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.

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.

New strategies for the treatment of hypertension

 There are more than 100 million hypertension patients in China, but the blood pressure control rate is less than 5%. How to treat can make blood pressure fall down and keep stable is what many patients and even doctors want to know. It is important to adopt a new strategy for the treatment of hypertension, that is, low-dose combination of drugs + heart rate control, to improve the compliance of patients and stabilize the curative effect.

Now it is found that there are many disadvantages in the treatment of hypertension with single drug in the past. In order to achieve the effective effect, the dosage is very large. It is not only easy to have adverse reactions and patients can not bear to interrupt the treatment, but also has poor protection for large blood vessels, which can not reduce the occurrence of cardiovascular and cerebrovascular diseases. In recent years, who and the International League of hypertension have emphasized and advocated the treatment principle of low-dose combination therapy and heart rate control at the same time. The former is to fully reflect the individual needs of patients, starting from a small dose of medication, the patient tolerated the dosage, the effect is not good, then add the second or third. After clinical use, low-dose combination has many advantages, because hypertension is a multifactorial disease. Combination on demand can not only intervene risk factors from many aspects, strengthen the protection of large blood vessels, but also offset the adverse reactions of drugs. Moreover, different combinations have fixed ways, simple treatment, low cost and easy promotion.

A large number of studies have shown that the increase of heart rate plays a great role in the increase of blood pressure, and with the increase of age, the heart rate increases, and the probability of coronary heart disease and myocardial infarction increases accordingly. Because heart rate is a sensitive index of sympathetic nerve, which can significantly predict hypertension and coronary ischemia, many countries have taken fast heart rate as the main risk factor for male sudden death. Using evidence-based medicine to treat hypertension can improve the therapeutic effect. Since the relationship between heart rate and hypertension is very important, the heart rate should be reduced to a satisfactory level when choosing antihypertensive drugs. What is the ideal level of heart rate control? At present, there is no unified standard. The heart rate of patients with hypertension should be about 60 times per minute.

Low alcohol consumption can prevent hypertension in women

 A small amount of alcohol intake in Harvard University School of medicine can prevent hypertension effectively. The incidence rate of hypertension is 15% lower than that of those who do not drink alcohol every week.

Dr. Ravi tedhani of Harvard Medical School followed 70891 women aged 25 to 42 for eight years. It turned out that 4200 of these people had high blood pressure. If you drink 1/4 to half a glass of wine a day (two to three cups per week), the incidence rate of hypertension will be reduced by 15% than those who do not drink alcohol on weekdays. But Dr. Ravi Tedehani warned women not to drink too much, because if you drink too much, the incidence rate of hypertension will increase, for example, if you drink a glass of wine a day, the chance of hypertension will increase by 30%.

The results of this study are basically consistent with the previous conclusion that a small amount of alcohol can prevent high blood pressure, but experts warn that although a small amount of alcohol can prevent high blood pressure, it is necessary to be cautious for women, because drinking may also have other side effects, such as causing breast cancer or giving birth to abnormal children.

Long shiteng cured my hypertension and shared it with you (Not checked, maybe)

 I have been suffering from high blood pressure for two years since I was 40 years old. I have high blood pressure more than 150 points. In fact, it's caused by family heredity. It's no surprise. It's just frequent dizziness, brain heat, rapid heartbeat, and I can't do strenuous exercise. I will feel dizzy after carrying a gas tank and going up a few stairs. I have no way to remember the year. I have to take antihypertensive drugs every day. So two years passed by Half a year ago, I learned that one of my junior high school classmates, whose age is similar, suffered from cerebral hemorrhage caused by high blood pressure and fell into hemiplegia. I realized that the impact of high blood pressure is so close to us. Now many diseases and mortality caused by diseases are younger. I think there are white haired parents and ignorant children, In the mainstay of our life, we can not fall in the middle of the road, because it is very irresponsible to ourselves and our relatives!

Knowing the situation of my classmates made me have a sense of urgency, because antihypertensive drugs can only treat the symptoms but not the root cause, and have dependence, and the side effects are also very big, so I am determined to use traditional Chinese medicine or dietotherapy to cure hypertension! So in the past half a year, I have been searching for medical advice and learning online. I have tried several kinds of folk prescriptions, and all kinds of tea and drinks to reduce blood pressure. I also pay attention to diet therapy, but they all have little effect. Just when I feel confused and not confident, I once organized a tour to Dabie District in the red base area last autumn. When I was eating in farmhouse, I inadvertently knew that I could cure hypertension It is a folk folk herbal medicine of longshiteng. So I drove alone to find longshiteng. In fact, I just had a try at the beginning. But within half a month, I didn't feel dizzy and my heart didn't beat so fast. I measured the high pressure 145 with a home sphygmomanometer. I couldn't believe that I went to the hospital again. It had dropped about 10 points. But I was so happy. Is it really this medicine After taking it for more than a month, I began to take nothing but longshiteng. In the past two months, the daily high pressure was 130 or so, and there was no rebound. I got some for my father. After they drank it, the effect was very good, and I was happy Dad is 62 years old and has a high pressure of more than 160. After taking it for a month, it began to drop obviously. I really want to thank the old man for his herbal medicine. Here I share it with the patients who want to be cured. I hope more people can use the panacea to make more people better!

The younger the patients with hypertension, the more dangerous they are, or the more likely they are to cause hemiplegia

 When Xiao Li, 34, was having dinner, he suddenly fell from his stool and the food was all over his body. The family thought that it was because he didn't sit like this: you are so grown-up, you still don't sit like this

I didn't expect that Xiao Li didn't stand up again after this fall, and there was no sensation in his right body. His family quickly dialed 120 and asked about him, but Xiao Li couldn't speak.

After 120 arrived, the blood pressure was 240 / 120 mmHg, and Xiao Li was sent to the hospital for brain examination immediately, and cerebral infarction was found. After the emergency thrombolysis operation, Xiao Li still left the sequelae of hemiplegia and speech disorder.

How can Xiao Li fall into hemiplegia when he is so young?

Xiao Li's parents introduce that Xiao Li is the only child in the family, and his family has favored him since childhood. Yes, he is very obedient. He drinks and fried chicken all day long and doesn't like sports. He is always fat. When he was in college, he had high blood pressure, so he didn't listen to his diet. He didn't feel uncomfortable or affected.

Doctor tips: hypertension is no small matter!

Hypertension has no effect on the body in the short term, but long-term hypertension can cause atherosclerosis and increase the risk of cerebral infarction. The reason why the number of patients with cerebral infarction remains high in China is that the number of patients with hypertension increases every year, and most of them do not pay attention to it, and do not carry out reasonable treatment, which has become the biggest inducement of cerebral infarction.

The six hazards of hypertension are beyond our imagination, so we should pay attention to them

1. Cerebral infarction

Long term hypertension can not only cause atherosclerosis, but also cause atrial fibrillation, which is easy to cause thrombosis. Thrombosis and atherosclerosis can cause cerebral infarction. There are two ways for hypertension to cause cerebral infarction, each of which has serious health hazards.

2. Cerebral hemorrhage

Many young patients with hypertension think that antihypertensive drugs have side effects. They feel that high blood pressure is not harmful to their health, causing extremely high blood pressure, cerebral hemorrhage and stroke.

3. Heart failure

Long term hypertension can cause excessive pressure of the heart, resulting in heart deformation, myocardial enlargement, cardiac function decline, chest tightness, shortness of breath, poor breathing, seriously affecting the normal life and health.

4. Myocardial infarction

Myocardial infarction is a serious heart disease, long-term hypertension can cause heart atherosclerosis, aggravate cardiovascular plaque, easily produce thrombosis, cause cardiovascular blockage, cause myocardial infarction.

5. Renal failure

Hypertension and renal failure are mutually reinforcing. Long term hypertension can cause renal failure, and renal failure can also cause hypertension. Therefore, controlling hypertension can effectively prevent nephropathy.

6. Aortic dissection

Aorta is the largest blood vessel in the human body, responsible for the main body blood circulation. Long term hypertension can cause arterial rupture, aortic dissection, myocardial infarction and cerebral infarction, which is harmful to health.

Timely control and prevention of hypertension will not cause these six hazards, nor affect the normal life span.

Hypertension daily prevention is very important, these two small things well, can stabilize blood pressure

1. Drink plenty of water

High blood pressure, drinking water is indispensable, because sufficient water can improve blood circulation, reduce blood viscosity, reduce blood pressure fluctuations.

For patients with hypertension, daily protection of blood vessels is very important, so you can add some Qingchi chrysanthemum when drinking water, enhance vascular elasticity, slow down vascular aging, and better stabilize blood pressure.

It is found that Qingchi chrysanthemum contains a lot of beneficial substances such as amino acids, selenium and stachydrine. Selenium can improve the elasticity of blood vessels, timely repair vascular damage, help dissolve lipid substances in blood, prevent vascular wall damage; amino acids and stachydrine can enhance the activity of blood cells, timely remove lipids and toxins in blood vessels, decompose thrombolytic substances in blood, and improve the smoothness and elasticity of vascular wall.

For people with poor blood pressure, soak two flowers every day, insist on drinking, blood pressure will be more and more stable, blood vessels will be more and more healthy.

2. Healthy diet

For example, after Xiao Li found out that he had high blood pressure, he did not control his diet reasonably, and still ate some fried and greasy food, which eventually led to cerebral infarction. Patients with hypertension should eat less high salt, high-fat food, more fresh fruits and vegetables and protein rich food, reduce the stimulation and damage to blood vessels, help to control blood pressure stability.

Suffering from high blood pressure, what habits do you need to develop? Don't let it go

 In case of hypertension, don't rush to use drugs indiscriminately. You can adjust your body through the cultivation of good habits in daily life. Maybe it can help reduce blood pressure. Many people just take medicine, but those good habits that are helpful for blood pressure control are not adhered to. They may still have blood pressure fluctuations. In the process of blood pressure rising, their health will be affected, and all kinds of adverse symptoms will appear. Therefore, it is necessary to know which methods have the effect of controlling blood pressure, and keep the blood pressure stable through correct methods.

1. Light diet

In order to alleviate the condition of hypertension, we should develop the good habit of light and healthy diet. The change of people's blood pressure is closely related to their diet. If they don't choose the right food to provide nutrients and often eat a lot of high salt food, they will increase the burden of excreting sodium ions, and their blood pressure will also change.

Some people also always eat spicy food, spicy substances stimulating, also can make blood pressure fluctuations. Those who eat a lot of high sugar, high-fat food, excessive energy acquisition makes the body fat, hypertension is difficult to alleviate. Therefore, it is necessary to stabilize blood pressure by controlling diet.

2. Stabilize the mood

In order to keep blood pressure normal, we need to learn to control emotions stably. Keeping a good attitude can also control blood pressure. Many people often have big mood swings, all kinds of negative emotions appear, excessive anxiety, tension, often sulking, these bad behaviors will stimulate the body, in the process of mood swings, the body adrenaline secretion increases, blood pressure will change.

If you can keep a good attitude in the process of controlling blood pressure and keep your mood stable, you will find that your blood pressure is stable.

3. Get enough sleep

To maintain normal blood pressure, we should also work and rest regularly to ensure adequate sleep time every day. This method also has the effect of controlling blood pressure. Many people often work and rest irregularly, stay up late, sleep time is not enough, in addition to affecting the liver, brain function, but also in the endocrine changes affect blood pressure.

Of course, some people are aging fast, which is also caused by staying up late for a long time. To avoid these situations, we should develop the good habit of going to bed early and getting up early in the process of promoting health.

4. Healthy exercise

If you can keep exercising, maybe the high blood pressure will be relieved. Now most people are lack of exercise, lack of exercise for a long time is easy to make the body fat, the more obese people are more likely to have high blood pressure. In addition, exercise can regulate blood sugar and control blood pressure.

In the process of exercise, blood vessels can be expanded, which can reduce the pressure on blood vessels and keep blood pressure stable. If you don't exercise for a long time, you will get fat after too little exercise, and your blood pressure will be unstable. All kinds of adverse symptoms are obvious. Therefore, people with high blood pressure threat to health need to exercise properly according to their own situation in order to achieve good control effect.

What is a long-acting drug for hypertension? How to choose short acting drugs?

 At present, the treatment of hypertension is mainly based on medication, and these drugs have long-term and short-term effects. Many people may not know what long-term hypertension drugs are, and even less how to choose drugs. Therefore, the family doctor interviewed Cheng Kanglin, chief physician of the Sixth Affiliated Hospital of Sun Yat sen University, to tell us in detail what long-term hypertension drugs are? How to choose short acting drugs?

What is a long-acting drug for hypertension?

The so-called long-term high blood pressure drugs mainly mean that the time of the drug in the body is relatively long, which can often act for about 24 hours, and some can also act for 25 hours. Dr. Cheng Kanglin thinks that in the treatment of high blood pressure, our preferred drug is long-term antihypertensive drugs, which can ensure a good 24-hour process The blood drug concentration can maintain the patient's blood pressure more smoothly. The representative drugs, such as felodipine sustained-release tablets, amlodipine besylate tablets, Telmisartan Tablets and so on.

Which is better for short acting and long-acting drugs of hypertension?

There are both short-term and long-term drugs for hypertension. However, according to the latest national clinical guidelines, it is recommended to choose long-term antihypertensive drugs to control blood pressure first. The purpose of this is that patients can get a good concentration of antihypertensive drugs. In the process of 24 hours a day, patients' blood pressure can be controlled very smoothly to avoid repeated fluctuations of blood pressure, while short-term antihypertensive drugs are only suitable for patients For very mild patients, this kind of patients can take short acting antihypertensive drugs orally, but the antihypertensive effect of this kind of drugs is not stable, the action time is short, but the onset is slow.

How to choose long-acting and short acting drugs for hypertension?

There are many kinds of long-acting and short acting drugs for hypertension. In the process of clinical blood pressure treatment, we first recommend oral long-acting antihypertensive drugs, so the action time is longer than the short-term effect, so to achieve a good concentration, can better stabilize the patient's blood pressure, and can reduce the frequency of taking drugs. There are many people who are afraid of trouble when taking medicine, so there are many benefits of taking long-acting drugs, such as felodipine sustained-release tablets and Telmisartan Tablets.

Whether long-term or short-term drugs, for the human body are certain side effects, some people will even have some adverse reactions, so we must choose some drugs with small side effects.

When should hypertension be prevented? What should pay attention to on the diet if suffering from hypertension?

 Now many people have diseases such as hypertension, so we should learn to prevent them in advance. If we have hypertension, we should avoid eating and drinking. Family doctor interviewed Cheng Kanglin, chief physician of the Sixth Affiliated Hospital of Sun Yat sen University, to tell us in detail when to prevent hypertension? What should you pay attention to when you have high blood pressure?

Should prevention of hypertension start from childhood?

It's true that prevention of hypertension should start with children. Because with the improvement of living habits and living standards. We should strictly control the diet structure, avoid eating some greasy food, and usually pay attention to the principle of low salt, low fat and low sugar diet structure. Only in this way can we avoid the occurrence of high blood pressure caused by excessive heart capacity and pressure load. In childhood, we should also have a light diet, but also a nutritious diet, and do not overwork. Doctor Cheng Kanglin believes that only such a comprehensive brain management can help prevent the occurrence of hypertension. We should also ensure good living habits, do not stay up late, and do not drink alcohol.

Can hypertension drink green tea?

Patients with high blood pressure can be treated with green tea. Whether it is green tea, black tea is OK, there is no effect on hypertension. Hypertension patients in the diet structure to low salt, low fat, low sugar diet principle, only in this way can reduce the pressure load of the heart, avoid the circulatory system caused by increased pressure blood pressure are not stable. The most critical point is that patients with hypertension should regularly take relevant drugs to maintain their blood pressure to a relatively stable state. Only stable blood pressure is conducive to the treatment and prevention of cardiovascular and cerebrovascular diseases. Usually, they should also regularly monitor their own blood pressure for protection.

Can hypertension eat spinach?

Patients with high blood pressure can eat spinach. Eating spinach has no effect on high blood pressure. And eat more vegetables and fruits is also conducive to stable blood pressure. It's very important to eat more vegetables. Patients with high blood pressure in the diet structure do not eat particularly greasy, and patients with high blood pressure to ensure good living habits, avoid excessive obesity. Because excessive obesity can lead to the increase of pressure load of the heart, indirectly lead to the occurrence of hypertension, obesity can also lead to the increase of blood viscosity, these are the risk factors of hypertension, we should pay special attention to.

Whether it is to prevent hypertension or other diseases, good living habits are essential, but also to maintain a happy mood, not because of a little bit of anger.

20 years' experience of 6 hypertension complications(6)

 Case 6: Ms. Wu, 66 years old, had poor control of hypertension all the year round, resulting in renal failure. Now she has dialysis twice a week in the hospital. When she was very young, Ms. Wu found that she had high blood pressure and had been taking medicine to control it, but she only took medicine and did not monitor it. She thought that taking antihypertensive drugs could control blood pressure well. Her blood pressure was about 170 / 100mmhg for a long time, which eventually led to renal insufficiency. Later, her blood pressure was higher than 200 / 110mmhg. Hypertension and kidney disease formed a vicious circle, which eventually led to severe renal failure. Now we have to go to the hospital for dialysis treatment twice a week.

Hypertension and kidney disease are happy enemies, hypertension will lead to renal failure, renal failure will aggravate hypertension, serious need long-term two times a week to hospital dialysis, affect life.

If Ms. Wu can monitor her blood pressure while taking antihypertensive drugs, she can control her blood pressure more effectively and avoid renal failure.

20 years' experience of 6 hypertension complications(5)

 Case 5: 49 year old Mr. Gao died of aortic dissection due to high blood pressure. 49 year old Mr. Gao suffered from sudden chest pain and did not relieve. He went to the hospital to check the ECG and showed no signs of myocardial infarction. The blood pressure of one arm was 140 / 90mmHg, and that of the other arm was 220 / 120mmhg. Later, he made a chest enhanced CT to show aortic dissection, which was gone before he had time to rescue.

It turned out that Mr. Gao had a history of hypertension for 10 years, without regular control and without discomfort at ordinary times, so he thought there was no danger. As a result, 10 years later, hypertension led to the biggest vascular tear in the body and aortic dissection.

In hypertension induced aortic dissection, 25% died within 24 hours, 50% within a week and 75% within a month.

If Mr. Gao could control his blood pressure earlier, he would greatly reduce the risk of aortic dissection and avoid sudden death.