Health Science Center

Blood pressure is the pressure exerted on the walls of blood vessels by the heart when it contracts. Pressure is usually measured in millimeters of mercury (mmHg). The pressure when the heart contracts is called "systolic blood pressure" and the pressure when the heart relaxes is called "diastolic blood pressure."

Hypertension is a common, unexplained disease characterized by elevated arterial pressure. The systolic blood pressure of normal adults is 18.67Kpa (140mmHg), and the diastolic blood pressure is 12Kpa (90mmHg). There are often certain fluctuations under different physiological conditions. When the systolic blood pressure is measured repeatedly at different times, it is greater than 18.67Kpa (140mmHg) and/or the diastolic blood pressure is greater than 12Kpa. (90mmHg) can be diagnosed as hypertension. At the same time, it may be accompanied by clinical syndromes of functional or organic damage to the heart, brain, kidney and other organs. Hypertension is the most common chronic disease and the main risk factor for cardiovascular and cerebrovascular diseases.

The onset of hypertension is related to factors such as genetics, excessive mental stress, obesity, smoking, alcoholism, and salt addiction. It may be asymptomatic in the early stage and is not easy to detect. Occasionally, elevated blood pressure is found during physical examination, and symptoms such as dizziness, dizziness, tinnitus, and fatigue may also occur. If persistently elevated blood pressure is not actively treated, it can lead to damage to the heart, brain, kidneys and other organs.

① Heart complications. Such as left ventricular hypertrophy, angina pectoris, myocardial infarction and heart failure;

② Stroke. Such as hemorrhagic stroke. Ischemic stroke, hypertensive encephalopathy;

③ Large and small arteries. Such as arteriosclerosis and aortic dissection;

④ Hypertension and renal damage. Such as slowly progressive arteriolar nephrosclerosis, malignant arteriolar nephrosclerosis, and chronic renal failure;

⑤ Fundus. Such as retinal arteriosclerosis and fundus changes; among them, slowly progressing arteriolar nephrosclerosis refers to benign hypertension for 5-10 years, starting with renal arteriolar disease, followed by renal parenchymal damage; malignant arteriolar nephrosclerosis refers to malignant Renal damage caused by hypertension includes renal arteriolar disease and renal parenchymal damage.

1. To prevent and control high blood pressure, adults over 35 years old should measure their blood pressure at least once a year.

2. Go to bed early and get up early, and maintain a regular life.

3. Relax mentally and reduce stress.

4. Start regular and moderate exercise from adolescence and continue it consistently.

5. Develop a good habit of not smoking. Ex-smokers should quit smoking as soon as possible.

6. Don’t drink or drink less alcohol, and drink light green tea.

7. The daily salt intake of 5-6 grams for adults can meet the normal needs of the body.

8. Eat less foods with high fat and cholesterol content, such as fatty meats and animal offal; eat more vegetables, fruits, and whole grains.

9. Measure your weight frequently to keep your weight normal and avoid sudden weight gain or weight loss.

10. After getting sick, you should take medicine for a long time under the guidance of a doctor. Keep blood pressure stable.

11. Take a nap at noon, have a small dinner, and have a rich lunch with both meat and vegetables, but it should not be greasy, and it should not be overly full. After a meal, you should take a nap or rest for a while, preferably half an hour to an hour. It is advisable to eat easily digestible food for dinner. Don’t be afraid of excessive urination at night and be afraid to drink water or eat porridge. Insufficient water intake will make the blood thicker at night and lead to thrombosis.

12. Entertainment is organized. Do not watch TV for more than 2 hours before going to bed, and do not watch stimulating programs. When playing chess and mahjong, you must limit your time, control your emotions, and avoid being too serious or excited.

13. Take a safe bath. The bath water should not be too hot and do not soak for too long.

1. Non-drug treatment

1) Weight loss, weight loss methods: on the one hand, reduce eating fat and sugar foods, on the other hand, increase physical exercise.

2) Diet: limit salt and reduce fat intake.

3) Increase and maintain appropriate physical activity.

① Avoid long-term excessive stressful work and fatigue, and ensure adequate sleep.

② Patients who have long been engaged in highly concentrated, overly stressful mental work and in environments with overstimulating visual and auditory stimuli should relax themselves and adjust their work and rest appropriately.

4) Do not smoke (smoking can increase blood pressure by 20mmHg after 15 minutes), and do not advocate drinking; patients with a clear diagnosis of hypertension should stop drinking.

Research shows that after smoking a cigarette, the heart rate increases by 5-20 beats per minute, and the systolic blood pressure increases by 10-25 mmHg. Because the nicotine contained in tobacco leaves will excite the sympathetic nerves, accelerate the heart rate, and constrict the arterioles. , leading to increased blood pressure.

What should patients with hypertension pay attention to?

① Do not participate in activities that can cause high levels of mental excitement;

② Keep warm in winter, because cold can cause vasoconstriction;

③Keep the stool smooth ;

④ Prevent orthostatic hypotension: Avoid standing still for a long time, sudden squatting or head-down movements. Movements should be slow when changing postures, and the water temperature in the shower room should not be too high. If hypotension occurs, you should immediately lie down and raise your feet to relieve it.

⑤ When taking antihypertensive drugs, do not increase or decrease the drugs according to your own feelings. Take the drugs on time and do not suddenly change the drugs on your own.

2. Drug treatment

There are five types of commonly used antihypertensive drugs:

1) CCB type: The main side effects are headache, heartbeat, flushing, etc. , long-term use may cause ankle edema and gum thickening.

2) ACEI: The main side effects include cough, increased blood potassium, angioedema, etc.

3) Beta blockers: The main side effects include slow heart rate and bronchospasm.

4) Diuretics: The main side effects are decreased blood potassium and increased blood uric acid.

5) ARB: The main side effects are increased blood potassium and angioedema.

So what is the principle of medication to lower blood pressure?

(1) Use a smaller effective dose to obtain possible therapeutic effects while minimizing adverse reactions. If it is effective but not satisfactory, the dose can be gradually increased to obtain the best therapeutic effect.

(2) Blood pressure is required to be stable and within the target range within 24 hours a day, which can prevent sudden death, stroke or heart attack from low blood pressure at night to sudden increase in blood pressure in the morning. To achieve this, it is best to use a drug that is administered once a day and lasts for 24 hours.

(3) In order to increase the antihypertensive effect without increasing adverse reactions, if low-dose single drug treatment is unsatisfactory, two or more antihypertensive drugs can be used in combination.

Precautions for taking oral antihypertensive drugs:

1. Take antihypertensive drugs orally as much as possible to gradually lower blood pressure to prevent insufficient blood supply to the heart, brain, and kidneys caused by a sudden drop in blood pressure. .

2. There are many types of antihypertensive drugs currently available, and the pharmacological effects of various antihypertensive drugs are different. The medication should be different from person to person and should be taken under the guidance of a doctor.

3. You must insist on long-term medication and understand the effects and side effects of the medication. For example, when taking hydrochlorothiazide, you should pay attention to the occurrence of hypokalemia, which may manifest as nausea, vomiting, limb weakness or paralysis, arrhythmia, etc.; stuck Topril has side effects such as dry cough, abnormal taste, and rash. When side effects occur, you should report to your doctor promptly and adjust your medication.

4. During the application of 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, to avoid syncope caused by a sudden drop in blood pressure. Accident.

1. Take medicine when your blood pressure is high, and don’t take medicine when your blood pressure is not high. This makes blood pressure fluctuate, which can easily cause damage to important organs such as the heart, brain, kidneys, and fundus of the eyes. Such as heart failure, cerebrovascular disease (cerebral hemorrhage, cerebral thrombosis), renal failure, fundus hemorrhage, etc.

2. Although the blood pressure is high, there are no symptoms and no medication is required. Although there are no conscious symptoms, the organs in the body such as the heart, brain, kidneys, etc. are always at high levels of blood pressure and are prone to danger.

3. Taking antihypertensive drugs every day can cause your blood pressure to drop too low.

Taking antihypertensive drugs every day to maintain normal blood pressure is just like eating every day to maintain life. Drugs and food are metabolized, and the minimum drug dose is used to maintain normal blood pressure without lowering blood pressure too low.

4. Western medicine has side effects on the human body, and long-term use of medicine can damage liver and kidney functions. Nowadays, it is advocated to use antihypertensive drugs in combination. When used in combination, the dosage of each drug is small and will not have a big impact on the body; high blood pressure requires long-term medication control, so it is more convenient to take Western medicine.

1. Monitoring of blood pressure: By measuring blood pressure, we can understand the blood pressure situation and use it as a basis for adjusting medication. When measuring blood pressure, you should determine your body position, location, and sphygmomanometer.

2. Hypertension often coexists with obesity, blood lipids, and blood sugar abnormalities. Changes in blood lipids and blood sugar should be monitored regularly. People with long-term hypertension can cause decreased kidney function, so routine urine and kidney function tests should be performed regularly.

3. When blood pressure suddenly rises, you should relax your whole body, lie down and rest, and immediately take 1 tablet of Xintongding under the tongue or take other antihypertensive drugs orally. Go to the hospital for treatment after you feel some relief. If you experience precordial pain, numbness or weakness on one side of your limbs, a crooked corner of your mouth, or increased nocturia, seek medical attention promptly.

Hypertension outpatient clinics are generally full starting in November, including not only outpatient clinics but also wards. Because blood pressure is relatively high in winter, blood vessels contract in cold weather and the human body is in a state of stress. Various reasons cause increased blood pressure in patients with vasoconstriction. For patients in winter, we usually adjust antihypertensive drugs first. The other thing is exercise. This patient is absolutely not allowed to get up at 5 or 6 in the morning to exercise, because at this time he is in a state of stress when he wakes up in the cold weather, and his blood pressure is relatively high, so it is easy for such adverse events to occur, so Patients with high blood pressure should pay attention to the following points:

1. Live regularly and keep warm.

Patients with high blood pressure should pay more attention to their work and rest patterns in winter and ensure adequate sleep. Don't stay up late. Staying up late can cause endocrine disorders and increase blood pressure. For elderly patients with hypertension who have the habit of morning exercise, they must wear scarves and gloves when going out in winter, especially to protect their head, neck, and feet, and try to avoid going out when cooling down. After getting up in the morning, you should stretch your body in bed and then get out of bed. To reduce cold stimulation, use warm water when washing your face and brushing your teeth. If you get up in the middle of the night to go to the bathroom, be sure to wear clothes and keep warm.

2. Monitor blood pressure and take medicine on time.

Since the blood pressure of patients with hypertension is often higher in winter than in other seasons, some patients may have good blood pressure control while taking several current antihypertensive drugs, but may find it difficult to reach the standard in winter. Therefore, you should pay attention to monitoring your 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 recommended that patients self-measure blood pressure at home, once a day, and record the blood pressure value after measurement for more than a week. The blood pressure record during the visit can accurately reflect the patient's recent blood pressure situation, which is helpful for doctors to understand the patient's condition. In addition, more attention should be paid to the continuity of antihypertensive treatment in winter. For patients who need to switch to other types of antihypertensive drugs, especially those taking α and β receptor blockers, the drugs should be stopped slowly to prevent blood pressure rebound. .

3. Eat healthily and develop good living habits.

In addition to drug treatment, good living and eating habits are also very important for blood pressure control. Patients with high blood pressure should pay attention to eating more vegetables and fruits, avoid eating high-fat, high-sugar and over-salty foods. 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, dairy and soy products, etc. In addition, proper water intake should be ensured. The elderly drink a cup of boiled water before going to bed and after getting up, which can help reduce blood viscosity at night and keep stool smooth, thereby reducing cerebrovascular events that are most likely to occur in the morning.

In addition, strictly quitting smoking, limiting alcohol consumption, keeping a calm mood, and developing the habit of scalding your feet with warm water before going to bed can help lower blood pressure. In order to enhance physical fitness and improve cold resistance, physical exercise should be adhered to, but strenuous physical exercise is not recommended. Outdoor walking, jogging, Tai Chi, Qigong, etc. are recommended.

In short, in the severe cold winter, patients with hypertension should pay more attention to blood pressure monitoring, take medicine on time, and develop good living habits to better control blood pressure and stay healthy.

Zhang Man, director of the Second Department of Cardiovascular Medicine at the Affiliated Central Hospital of Shenyang Medical College, chief physician, MD, master's tutor, and academic leader. One of the 100-level talents of Liaoning Province’s “Hundreds and Thousands of Talents Project”, and deputy director of the Clinical Epidemiology and Evidence-Based Medicine Branch of Shenyang Medical Doctors Association. He specializes in the treatment of hypertension, coronary heart disease, angina pectoris, heart failure, arrhythmia, etc. He has certain attainments in coronary intervention and pacemaker implantation, and has certain expertise in basic and clinical research on coronary heart disease.