Teacher Xia is almost 60 years old, and has a history of hypertension for more than ten years. She pays attention to her daily life and has been taking antihypertensive drugs under the guidance of the doctor: candesartan and amlodipine ; her blood pressure has been controlled ideally; in May and June this year, her blood pressure was measured many times, only about 110/65mmHg, and she felt dizzy at times. So with the doctor's consent, Teacher Xia stopped amlodipine and only took candesartan. Later, after multiple measurements of blood pressure were normal, basically around 120/75mmHg, and she did not feel dizzy again; before National Day, the blood pressure was also measured, which was 120/80mmHg.
On October 6, Teacher Xia took the health examination report from a while ago to consult, and the results of the health examination were basically normal; so he took a blood pressure by the way, and it actually reached 180/110mmHg, but he didn't feel any discomfort. He didn't really believe that his blood pressure was so high. After resting for 15 minutes, he measured it again and found that his blood pressure was still 170/105mmHg. The doctor saw that the electrocardiogram and liver and kidney function of his physical examination a few days ago were still normal, so he told him to go back and continue to monitor his blood pressure. If it was still high, add the original amlodipine tablet; if there were symptoms such as dizziness, headache, vomiting, etc., you should come to the hospital in time.
At around 5 pm that day, Teacher Xia's blood pressure measured at home was 180/100mmHg, so Teacher Xia felt a little nervous, afraid that he would have stroke . At around 6 o'clock, Teacher Xia felt dizzy, dizzy, his whole body trembled slightly, afraid of falling, so he went to the hospital after taking one tablet of amlodipine. The emergency doctor asked about his medical history and gave him the corresponding examination and told Teacher Xia not to be nervous. At present, it was just that his blood pressure was high and he was dizzy, and there was no obvious abnormality in his brain. Often, it will be cured after blood pressure is controlled; and Teacher Xia took a tablet of captopril and injected a small dose of sedative intramuscularly. Soon, Teacher Xia stopped trembling and fell asleep slowly. The next day, Teacher Xia improved significantly, and his blood pressure was around 150/90mmHg. The doctor prescribed some anti-diaphragm drugs and told him to go back and continue taking candesartan and amlodipine, and monitor his blood pressure more. On the third day and fourth day after he came back, Teacher Xia's blood pressure was controlled at 120/80mmHg and he was not dizzy.
Teacher Xia was very confused: I controlled my blood pressure well, why did it suddenly rise to 180/110mmHg?
In fact, our blood pressure changes continuously throughout the year with the changes of temperature and seasons. When the temperature rises in summer, the blood pressure decreases. In autumn and winter, the temperature decreases, and our blood pressure rises; during the day, the blood pressure also changes at any time. When we are active during the day and sleep at night, our blood pressure fluctuates greatly, high during the day and low at night; 24-hour blood pressure fluctuates, systolic blood pressure can fluctuate by 50mmHg, and diastolic blood pressure can fluctuate by 20mmHg; generally the blood pressure at night is the lowest.
In addition to changing temperature and day and night, blood pressure will also change with changes in the environment and mood: for example, some patients will have their blood pressure when they go to the hospital for examination, which is called " white coat hypertension "; for example, under tension, anxiety, and anger, blood pressure will also increase; specifically, Teacher Xia, why does his blood pressure fluctuate so much in just about a week? Teacher Xia usually takes candesartan and amlodipine. Because the temperature rises in May and June, his blood pressure is well controlled, so he reduces antihypertensive drugs and only takes one candesartan. Around this National Day, the temperature dropped by more than 20 degrees, and the temperature suddenly becomes cold. Because there is no special discomfort, Teacher Xia also neglected to monitor blood pressure. At the same time, due to the National Day holiday, relatives and friends have more contacts, Teacher Xia feels tired and has not had a good rest, which leads to: Although Teacher Xia is taking antihypertensive drugs seriously, his blood pressure still suddenly rises. Fortunately, no serious complications occurred.
In the autumn and winter season when the temperature plummets, it is the season for hypertension and cerebrovascular accidents.A sudden and significant drop in temperature will stimulate the contraction of blood vessels in the human body, increase the resistance to blood circulation, slow down the blood flow rate, cause blood pressure to rise, and also prone to cardiovascular and cerebrovascular accidents. There is evidence that for every 1 ℃ drop in the temperature, the systolic pressure can be increased by 1.3 mmHg and the diastolic pressure can be increased by 0.6 mmHg; then when the temperature drops by more than 20 degrees, coupled with other factors such as fatigue, poor rest, and mood swings that raise blood pressure, it is not surprising that Teacher Xia's sudden increase in blood pressure.
Therefore, for patients with hypertension, in the season when the temperature suddenly changes, you must monitor your blood pressure more, especially for patients with unstable blood pressure. Patients with hypertension who reduce or stop taking medication in summer should monitor more; it is recommended to measure blood pressure three times a day to observe changes in their blood pressure in the morning, noon and late, and avoid cardiovascular and cerebrovascular accidents caused by sudden increase in blood pressure. It is best for patients with hypertension to develop the habit of measuring blood pressure regularly and accurately recording it every day, so that they can not only grasp the changes in their blood pressure, but also provide a reference for doctors to diagnose the condition. Because the blood pressure measured by the patient at home can more objectively reflect the blood pressure status than the blood pressure measured in the hospital clinic: it can check the hypertension of white coats, find occult hypertension, and also find nocturnal hypertension.
The blood pressure of normal people and most hypertensive patients is "spoon-type blood pressure" with "two peaks and one valley": that is, there are two peak periods of blood pressure during the day, that is, starting from the early morning, the blood pressure gradually rises, and reaches a peak at 8 to 10 am, and then it drops slightly. It starts to gradually rise at around 2 pm, and reaches a peak at 4 to 6 pm. Therefore, when blood pressure is measured in the morning and evening, you can understand the highest point of blood pressure in the day. Generally, the lowest point of blood pressure in the day is around 1 to 2 am. Some patients have the highest point of blood pressure in the day after getting up in the morning, while some patients have the highest point of blood pressure in the day when they have the evening. Of course, a very small number of patients have the highest peak at night. According to the time when the highest peak of blood pressure occurs, it can help us adjust the medication time to better control needs.
Therefore, we need to measure the blood pressure after waking up in the morning and keep records, and then measure the blood pressure at noon and evening. We can compare the blood pressure changes at different times of the day, and the blood pressure changes at the same time every day, so as to fully understand our blood pressure status. At the same time, we can avoid missed diagnosis of occult hypertension and provide more reference for doctors to adjust antihypertensive drugs. Of course, the blood pressure change pattern of everyone is not exactly the same. Pay attention to adding more measurements, observe and find out what time period is the highest peak and lowest trough of your blood pressure. This can provide more reference for doctors to develop more reasonable treatment plans.
The temperature drops sharply, and blood pressure should be prevented to prevent the sudden increase in blood pressure and cause serious adverse effects; the temperature drops, have your blood pressure monitored? In the cold autumn and winter seasons, I hope you can pay attention to your own and your family’s blood pressure.
(Medical card has been added here, please go to the Toutiao client to view)
