Aunt Zhang is a patient with hypertension. It has been more than ten years since she was diagnosed with hypertension. She has always loved salty food and would rather not eat it. At the same time, for the problem of hypertension, she should have taken antihypertensive drugs for a long time to control her blood pressure, but she only took antihypertensive drugs when she found that her blood pressure was rising or she felt uncomfortable with her headache. I have a cough problem recently. Originally, she only thought it was caused by tracheal inflammation or autumn dryness. But I found that all kinds of medicines for treating cough were taken, and the effect was not obvious. Even when coughing at night, I can't lie flat and rest, and my legs are swollen. Go to the hospital quickly. According to the doctor's examination, Aunt Zhang's cough has nothing to do with bronchitis and autumn dryness. Because of hypertensive heart disease caused by uncontrolled hypertension for a long time, Aunt Zhang's heart has a compensatory increase, forming a serious dilated cardiomyopathy problem, which is only one step away from heart failure. The cause of cough is also caused by heart disease. After a period of conditioning treatment, although heart disease and cough have been alleviated and improved after a period of intervention treatment, it is impossible to completely restore heart function.
This case, which could have been prevented but was caused by "too big a heart", is really deplorable. Why heart disease can also cause cough, and how can hypertensive patients prevent the harm of hypertension to heart health? Today we will talk about this topic.
Many friends will be surprised to see such a statement. What? Isn't the cough due to organ or lung problems? Why is it still related to heart disease? In fact, if you understand the physiological mechanism, you won't feel anything strange.
One word we often mention is-cardiopulmonary function. In fact, the heart and lungs are both in the chest cavity, and there is a close relationship between the two organs. The lung is an important organ for blood exchange gas, which has been working for supplying oxygen and discharging carbon dioxide, while the heart is an important organ for blood circulation. Therefore, the small circulation between the heart and the lungs completes our life-sustaining oxygen supply process and provides a basic guarantee for the blood circulation of the body, so the heart will be affected if something goes wrong.
Patients with hypertension and coronary heart disease, if they do not actively intervene and control these chronic diseases, will cause health hazards to organs such as heart and kidney. Many friends know the health hazards of hypertension to the heart, such as coronary heart disease and myocardial infarction, but in fact, hypertension may also cause health hazards to the heart itself. The load of the heart will increase under long-term pressure, which may lead to changes in structure and function, including left ventricular hypertrophy, dilated cardiomyopathy and anxiety.
When the structure and function of the heart are changed under the influence of hypertension, the function of the left ventricle is decreased, and the ejection function of the heart is weakened, which will affect the blood delivery from pulmonary veins to the heart, thus causing the increase of pulmonary vein pressure, further causing blood stasis, further causing the increase of fluid exudation in alveoli to cause pulmonary edema, and bronchial mucosa will also be congested. Judging from the clinical symptoms, it will be manifested as a severe cough. And it may be accompanied by difficulty breathing at night and inability to lie flat. At the same time, it may be accompanied by expectoration, and the expectoration is pink. If the cough of hypertensive patients meets the above symptoms, we should be alert to the cough caused by hypertensive heart disease and decreased ventricular function.
Therefore, for patients with hypertension, high-risk groups of cardiovascular diseases or patients with cardiovascular diseases, when cough symptoms appear, not only lung and trachea problems, but also the possibility of dilated cardiomyopathy or heart failure should be considered. If you are accompanied by edema of lower limbs, you should highly doubt the possibility of cough caused by heart disease.
First of all, it should be clear that not all patients with hypertension will eventually have heart structure and function problems because of hypertension. If the rising blood pressure can be actively controlled and monitored at the beginning of hypertension discovery, so as to keep the blood pressure within a reasonable range, the risk of heart disease caused by hypertension will be very small. Some patients with hypertension will never have heart problems caused by hypertension because their blood pressure is well controlled.
How much should the blood pressure of hypertensive patients be controlled to be safer? According to the latest edition of WHO guidelines, for hypertensive patients with high risk of cardiovascular diseases, the blood pressure control target should be below 130/80mmHg. Such a blood pressure control goal will have greater health benefits for reducing cardiovascular and cerebrovascular risks in an all-round way, such as controlling blood pressure below 140/90, and for patients with new hypertension, the increase of blood pressure is often easier to control or even worse.
The antihypertensive drugs used in the first line of clinic, such as long-acting antihypertensive drugs, Pulitzer antihypertensive drugs and sartan antihypertensive drugs, have a certain heart protection effect while strengthening blood pressure control. These drugs have clear clinical benefits in preventing left ventricular hypertrophy caused by hypertension, and they are the first choice for hypertensive patients as long-term antihypertensive treatment. Of course, it should be emphasized that this cardioprotective effect is first based on the antihypertensive effect of the drug itself. Only when the antihypertensive effect is clear and the blood pressure can be controlled within the above standard range, the cardioprotective effect of these drugs will be more clear and significant.
For patients with cough caused by dilated heart disease, active intervention in dilated cardiomyopathy is an important way to relieve cough symptoms. Some drugs to improve and slow down ventricular remodeling, such as beta blockers, powders and sartans, are commonly used drugs. Depending on the severity of the disease, enkephalinase inhibitors and aldosterone receptor antagonists may also be needed. The specific drug selection needs clinicians to choose reasonably according to the specific situation. For the relief of cough, we can consider using expectorant drugs such as ambroxol, and for patients with inflammation, we can use anti-inflammatory and anti-infection treatment. But on the whole, instead of developing to the stage of cardiac decompensation for remedial treatment, it is better to do prevention and control as soon as possible to avoid this serious disease as much as possible, don't you think?