High blood pressure
Hypertension is characterized by increased systemic arterial blood pressure (systolic and/or diastolic blood pressure) (systolic blood pressure ≥140 mmHg, diastolic blood pressure ≥90 mmHg), and may be accompanied by the functions of the heart, brain, kidneys and other organs Or the clinical syndrome of organic damage.
Hypertension is the most common chronic disease and the most important risk factor for cardiovascular and cerebrovascular diseases. Normal people's blood pressure fluctuates within a certain range with changes in internal and external environments. In the overall population, blood pressure levels gradually increase with age, with systolic blood pressure being more pronounced, but after the age of 50, the diastolic blood pressure shows a downward trend, and the pulse pressure also increases. In recent years, people’s understanding of the role of multiple risk factors for cardiovascular disease and the protection of heart, brain, and kidney target organs has continued to deepen, and the diagnostic criteria for hypertension have also been continuously adjusted. It is currently believed that patients with the same blood pressure level are at risk of developing cardiovascular disease. Different, so there is the concept of blood pressure stratification, that is, patients with different risks of cardiovascular disease should have different appropriate blood pressure levels.
1. Genetic factors
About 60% of hypertensive patients have a family history. It is currently believed to be caused by polygenetic inheritance, and 30% to 50% of hypertension patients have a genetic background.
2. Mental and environmental factors
Long-term mental tension, excitement, anxiety, noise or poor visual stimulation and other factors can also cause the occurrence of high blood pressure.
3. Age factor
The incidence rate tends to increase with age, and the incidence rate is higher for persons over 40 years old.
4. Lifestyle factors
Unreasonable dietary structures, such as excess sodium, a low-potassium diet, heavy drinking, and excessive intake of saturated fatty acids can all increase blood pressure. Smoking can accelerate the process of atherosclerosis and is a risk factor for hypertension.
5. Effects of drugs
Birth control pills, hormones, anti-inflammatory painkillers, etc. can affect blood pressure.
6. The impact of other diseases
Obesity, diabetes, sleep apnea-hypopnea syndrome, thyroid disease, renal artery stenosis, renal parenchymal damage, adrenal gland mass lesions, pheochromocytoma, other neuroendocrine tumors, etc.
The main goal of hypertension treatment is to reach the target blood pressure, and the ultimate goal of antihypertensive treatment is to minimize the incidence and mortality of heart and cerebrovascular diseases in hypertensive patients. Antihypertensive therapy should establish a target value for blood pressure control. On the other hand, hypertension often coexists with other risk factors for heart and cerebrovascular diseases, such as hypercholesterolemia, obesity, diabetes, etc., which synergistically increase the risk of cardiovascular disease, and treatment measures should be comprehensive. Different populations have different blood pressure goals. The blood pressure goal of general patients is 140/90mmHg or less. For high-risk patients with diabetes or kidney disease, it should be lowered as appropriate. For all patients, regardless of whether the blood pressure at other times is higher than the normal value, attention should be paid to the monitoring of blood pressure in the morning. Studies have shown that more than half of the patients whose blood pressure in the office reach the standard have not met the standard in the morning.
(1) Improve life behavior ①Reduce and control weight. ②Reduce sodium intake. ③Supplement calcium and potassium salts. ④ Reduce fat intake. ⑤ Increase exercise. ⑥ Quit smoking and limit drinking. ⑦Reduce mental pressure and maintain psychological balance.
(2) Individualization of blood pressure control standards Due to different causes of hypertension, the pathogenesis of hypertension is different. Clinical medications are treated separately, and the most appropriate drugs and doses are selected to obtain the best curative effect.
(3) Coordinated control of multiple cardiovascular risk factors Although blood pressure is controlled within the normal range after antihypertensive treatment, multiple risk factors other than elevated blood pressure still have an important impact on the prognosis.