1, the harm of systolic hypertension
High prevalence rate
It is reported that in 390 cases of senile hypertension, mixed hypertension accounts for 55.0%, while isolated systolic hypertension accounts for 45.0%. Sampling survey of natural population in some areas of Shanghai shows that the prevalence rate of hypertension in the elderly is 43.7%, among which isolated systolic hypertension accounts for 49.5% of the elderly. The results reported abroad are consistent with those reported at home. In addition, the literature reported that the prevalence of isolated systolic hypertension in the elderly gradually increased with age.
Foreign scholars have followed up 5727 people for 20 years. The results show that the relationship between coronary heart disease and systolic blood pressure is significantly higher than diastolic blood pressure, and the relationship between systolic blood pressure and stroke, left ventricular hypertrophy and congestive heart failure is closer than diastolic blood pressure. China reported 7 cases of isolated systolic hypertension11in the elderly, of which 4 1.9% were complicated with stroke, 32.5% with myocardial infarction, 28.2% with heart failure and 57.3% with renal insufficiency, which were higher than other types of hypertension.
Blood pressure fluctuates greatly.
The blood pressure fluctuation of elderly patients with isolated systolic hypertension is obvious whether they are active or at rest. Even within 1 day, there are large fluctuations, especially systolic blood pressure. The abnormal fluctuation of blood pressure in elderly patients with isolated systolic hypertension may be related to the dysfunction of blood pressure regulation in the elderly, mostly due to the decreased sensitivity of pressure receptors in the elderly to regulate blood pressure.
It is suggested that it is not appropriate to use only 1 blood pressure value and 24-hour blood pressure average as diagnostic basis. It is suggested that the average value obtained from 2-hour continuous blood pressure monitoring can better represent the 24-hour average value of blood pressure. Considering this characteristic, it is very necessary to use drugs carefully for this kind of hypertension, choose the time of drug use and measure blood pressure in standing position routinely.
Prone to orthostatic hypotension.
Elderly patients with isolated systolic hypertension not only have large blood pressure fluctuations, but also have unique clinical manifestations of hypotension when posture changes. The reason may be related to the decrease of reflex blood pressure regulation caused by body position change.
For example, arteriosclerosis, decreased baroreceptor sensitivity and decreased ability of sympathetic nervous system to regulate cardiovascular reflex in elderly patients with isolated systolic hypertension may be the reasons for the significant decrease of blood pressure caused by body position change. The incidence of orthostatic hypotension is 1 1%~50%.
Orthostatic hypotension not only reduces systolic blood pressure by 30mm Hg and diastolic blood pressure by 65438±05mm Hg, but also presents hypotension symptoms, such as amaurosis, dizziness and even syncope, and a few patients have angina pectoris. Therefore, patients with this kind of hypertension should avoid standing up suddenly in prone position and taking too many diuretics, sedatives and some antihypertensive drugs that cause orthostatic hypotension.
There are many and serious complications.
The complications of isolated systolic hypertension in the elderly are not only high, but also serious. Common complications include cerebral hemorrhage, cerebral infarction, cerebral thrombosis, myocardial infarction, heart failure and renal insufficiency.
The mortality rate is high.
The mortality rate of isolated systolic hypertension in the elderly is significantly higher than that of typical hypertension. Some people have made a general survey and follow-up of hypertension, and put forward that the mortality rate of isolated systolic hypertension is 17.6%, while the mortality rate of people with systolic blood pressure lower than160mmhg is 7.7%.
Multiple regression method was used to analyze isolated systolic hypertension in the elderly. After controlling other risk factors, the annual mortality increased by 65,438 0% every time the systolic blood pressure of systolic hypertension increased in the 60-90 age group. It is not difficult to see that isolated systolic hypertension in the elderly is not only prone to complications, but also the main clinical type of death in hypertensive patients, so prevention should be strengthened.
It's really serious
There are also some reports that several complications of hypertension in the elderly are the most common in patients with systolic hypertension, especially ischemic stroke. It can be seen that simple systolic hypertension must not be taken lightly.
A recent international study also pointed out that it is safe and effective to treat simple hypertension in the elderly, which can reduce cerebrovascular diseases by 36% and cardiovascular diseases by 32%. Therefore, it is advocated that isolated systolic hypertension should be treated in time.
The treatment of isolated systolic hypertension includes non-drug therapy and drug therapy. Non-drug therapy refers to life intervention measures, including adjusting life rules, reducing emotional stimulation, reducing overweight, limiting overnutrition, insisting on physical exercise, limiting salt, quitting smoking and avoiding alcoholism. This is an indispensable basic treatment for any patient with hypertension.
The principle of drug therapy is to emphasize individualized treatment and pay attention to risk factors such as blood pressure fluctuation, target organ damage and complications. First of all, choose a single antihypertensive drug, start with a small dose, and don't drop blood pressure sharply, especially for the elderly. Under the guidance of a doctor, drugs and their dosage should be adjusted in time according to blood pressure monitoring.
2. What is good for high blood pressure?
(1) celery
Celery is rich in bioflavonoids, which can reduce capillary permeability and resist the pressor effect of adrenaline. Rich potassium can also promote the body to excrete excess sodium salt, thus lowering blood pressure and diuresis.
How to eat: Take tender bamboo shoots 100g, slice them after cooking, blanch celery 100g, drain the water, mix them with bamboo shoots, and season with salt, chicken essence and sesame oil.
Note: Celery contains a lot of crude fiber, which is cool. Children with spleen and stomach deficiency, loose stool and spleen deficiency should not eat more. The nutrient content of celery leaves is higher than that of petioles, among which the content of carotene is 88 times that of petioles, the content of vitamin C is 13 times that of petioles, and the content of vitamin B 1 7 times that of petioles.
(2) Onions
Prostaglandin contained in onion can reduce the resistance of peripheral blood vessels and coronary arteries, resist pressor substances in human body, and promote the excretion of sodium salts, thus lowering blood pressure.
How to eat: Take 2 onions and 500ml of red wine, wash them, cut them into eight equal parts, put them in a glass bottle, add red wine, seal the glass bottle, keep it in the shade for 2-8 days, take out the onion slices, separate them from the red wine, put them in the bottle, and put them in the refrigerator for refrigeration, with a daily reference of 20-50ml, which is used to treat hypertension.
Note: People with itchy skin, eye diseases and lung and stomach inflammation should not eat onions, which may aggravate the symptoms. Onions should not be eaten more, which will cause blurred eyes, flatulence and exhaust.
(3) kelp
Kelp contains more alginic acid and alginic acid, which has obvious antihypertensive effect. The layer of white cream presented by dried kelp is called mannitol, which has the effect of diuresis and detumescence, and it helps to prevent edema with iodine, potassium and vitamin B3.
How to eat: Take kelp 150g, tofu 250g, japonica rice 30g, vegetable oil and a little salt. Soak kelp in warm water until soft, then cut it into filaments. Stir-fry tofu with vegetables until golden, then cut it into small pieces. Wash japonica rice, put it in a pot, add appropriate amount of water, cook porridge with kelp and tofu, and cook over medium heat until the rice is boiled and the soup is thick. Add a little salt to taste.
Precautions: kelp is cold, the constitution is cold, people with diarrhea due to spleen deficiency should not eat more, kelp contains high iodine, pregnant women should not eat more, otherwise it will affect the thyroid development of the fetus.
(4) carrots
Carrots contain quercetin and kaempferol, which can increase coronary blood flow, reduce blood lipid, promote adrenaline synthesis, lower blood pressure and strengthen the heart.
How to eat: Take 100g fresh carrot, wash it, dice it, cook porridge with rice, and eat it every morning and evening. Can be used for the adjuvant treatment of night blindness and hypertension.
Note: Carrots should not be eaten too much, because carotene will deposit on the skin surface and make the skin yellow. Excessive carotene will also affect the synthesis and secretion of lutein in women's ovaries, and even cause irregular menstruation and ovulation.
(5) garlic
Garlic contains capsaicin called propylene sulfide, which can kill pathogenic bacteria and parasites. It has the best antibacterial effect among natural plants at present. This capsaicin can not only prevent colds, but also effectively lower cholesterol, regulate blood pressure, inhibit thrombosis and prevent arteriosclerosis.
How to eat: Take 1 0,000 grams of salted garlic, soak it in clear water for half a day, take it out and drain it, put it in a jar, mix sugar and balsamic vinegar evenly, pour it into garlic, turn it once a day, eat it for 3 days, and seal the jar after 2 months.
Precautions: The irritating ingredients in garlic are ignored by patients with gastric ulcer and eye diseases, so it is not suitable for eating. In addition, garlic should not be eaten on an empty stomach, which is easy to stimulate gastrointestinal mucosa. It is not advisable to eat too much at once, which is not good for your eyes.