Hypertension is a common disease with unknown causes, which is mainly caused by the increase of arterial pressure. The systolic blood pressure of normal adults is 18.67Kpa( 140mmHg), and the diastolic blood pressure is 12Kpa(90mmHg), which often fluctuates under different physiological conditions. When systolic blood pressure is greater than18.67kpa (140mmhg) and/or diastolic blood pressure is greater than. Clinical syndrome with functional or organic damage of heart, brain and kidney. Hypertension is the most common chronic disease and the most important risk factor for cardiovascular and cerebrovascular diseases.
The incidence of hypertension is related to heredity, mental stress, obesity, smoking, alcoholism, salt addiction and other factors. It can be asymptomatic in the early stage and is not easy to be found. Occasionally, blood pressure rises during physical examination, and symptoms such as dizziness, dizziness, tinnitus and fatigue may also occur. Persistent hypertension, if not actively treated, will lead to damage to heart, brain, kidney and other organs.
① Cardiac complications. Such as left ventricular hypertrophy, angina pectoris, myocardial infarction and heart failure;
② Stroke. Such as hemorrhagic stroke. Ischemic stroke and hypertensive encephalopathy;
③ Large and small arteries. Such as arteriosclerosis and aortic dissection;
④ Hypertensive renal damage. Such as slow progression of arteriolar nephrosclerosis, malignant arteriolar nephrosclerosis and chronic renal failure;
⑤ Fundus. Such as retinal arteriosclerosis and fundus changes; Among them, arteriolar nephrosclerosis, which progresses slowly, refers to benign hypertension for 5- 10 years, which begins with renal arteriolar lesions and then renal parenchymal damage; Malignant arteriolar nephrosclerosis refers to renal damage caused by malignant hypertension, including renal arteriolar lesions and renal parenchymal damage.
1. In order to prevent and control hypertension, adults over 35 should have their blood pressure measured at least once a year.
2. Go to bed early and get up early, and keep a regular life.
3. Relax and relieve stress.
4. Exercise regularly and moderately from adolescence, and persevere.
5. Develop a good habit of not smoking. Those who have smoked should give up smoking as soon as possible.
6. Do not drink or drink less, and drink light green tea.
7. Adults' daily salt intake of 5-6 grams can meet the normal needs of the body.
8. Eat less foods with high fat and cholesterol content, such as fat and animal offal; Eat more vegetables, fruits and coarse grains.
9. Measure your weight regularly, keep it normal, and avoid sudden weight gain or loss.
10. Take medicine for a long time under the guidance of a doctor after getting sick. Keep blood pressure stable.
1 1. Dinner should be less, lunch should be richer, and meat should be cooked well, but it should not be greasy or too full. Take a nap or rest after meals, preferably for half an hour to an hour. Eat digestible food for dinner. Don't be afraid to drink water or eat porridge for fear of peeing at night. Insufficient water intake will thicken blood at night, leading to thrombosis.
12. Have fun. Don't watch TV for more than 2 hours before going to bed and don't watch exciting programs. When playing chess and mahjong, you should limit your time, control your emotions, and don't be too serious and excited.
13. Take a bath safely. Bath water should not be overheated or soaked for too long.
1. Non-drug therapy
1) weight loss, weight loss methods: on the one hand, reduce the consumption of fat and sugar foods, on the other hand, increase physical exercise.
2) Diet: Limit salt and reduce fat intake.
3) Increase and maintain proper physical activity.
(1) Avoid long-term excessive tension and fatigue and ensure adequate sleep.
② Patients who have been engaged in mental work with high concentration and excessive tension for a long time and work in an environment with excessive visual and auditory stimulation should relax themselves and adjust their work and rest appropriately.
4) Do not smoke (smoking 15 minutes can increase blood pressure by 20mmHg) and do not advocate drinking; Patients diagnosed with hypertension should stop drinking.
Studies have shown that after smoking a cigarette, the heart rate increases by 5-20 times per minute, and the systolic blood pressure increases by 10-25mmhg, because nicotine contained in tobacco leaves can excite sympathetic nerves, accelerate the heart rate, contract arterioles, and lead to an increase in blood pressure.
What matters should hypertensive patients pay attention to at ordinary times?
(1) Don't participate in activities that are likely to cause high mental excitement;
2 Pay attention to keep warm in winter, because cold will cause vasoconstriction;
③ Keep the stool unobstructed;
④ Prevention of postural hypotension: Avoid standing still for a long time, suddenly squatting or bowing, and move slowly when changing posture. The water temperature in the shower room should not be too high. If hypotension occurs, you should lie flat and raise your feet immediately to relieve it.
⑤ Don't increase or decrease drugs according to your own feelings during taking antihypertensive drugs. Take the medicine on time, and don't suddenly change the medicine yourself.
2. Drug therapy
Commonly used antihypertensive drugs * * * five categories:
1) CCB: The main side effects are headache, heartbeat and blushing. Some people will have ankle edema and gum thickening after taking it for a long time.
2) ACEI: The main side effects are cough, hyperkalemia and vascular edema.
3) Beta blockers: The main side effects are bradycardia and bronchospasm.
4) Diuretics: The main side effects are decreased blood potassium and increased blood uric acid.
5) ARB: The main side effects are hyperkalemia and vascular edema.
So what is the principle of drug antihypertensive?
(1) Use a small effective dose to obtain the possible curative effect and minimize the adverse reactions. If it is effective but not satisfactory, the dosage can be gradually increased to obtain the best curative effect.
(2) It is required to keep blood pressure within the target range within 24 hours every day, from low blood pressure at night to sudden increase of blood pressure in the morning, which can prevent sudden death, stroke or heart attack. In order to achieve this goal, it is best to use drugs administered once a day for 24 hours.
(3) In order to increase the antihypertensive effect without increasing adverse reactions, if the curative effect of low-dose single drug is not ideal, two or more antihypertensive drugs can be used for combined treatment.
Precautions for oral antihypertensive drugs:
1. Take antihypertensive drugs orally as much as possible, gradually reduce blood pressure, and prevent the blood supply of heart, brain and kidney from being insufficient due to the sudden drop of blood pressure.
2. There are many kinds of antihypertensive drugs, and the pharmacological effects of various antihypertensive drugs are different. Medication should vary from person to person and should be taken under the guidance of a doctor.
3. Be sure to take the medicine for a long time and understand the effects and side effects of the medicine. For example, attention should be paid to the emergence of hypokalemia when taking dihydrograms of urine plug, which is manifested as nausea, vomiting, limb weakness or paralysis, arrhythmia and so on. Captopril has side effects such as dry cough, abnormal taste and rash. When there are side effects, it is necessary to report them to the doctor in time and adjust the medication.
4. In the process of applying antihypertensive drugs, when standing up from a sitting or lying position, the movement should be as slow as possible, especially when getting up at night to urinate, so as to avoid syncope and accidents caused by sudden drop of blood pressure.
1. Take medicine if your blood pressure is high, and don't take medicine if it is not high. This makes blood pressure rise and fall, which is easy to cause damage to important organs such as heart, brain, kidney and fundus. Such as heart failure, cerebrovascular diseases (cerebral hemorrhage, cerebral thrombosis), renal failure and fundus hemorrhage.
Although the blood pressure is high, there are no symptoms, so there is no need to take medicine. Although there are no conscious symptoms, the heart, brain, kidney and other organs in the body are always at a high level of blood pressure, which is prone to danger.
Taking antihypertensive drugs every day will make blood pressure drop too low. Taking antihypertensive drugs every day to maintain normal blood pressure, just like eating every day to maintain life, drugs and food are metabolic, and maintaining normal blood pressure with the minimum dose of drugs will not make blood pressure drop too low.
Western medicine has side effects on human body, and long-term medication will damage liver and kidney function. At present, the combined use of antihypertensive drugs is advocated, and the dosage of each drug is very small when used together, which will not cause great influence on the body; Hypertension needs long-term medication control, and it is more convenient to take western medicine.
1. Blood pressure monitoring: By measuring blood pressure, we can know the situation of blood pressure and use it as a basis for adjusting medication. When measuring blood pressure, you should set the posture, posture and sphygmomanometer.
2. Hypertension often coexists with obesity and abnormal blood lipid and blood glucose, and the changes of blood lipid and blood glucose should be monitored regularly. Long-term hypertension can cause renal insufficiency, so urine routine and renal function examination should be carried out regularly.
3. When the blood pressure suddenly rises, you should relax all over, lie still and rest, immediately take metoclopramide L tablets sublingually or take other antihypertensive drugs orally, and then go to the hospital after a little relief. If you have precordial pain or numbness, weakness, skewed mouth and increased nocturia, please go to the hospital in time.
Hypertension generally starts from June 5438+065438+ 10, and the outpatient service is full, including not only the outpatient service but also the ward. Because blood pressure is relatively high in winter and blood vessels contract in cold weather, the human body is in a state of stress. Various reasons make the blood pressure of patients with vasoconstriction increase. For patients in winter, it is generally necessary to adjust antihypertensive drugs first. The other is exercise. This patient is definitely not allowed to get up at five or six o'clock in the morning to exercise, because the weather is cold in the morning and the blood pressure is relatively high at this time, which is prone to such adverse events. Therefore, patients with hypertension should pay attention to the following points:
1. Live regularly and keep warm.
Patients with hypertension should pay more attention to the law of work and rest in winter to ensure adequate sleep. Don't stay up late, staying up late will cause endocrine disorders and lead to high blood pressure. For elderly hypertensive patients who have the habit of doing morning exercises, they must wear scarves and gloves when going out in winter, especially to protect their heads, necks and feet, and try to reduce going out when cooling down. After getting up in the morning, you should stretch yourself in the bedding and get up. In order to reduce the stimulation of cold, you should wash your face and brush your teeth with warm water. Get up in the middle of the night to go to the bathroom. Be sure to get dressed and keep warm.
2. Monitor blood pressure and take medicine on time.
Because the blood pressure of hypertensive patients in winter is often higher than that in other seasons, some patients usually have good blood pressure control after taking several antihypertensive drugs at present, and it may be difficult to reach the standard in winter. So pay attention to monitoring blood pressure in winter. If you find that your blood pressure is significantly higher than before, you should see a doctor in time and adjust your antihypertensive drugs appropriately. It is suggested that patients use home self-test blood pressure once a day, and record the blood pressure value after measuring for more than one week. The blood pressure record at the time of seeing a doctor can accurately reflect the patient's recent blood pressure, which is beneficial for doctors to understand the patient's condition. In addition, we should pay more attention to the continuity of antihypertensive treatment in winter. Patients who need to switch to other antihypertensive drugs, especially those who take α and β blockers, should stop taking drugs slowly to prevent blood pressure from rebounding.
3. Eat healthily and develop good living habits.
Besides medication, good living and eating habits are also important for controlling blood pressure. Patients with hypertension should pay attention to eating more vegetables and fruits, and avoid eating foods high in fat, sugar and salt. The salt intake should be less than 6 grams per day. They should eat more high-calorie and nutritious foods, such as lean meat, chicken, fish, milk and bean products, and ensure proper water intake. Drinking a cup of boiled water before going to bed and after getting up is conducive to reducing the blood viscosity at night and keeping the stool unobstructed, thus reducing the most prone cerebrovascular events in the morning.
In addition, strictly quitting smoking, limiting drinking, keeping calm and getting into the habit of scalding feet with warm water before going to bed will all help to lower blood pressure. In order to strengthen physical fitness and improve cold tolerance, we should insist on physical exercise, but not strenuous exercise. Outdoor walking, jogging, Tai Ji Chuan and Qigong are recommended.
In short, in the cold winter, patients with hypertension should pay more attention to blood pressure monitoring, take medicine on time and develop good living habits, so as to better control blood pressure and maintain health.
Zhang Man, director of the Second Department of Cardiology, Affiliated Central Hospital of Shenyang Medical College, chief physician, doctor of medicine, tutor of master students and academic leader. There are 100 talents in the "100 Million Talents Project" in Liaoning Province, and vice chairman of the Clinical Epidemiology and Evidence-based Medicine Branch of Shenyang Medical Association. He is good at treating hypertension, coronary heart disease, angina pectoris, heart failure and arrhythmia. He has certain attainments in coronary intervention and pacemaker implantation, and has certain expertise in basic and clinical research of coronary heart disease.