hypertension is the main cause of coronary heart disease, stroke and other cardiovascular and cerebrovascular diseases. However, many patients with hypertension do not care, which brings great threat to their health. Therefore, we need to understand the related problems of hypertension in detail to prevent the occurrence of hypertension.

How to measure hypertension?

According to the World Health Organization (who), the standard of blood pressure is: systolic blood pressure ≥ 140mmHg (18.6kpa), diastolic blood pressure ≥ 90mmHg (12kpa). If adult systolic blood pressure ≥ 160mmhg (21.3kpa), diastolic blood pressure ≥ 95mmhg (12.6kpa) is hypertension; blood pressure value between the above two, that is, systolic blood pressure between 141-159mmhg (18.9-21.2kpa), diastolic blood pressure between 91-94mmhg (12.1-12.5kpa), is critical hypertension. In the diagnosis of hypertension, the blood pressure must be measured several times, and the mean diastolic blood pressure of at least two consecutive times is 90mmHg (12.0kpa) or above. Patients with elevated blood pressure only once can not be diagnosed, but need follow-up observation.

Pathogenesis of hypertension

The pathogenic factors of the disease: heredity, diet, obesity, occupation and environment, smoking and so on can lead to hypertension.

Due to improper diet, bad habits, work pressure and other reasons, the body's blood is acidic environment, the long-term existence of this acidic environment, will make red blood cells, white blood cells, platelets and other functional abnormalities. When the blood is in acidic environment, it will reduce the oxygen carrying capacity and transport capacity of red blood cells, damage the normal state of the blood vessel wall due to the deterioration and erosion of metabolites, thicken the blood vessel wall, narrow the lumen, slow down the blood flow speed, resulting in the formation of arteriosclerosis; in the acidic environment of blood, the normal defense and phagocytosis capacity of white blood cells decrease, resulting in the virus infection in human organs and tissues Harmful substances, such as bacteria, endotoxin, can not be engulfed and destroy the normal metabolism of all kinds of cells in the vascular wall, resulting in the damage and shedding of all kinds of vascular cells, which leads to the occurrence of atherosclerosis and the rise of blood pressure; the body's blood is acidic, which also causes the abnormal function of blood platelets. When the amount of acidic substances in blood increases, the endothelial cells of blood vessels will appear edema, rupture, shedding and other phenomena due to the corrosion of acidic substances, resulting in the bleeding of vascular smooth muscle due to exposure. The bleeding phenomenon will attract platelets to adhere and aggregate at the exposed place. In the process of adhesion and aggregation, platelets will also have a series of release reactions, resulting in the contraction of vascular wall, It can also cause high blood pressure.

Early treatment to control the disease

Hypertension patients should control the development of the disease in time, if not in time to reduce blood pressure, it will damage the heart, brain, kidney, lead to coronary heart disease, stroke, renal failure and even cerebral infarction and other serious consequences of disability and death.

With the development of medicine, there are more and more drugs for the treatment of hypertension, but the effect is not very ideal. Up to now, we have found a drug that can neutralize the acidic environment in the body. It is a newly developed biological agent in China. Maikang mixture, produced by Shijiazhuang Shentong Pharmaceutical Co., Ltd., contains a large number of chitin, amino acids, Auricularia auricula polysaccharide and other alkaline precursors. It can neutralize the acidic environment in the blood by oral administration of alkaline precursors, so as to make the blood present The acidic blood environment was improved. After the improvement of blood acidic environment, the oxygen carrying capacity of hemoglobin in red blood cells can be restored. When hemoglobin flows through the lung, oxygen in alveoli will be greatly combined by hemoglobin in red blood cells, and then effectively transported to cells and tissues with ischemia and hypoxia. With the recovery of oxygen transport capacity of red blood cells, the oxygen content in blood increases significantly, the hypoxia state of endothelial cells, smooth muscle cells and various tissues in blood vessels will be improved, and nutrients will be fully supplied. The acid-base imbalance in the body is balanced, the composition of blood, white blood cells, platelets and other functions are restored, the internal environment of the body's blood returns to normal, and hypertension is treated.

Hypertension crisis: 1 billion people suffer from hypertension in the world

 Developing countries and countries that are rapidly adopting Western lifestyles are growing fastest

A group of scientists published a report on the 14th, revealing a set of shocking data: nearly 1 billion people in the world suffer from hypertension, and the number of patients with hypertension will increase by more than 500 million by 2025. Moreover, this silent and terrible disease is not only widespread in the western world, but also increasingly common in Africa and other developing countries and regions.

Hypertension crisis

The report, written by Jane ostgren of Karolinska University Hospital in Sweden and experts from the London School of economics and the State University of New York, is the world's first hypertension report. The report points out that an era of high blood pressure crisis is coming. By 2025, there will be 1.56 billion people suffering from high blood pressure in the world.

According to the report, heart disease caused by high blood pressure causes millions of deaths every year. However, the problem of high blood pressure has not received the same attention as avian influenza. So far, the death toll caused by avian influenza is less than 200.

Hypertension is not only a cause of heart disease, but also a major cause of stroke, renal failure, blindness and dementia. Patients usually pay little attention to symptoms before organ damage.

The report calls on governments to take action to deal with high blood pressure just as they did with infectious diseases in the past.

"Even in the United States, most people with high blood pressure are not adequately treated." Dr. Smith of the University of North Carolina, who is a consultant to the World Heart Association, said, "look at Africa, look at the world, it's a major risk factor."

It's not easy to treat high blood pressure because patients often stop taking drugs and don't understand that they should stick to taking drugs even when they feel good.

Ideas need to change

The report calls for a change in the perception of hypertension in some countries. In the United States, sympathy for patients with high blood pressure is a recognized dinner topic. About 40% of African Americans have high blood pressure. In some black dominated churches, high blood pressure has become the topic of preaching.

However, in some countries and regions, the concept of hypertension is not as open as that in the United States. Michael Weber, one of the report's authors, said that in some areas, "it's a shame to have adults take antihypertensive drugs." He estimates that one third of adults in Mexico, Paraguay and Venezuela are affected by high blood pressure.

"We need to break these barriers and make this topic popular. We need to set a model in these countries so that we can face and discuss this issue openly."

Over 25% of Chinese adult patients

In the United States, hypertension affects as many as 72 million people, equivalent to one-third of the adult population, Weber said. The report points out that the proportion of people with high blood pressure in some Western European countries is higher than that in the United States, such as the United Kingdom, Sweden and Italy, accounting for 38% of the total population; the proportion in Spain is 45%, and that in Germany is 55%.

However, the report warns that it is developing countries and countries that are rapidly adopting Western lifestyles that are experiencing the fastest growth in hypertension. For example, the study found that in parts of India, one-third of urban adults have high blood pressure, while in rural areas where traditional lifestyles are maintained, patients with high blood pressure are rare. More than a quarter of Chinese adults have high blood pressure.

However, Smith stressed that reducing the number of people with high blood pressure will help developing countries avoid the spread of heart disease. Compared with hypertension, heart disease treatment is obviously more expensive.

Renal hypertension

 What is the cause of renovascular hypertension and what are its clinical characteristics?

The main causes of renovascular hypertension are as follows

(1) Renal artery lesions: 1. Atherosclerotic plaque of renal artery intima; 2. Fibrous tissue hyperplasia of renal artery; 3. Nonspecific Takayasu arteritis; 4. Congenital renal artery abnormalities; 5. Renal aneurysm, acquired or congenital; 6. Nodular periarteritis; 7. Renal artery embolism; 8. Renal artery or aberrant renal artery thrombosis; 9. Syphilitic renal arteritis; 10. Thrombotic renal arteritis; 1 1. Renal artery injury, trauma or surgical trauma; 12. Renal pedicle distortion; 13. Renal arteriovenous fistula; 14. Abdominal aorta coarctation with or without renal artery obstruction.

(2) Renal artery compression: 1. Abdominal aortic aneurysm; 2. Other mechanical factors, such as tumor, cyst, hematoma, fibrous band, paraaortic lymphadenitis and chronic inflammation around renal artery.

Renovascular hypertension in children is mostly caused by congenital renal artery abnormalities; young people are often caused by renal artery fibrous tissue hyperplasia, non-specific Takayasu arteritis; more than 50 years old patients, renal atherosclerosis is the most common cause.

What is the cause of renal parenchymal hypertension and what are its clinical characteristics?

The diseases causing renal parenchymal hypertension are as follows:

1. Primary glomerulonephritis, such as acute glomerulonephritis, progressive glomerulonephritis and chronic glomerulonephritis; 2. Lupus nephritis is more common in secondary glomerulonephritis; 3. Polycystic kidney; 4. Congenital renal hypoplasia; 5. Chronic pyelonephritis; 6. Radioactive nephritis; 7. Renal tuberculosis; 8. Giant hydronephrosis; 9. Renal tumor; 10. Renal calculus; 11. Renal amyloidosis; 12. Renal medullary cystosis.

Almost every kind of kidney disease can cause hypertension, whether unilateral or bilateral renal parenchymal disease. Usually glomerulonephritis, lupus nephritis, polycystic kidney, congenital renal hypoplasia and other diseases, if the lesion is more extensive and accompanied by vascular disease or renal ischemia is more extensive, often accompanied by hypertension. For example, diffuse proliferative glomerulonephritis often due to extensive lesions, severe renal ischemia, so that hypertension is very common; conversely, small lesions, focal proliferative glomerulonephritis rarely occur hypertension. Renal tuberculosis, renal calculi, renal amyloidosis, hydronephrosis, simple pyelonephritis, renal medullary cystosis and other lesions with renal tubulointerstitial damage are less likely to produce hypertension. But once these diseases develop to affect glomerular function, hypertension often occurs. Therefore, the incidence of renal parenchymal hypertension is closely related to glomerular function. The incidence of hypertension in end-stage renal failure can reach 83%.

What is the pathogenesis of renal hypertension?

The pathogenesis of renal hypertension mainly includes the following two points

* (1) easy to rely on hypertension: about 90% of renal hypertension is caused by water sodium retention and blood volume expansion. When the renal parenchymal lesion causes the kidneys to lose the amount of * (excess) water and salt contained in the excretory diet, it will cause water and sodium to remain in the body and cause excessive blood volume to cause hypertension. As long as there is mild renal insufficiency, this mechanism will appear. Plasma renin and angiotensin Ⅱ (a Ⅱ) levels are usually low in these patients. Hypertension can be reduced by limiting the amount of water and salt or removing too much water and salt through dialysis.

(2) Renin dependent hypertension: renal artery stenosis and 10% of renal parenchymal hypertension are caused by increased renin angiotensin aldosterone. Diuresis and dehydration can not control this kind of hypertension. On the contrary, the decrease of renal blood flow after diuresis and dehydration often leads to the increase of renin secretion and the increase of blood pressure. It is suggested that the renin angiotensin system plays an important role in the pathogenesis of this type of hypertension.

In fact, the pathogenesis of hypertension is much more complex than this simple classification. Because some patients' hypertension can't be explained by volume overload or excessive renin. At the same time, these two kinds of pathogenesis are interrelated. Increased blood volume often inhibits renin-angiotensin system, while salt loading greatly increases the sensitivity of a Ⅱ. The pressor effect of a Ⅱ mainly depends on the stability of sodium internal environment. Therefore, renal hypertension is divided into two categories, mainly to help understand and study the pathogenesis of hypertension, so as to find an effective way to reduce blood pressure.

Which diseases should renal hypertension be differentiated from?

Renal hypertension should be differentiated from the following diseases:

(1) Endocrine hypertension: in endocrine diseases, hypertension occurs in hypercortisolism, pheochromocytoma, primary aldosteronism, hyperthyroidism and menopause. However, the diagnosis can be made according to the history of Endocrinology, special clinical manifestations and endocrine test.

(2) Vascular disease: congenital coarctation of aorta, multiple Takayasu arteritis can cause hypertension. It can be differentiated according to the blood pressure of the upper and lower extremities, as well as pulseless disease.

(3) Intracranial disease: some encephalitis or tumor, intracranial hypertension, etc. often have hypertension. The nervous system symptoms of these patients are often prominent, which can be diagnosed by detailed examination of the nervous system.

(4) Other secondary hypertension: such as pregnancy poisoning and some rare diseases can appear hypertension, such as renin secreting tumor.

(5) Primary hypertension: the onset age is relatively late, may have family history, after excluding secondary hypertension can make a diagnosis.

High blood pressure for expectant mothers in winter

 Experts from obstetrics and Gynecology Hospital of Zhejiang University Medical College found that the number of patients with pregnancy induced hypertension syndrome increased significantly, which may be related to sudden cold weather and vasoconstriction. The index of hypertension of pregnant women is the same as that of ordinary people. If the blood pressure exceeds 140 / 90mmHg, we should go to the hospital in time to check the urine and exclude pregnancy induced hypertension syndrome.

Obstetric director He Jing reminded that although the most easy to find is edema, but to the third trimester of pregnancy, many people will often have swollen legs. If the swelling is good the next day, there is no need to worry, which is a normal phenomenon; but if it is not good to rest for a few days, and it is not only swollen legs, face and hands, it is necessary to see a doctor in time.

The incidence rate of pregnancy induced hypertension is about 5%. At this time, the blood vessels of expectant mothers are as fragile as those of the elderly. If the weather changes slightly or the mood is excited, the blood pressure may go up. Generally speaking, young primiparas, elderly primiparas, pregnant women with a history of chronic hypertension, nephritis and diabetes, malnourished or short body, expectant mothers with a history of hypertension are the most likely to get sick, mainly manifested as edema, hypertension and proteinuria.

Due to high blood pressure, the placenta can not get enough blood, children are prone to premature delivery, and the incidence of sequelae such as poliomyelitis is also high. When pregnancy induced hypertension syndrome is serious, convulsions, coma, cardiac and renal insufficiency will occur, and even the mother and baby will die. This probability accounts for 4.2% of pregnant women with pregnancy induced hypertension syndrome. Director He Jing also suggested that prenatal examination should be done to see if it is the high-risk constitution of pregnancy induced hypertension syndrome; when the pregnancy reaches the middle and late stage, try to keep a relaxed and happy mood. Eat more light, digestible, high calorie, high protein food, salt must not eat more. If there is pregnancy induced hypertension syndrome, it is best to rest in bed, sleep to the left side as far as possible, in order to reduce the uterine compression of inferior vena cava.

80% of hypertension patients have complications

 Most patients with hypertension may need the combination of drugs to achieve the target level of blood pressure control. This is a new concept brought by authoritative experts in the field of hypertension prevention and treatment in China recently at the news conference of "the Chinese heart of lotine in the new decade". "The pathogenesis of hypertension is complex and diverse.

There are data showing that nearly 80% of the patients with hypertension are in stage 2 and 3 hypertension with complications. " Liu Lisheng, President of the Chinese Association of hypertension and Professor Liu Lisheng of Fuwai Hospital, said at the meeting that taking community-based health promotion activities, including health education, lifestyle intervention and drug treatment intervention, for the normal people, high-risk groups and hypertension patients, can effectively reduce and delay the incidence of hypertension, control and reduce the water of hypertension in the population Flat. This should be the way to explore the comprehensive prevention and treatment of chronic diseases in China.

Patients with hypertension are prone to coronary heart disease

 According to statistics, 60% - 70% of patients with coronary heart disease have hypertension, and the incidence of coronary heart disease in patients with hypertension is about 4 times of that in ordinary people. Among many pathogenic factors of coronary heart disease, hypertension is one of the main risk factors of coronary heart disease. Studies in China have shown that for every 10 mmHg increase in systolic blood pressure, the risk of myocardial infarction or sudden death of coronary heart disease increases by 28% after 9 years, while for every 5 mmHg increase in diastolic blood pressure, the risk increases by 24%.

Why is hypertension prone to coronary heart disease? This is because when the blood pressure rises, the vascular wall (mainly vascular intima, endothelial cells) is easy to be damaged, so that blood lipids (such as low-density lipoprotein, cholesterol, triglyceride, etc.) are easy to invade the arterial wall; at the same time, the function and metabolism of the vascular wall are also changed. High blood pressure can also cause vasodilation, stimulate the proliferation of smooth muscle cells, collagen and elastic fibers, and then promote the formation of atherosclerotic plaque. Extensive atherosclerotic lesions can easily lead to senile hypertension. Therefore, atherosclerosis and hypertension are closely related. In view of this, in the active prevention and treatment of coronary heart disease at the same time, we must prevent and treat hypertension. Focus on the following points:

1. Maintain normal blood pressure: normal blood pressure means that the systolic blood pressure is lower than 140 mmHg and the diastolic blood pressure is lower than 90 mmHg. Once suffering from hypertension, we must adhere to drug treatment.

2. Keep the weight normal: mainly through controlling diet and increasing the amount of exercise to carry out self-regulation. To this end, we should pay attention to the following points: diet, avoid too much sugar; fat intake should not exceed 30% of the total calories, including unsaturated fatty acids should be less than 10%; eat more vegetables, fruits, quit smoking, less alcohol; adhere to sports, such as walking, doing exercises, playing ball, etc.

3. Keep the blood lipid normal: if the blood lipid rises, it should be treated under the guidance of the doctor.

4. Proper medication: taking small dose aspirin can prevent platelet accumulation, reduce blood viscosity and improve microcirculation. This medicine can be taken under the guidance of a doctor.

What is the relationship between myocardial infarction and hypertension?

 Although hypertension itself is not fatal, but long-term uncontrolled hypertension is easy to cause fatal myocardial infarction. Hypertension increases the risk of myocardial infarction mainly through the following aspects:

1) Hypertension promotes coronary atherosclerosis, narrowing the lumen, resulting in the reduction of blood supply to the myocardium;

2) Long term hypertension leads to left ventricular hypertrophy, and the structure of capillaries in myocardium will be changed, which can not provide enough blood for myocardium;

3) Hypertension is very easy to cause coronary artery spasmodic contraction, so that the coronary artery is closed, and the blood supply to the myocardium is interrupted;

4) Sudden increase of blood pressure will cause the original atherosclerotic plaque to break off, form thrombus and block the coronary artery.

Studies have shown that effective control of hypertension can reduce the mortality of myocardial infarction by 27%. Therefore, the control of hypertension is of great significance to the prevention of myocardial infarction.

How does hypertensive patient control weight?

 Obesity is closely related to hypertension, which can be one of the causes of hypertension. Weight loss of obese people can reduce blood pressure, relieve headache, edema, proteinuria, dyspnea and other symptoms. Therefore, we should fully understand the harm of overweight and obesity, consciously cooperate with doctors, and effectively control weight.

The main way to lose weight is to control diet and increase physical activity. Some studies have pointed out that reducing 418.63kj calorie diet or consuming 418.63kj extra calories through physical exercise can control the development of obesity and achieve the goal of gradually losing weight.

How to control diet? Generally speaking, it is not necessary to control the amount of three meals a day for mildly obese people, but they should avoid extra food intake, such as snacks, candy and sugary drinks. At the same time, they should pay attention to increasing the intensity of labor and sports, so as to reduce the weight of 0.5-1kg per month until they return to normal. In addition to using low calorie food as far as possible, they should also greatly reduce the amount of food, starting from reducing the staple food by 100-150g per day, and starting from reducing the staple food by 150-250g per day for those with large amount of food. High fat and high sugar diet should be restricted, and then adjusted according to their weight and other reactions. Secondly, we should control potatoes, fat meat, and fatty dried fruits and oilseeds, and eat more low calorie foods such as vegetables and fruits, which can not only reduce hunger, but also provide sufficient inorganic salts and vitamins.

In the process of diet control, it is necessary to step by step and avoid rushing for success. Otherwise, malnutrition, dizziness and weakness of limbs will occur, resulting in reduced physical activity. It will not only fail to achieve the goal of weight loss, but also increase weight. Therefore, the intake of high-quality protein should be appropriately increased when reducing staple food, so as to increase calorie consumption and improve weight loss effect.

If you stop controlling your diet after losing weight, your weight will soon return to its original level, even fatter. At the same time, we should also adhere to long-term sports and physical labor, so as to receive better weight loss effect.

Scientists: noise environment can cause high blood pressure

 Scientists recently confirmed that people who live in noisy environment for a long time are prone to high blood pressure. However, relevant studies have not found a significant correlation between noise environment and hypertension, migraine and other diseases.

In a survey of 1700 residents in Berlin, the scientists found that those who had more than 55 decibels of ambient noise while sleeping at night had twice the risk of developing high blood pressure as those who had less than 50 decibels of ambient noise. In addition, the survey also found that residents who are used to sleeping with windows open at night have a higher risk of hypertension. However, the announcement pointed out that the survey did not find a significant correlation between noise environment and diseases such as hyperlipidemia and migraine.

It is reported that the newly released survey results are consistent with the findings of another survey on noise and cardiovascular disease released earlier by the Ministry of environment. Based on these findings, Germany has taken measures to reduce noise, such as limiting the speed of motor vehicles in residential areas at night.

Etiology and pathology of hypertension excessive sodium intake theory

 A large number of experimental, clinical and epidemiological data confirmed that sodium replacement is closely related to hypertension. In areas with high salt intake, such as native Japanese, the prevalence of hypertension is high, while in areas with low salt intake, such as Eskimos in Alaska, hypertension almost does not occur. Limiting sodium intake can improve hypertension, and taking diuretics to increase sodium excretion can also reduce elevated blood pressure. Renovascular hypertension worsens under the influence of high blood sodium, and improves when the sodium intake is reduced. The application of Desoxycorticosterone can cause hypertension only in the case of salt. The hypertension caused by adrenal hyperplasia also needs the participation of sodium. The contents of sodium and water per unit volume of dry matter in renal artery of patients and animals died of hypertension were higher than those without hypertension. Sodium retention can increase extracellular fluid volume and cardiac output, increase water content of arteriole wall and increase peripheral resistance, and increase arteriole tension due to the change of ratio of intracellular and extracellular sodium concentration. However, laboratory and clinical studies have found that changing the salt intake and blood sodium level can only affect the blood pressure level of some individuals, but not all individuals. Therefore, it is considered that the pathogenesis of salt in diet is conditional, and it has the effect of causing high blood pressure only when there is a genetic defect of sodium movement in the body, which makes it sensitive to salt intake.

Expert's report on controlling hypertension

 The purpose of hypertension control, including initial prevention, early diagnosis and appropriate treatment, was clarified in a 1996 report of who expert comintee (WHO Expert Meeting). The author of this paper is the chair of who expert meeting, and agrees with the need to supplement these objectives, namely, to use various restriction programs in the population and to mobilize social participation to change the lifestyle, to use diagnostic techniques in high risk factors, to measure lifestyle, and to treat drugs. The report clearly emphasizes the integrated programme for controlling hypertension in order to reduce the risk of cardiovascular disease in general, and points out the importance of systolic hypertension and annual hypertension treatment and importance. The report reminds us that hypertension is an important health problem in most countries, involving 20 per cent of adults. The long-term goal designed for all countries is to eliminate preventable cardiovascular diseases among young and middle-aged people and to minimize them in the elderly.

Definition and classification of hypertension

The new who report, like the 1978 report before, is needed but difficult and artificial. The difference between normal and hypertension can only grasp the benefits of intervention clinical trials after hypotension are uncertain. Since 1978, the definition of hypertension has not only been limited to diastolic blood pressure, but also systolic blood pressure. Therefore, hypertension is defined in who's report as systolic period of more than 140mmHg, and diastolic pressure equal to that of me over 90mmHg, and emphasizes that it should be the result of repeated blood pressure measurement in weeks, sometimes even months.

The report proposes two classifications of hypertension: one is based on blood pressure level and the other is the scope of organ damage. This is based on 1978 report and 1993 who international society of hypertention (ISH). These classifications are somewhat different from the fifth joint US National Committee report (1993jnc-v), so further discussion is needed. The blood pressure level in WHO classification keeps "light, medium and heavy" hypertension because of the fact that it is commonly used in clinical work and replaced by "grade" in US classification. The WHO report emphasizes that using "light, medium, heavy" as popular users does not mean the severity of the overall clinical situation, but simply indicates the range of blood pressure rise. The severity of clinical conditions is also based on all cardiovascular risk factors. This category of organ damage in terms of scope and severity is used in the new WHO classification as in the 1978who report. This classification helps us to clarify the concept of organ damage in the development of hypertension over time.

Epidemiology of hypertension

A large part of the report deals with the epidemiology of hypertension. Hypertension is the risk factor of cardiovascular disease, the prevalence of hypertension, the risk factors and predictors of hypertension include genetic and lifestyle factors.

The report points out that systolic blood pressure rise is an important risk factor for cardiovascular disease, and the borderline character between blood pressure level and risk, but it can not prove the critical value of risk or J-curve relationship. The risk of cardiovascular events and organ damage in patients with hypertension increases due to the co existence of other risk factors, such as smoking, high cholesterol and diabetes. Therefore, it is important to determine the whole cardiovascular risk factors in the high blood pressure population in order to determine the treatment limits. The report emphasizes that the absolute number of complications in a group of patients with mild hypertension is high. Therefore, the control of hypertension in the population requires that the patients in this group should be treated with antihypertensive measures like those with obvious blood pressure rise.

clinical examination

The report points out that a patient who has observed and confirmed hypertension must have several objectives: to determine that blood pressure is a chronic increase; to estimate the whole cardiovascular risk; to find out the existing organ damage and concomitant diseases; and to find out the causes of high blood pressure. It is clear that all of these aims can be identified in a single consistent, consistent, and step-by-step diagnostic process, the medical record experience test. The scope of the test is scalable according to the medical record and physical examination and recommended tests.

The new report emphasizes that hypertension is only one of many risk factors for cardiovascular disease. Since the absolute benefits of antihypertensive treatment are determined based on the absolute risk of cardiovascular disease (i.e. greater benefits are achieved in those with higher risk), each cardiovascular risk factor should be carefully determined before the decision to treat hypertension is recommended.

Blood pressure measurement

The report noted that the measurement of blood pressure should be highly valued. Blood pressure measurement is usually done in outpatient or in the doctor's office or by the patient's bed using mercury sphygmomanometers and stethoscope. These values are often referred to as "outpatient" or "office" blood pressure. It is used in all intervention clinical trials to measure the benefit of antihypertensive and is currently recognized as the standard of high blood pressure.

Family blood pressure measurement and ambulatory blood pressure are complementary means of clinical blood pressure measurement. Ambulatory blood pressure is the best sound for the following cases: when there is a large difference between outpatient and family blood pressure measurement values; when there is evidence of increased blood pressure without organ damage; when there is a significant difference in blood pressure measured in outpatient service: when there is resistance to treatment. In all cases, the recent summary of the population must be paid attention to that the 24-hour mean value of home blood pressure and ambulatory blood pressure is lower than that of outpatient blood pressure measurement mmHg. For the elderly and the patients with higher outpatient blood pressure, the difference between outpatient value and dynamic value is greater, although it is well known that the appearance of a doctor and a winner (to a lesser extent) can lead to a certain degree of increase in blood pressure ("white big" But people who have low ambulatory blood pressure or at home have doubts about the effect of "clothes"), but the use of white coat hypertension to show that outpatient blood pressure is in the category of hypertension. The report does not advocate the use and suggests that the more precise term "isolated outpatient hypertension" should be used instead. It is not proved that the so-called white coat hypertension is "conscious" hypertension, and there is no sexual risk, so no treatment is needed. Once the physician decides to use home or ambulatory blood pressure, he or she must bear in mind that the blood pressure values provided by these methods are several mmHg lower than those in the outpatient, especially in older patients. When the blood pressure measured by these methods is set as the threshold value of hypertension to be treated and the expected blood pressure value is reached after treatment, the low point should be set to avoid excessive diagnosis and over treatment.

Organ damage

The report emphasizes that organ damage involved in hypertension is affected by the presence of other risk factors, such as smoking, obesity and diabetes. The term "hypertension heart disease" is not advocated because hypertension involves the heart to produce these complications and has a very different relationship with high blood pressure. The term used in the report is for individual cases: left ventricular hypertrophy, coronary heart disease, micro coronary artery disease and congestive heart failure.

Many articles explain the relationship between brain damage and hypertension, but it has not been resolved, regardless of whether the instrument is improving in evaluating cerebrovascular disease or not. These articles also contain the relative efficacy of antihypertensive therapy in preventing different types of stroke, such as lacunar disease, leucoaraiosis, antihypertensive therapy in reducing vascular dementia, reducing blood pressure in preventing cerebral infarction again, and opening treatment window in the early stage of ischemic stroke.

The first manifestation of proteinuria is often emphasized in reviewing renal damage caused by hypertension. Although the report mentions that the renal function damage of hypertension can be delayed by antihypertensive treatment, it is also disappointing that long-term antihypertensive treatment can not prevent the end-stage of renal disease. Of all kidney failure in the United States, 15-20% are from high blood pressure, and African Americans 33%.

Prevention and control

The report states that there are two aspects to be needed in the treatment of hypertension prevention and complications in any population: one is "treatment of the population" to treat the population as a whole to reduce the risk of hypertension; the other is to determine and treat the patients with high risk factors who have the risk of complications in order to reduce the risk of complications.

The two aspects of the treatment are not only complementary but collaborative and not contradictory. Indeed, the determination and treatment of clinically hypertensive patients in the population does not reduce the overall risk, or even in the most satisfactory cases. The recent national health and Nutrition Examination Survey (NHANES III) "international health and nutrition test method" confirmed that only half of the patients with hypertension received drug treatment and only about 1/4 of them had blood pressure below 140/90mmhg. The situation is worse in developing countries. Society plays a role in the transformation of epidemiology, which is harmful to the physical and mental lifestyle and economic development. Prevention and control at the level of such a population is even more important, and training programs for lifestyle workers are needed in both developed and developing countries.

The report considered that the actual effect of reducing blood pressure was weight loss, alcohol consumption, physical activity and moderate salt restriction. Those with limited or unproven effects include load management, dietary supply of potassium, calcium or magnesium therapy, micronutrient supply and cellulose supply.

These changes are adopted by the community collectively and the commandments are accepted by individuals, which require changes in behavior. In turn, there are three training plans: public education, professional education and patient education with high blood pressure. Such a plan will succeed only through the joint efforts of health professionals, policy makers, industry, intermediates and other media to develop long-term plans for all sectors of society and age groups.

Hypertension in children and adults in special population

Unfortunately, there is no prospective study involving children and adults with high blood pressure, so we need to rely on epidemiological definitions to consider hypertension at least three times when the average systolic or diastolic pressure of young people is equal to or greater than 95 per cent of his age. The report emphasizes that it is not possible to prove that isolated mild systolic hypertension in adults and young people needs treatment in addition to lifestyle advice.

woman

The report found that the extent to which large antihypertensive trials benefit men and women is limited. Although the overall cardiovascular risk of middle-aged women is significantly lower than that of men, there is insufficient data to support different treatment of hypertension in women.

Women have two special types of hypertension, that is, daily contraceptive induced hypertension and pregnancy hypertension. Hypertension caused by daily contraceptive treatment usually improves after months of stopping. It is not known that hormone like contraceptives, such as low estrogen or only progesterone, can also lead to high blood pressure. However, hormone replacement therapy is not taboo for menopausal women, although their blood pressure must be monitored from time to time.

The report noted that high blood pressure during pregnancy was the main cause of premature and perinatal death and 1 / 5 maternal death. In developing countries, health issues are the main. Mothers with hypertension and proteinuria born in late pregnancy are small, often born, and are at high risk of death in the neonatal period. The incidence rate of reported disease varies greatly. However, according to the estimate, less than 5% of pregnancies are associated with elevated clinical blood pressure. The classification of pregnancy hypertension has been discussed.

Hypertension in the elderly

The attention to hypertension in the elderly is one of the main new topics in the new who report, which was not existed before 1978. Although in 1978, it was not possible to prove the benefits and risks of antihypertensive treatment in the elderly. In recent 10 years, several randomized elderly anti hypertension trials have been completed, which makes the new report can suggest that it is particularly beneficial for the elderly to treat hypertension.

diabetes

Hypertension and type II diabetes coexist very frequently, often with dyslipidemia and central obesity. Patients with hypertension and diabetes are particularly prone to cardiovascular and renal complications. Therefore, it is very important to control hypertension and dyslipidemia and quit smoking. The blood pressure of patients with early diabetic nephropathy can be reduced to 130 / 85mmHg.

Treatment of hypertension

This is briefly summarized in this article because the report is different from those of 1978, but it is very close to the method recommended by 1993who/ish. The decision to need treatment must be based on diastolic and systolic blood pressure, as well as the overall cardiovascular risk of individual patients. If the blood pressure of moderate and severe hypertension is larger than 105mmhg, the systolic) is 180mmhg, or even without other risk factors, the treatment should also be started immediately. However, blood pressure diastolic pressure is lower than 105 contractions (180mmhg) and treatment must be determined after careful examination for weeks or months. The treatment plan for light hypertension is essentially the same as that of 1993, but the new report uses a simplified flow chart as shown in Figure I.

The report also referred to who/ish brief introduction in 1993 and JNC-V profile, and five groups of drugs were used as first-line drugs for the treatment of high blood. The results showed that diuretics, B block, ACE-I, calcium channel blockers and a blockers were used. Other drug groups can be used in specific cases. Diuretics and B- blockers have been extensively studied for the first time in the 5 groups of drugs. They can reduce blood pressure and reduce incidence rate. But the report noted that all of these studies were designed to determine the effect of blood pressure on it rather than the benefits of a particular drug or group of drugs. Therefore, the first-line drug selection of individual patients is largely determined by the Albert syndrome. Especially the risk factors of patients, the organ damage, pay for the role and coexist with the disease. Drug selection also depends on socio-economic factors so that countries that do not sell are more applicable.

Input / effect ratio

The report recommends that the investment effectiveness ratio analysis of hypertension treatment should seek balance in benefit, health status and economic income. It also recommends that the system of input effect ratio analyze all factors, namely, there are high risk programs for individual patients and national and local treatment of high blood pressure control. This is important because it allows all countries to choose those programmes that maximize health benefits and to spend limited inputs to the appropriate level where financial support is permitted.