Constipation is one of the most common accompanying symptoms in cardiovascular and cerebrovascular diseases such as . Constipation will not only cause physical and mental pain to the patient, but will also cause or aggravate complications such as heart failure , arrhythmia , angina pectoris, sudden death, etc. Patients with cardiovascular and cerebrovascular diseases such as hypertension and other cardiovascular and cerebrovascular diseases are common. The main reason is that the abdominal pressure suddenly increases when the patient defecates with force, resulting in a sharp increase in blood pressure. In addition, the defecation habits of most people are after getting up in the early morning. At this time, many patients with hypertension are in the "morning peak of hypertension", which makes it even worse, resulting in further increase in blood pressure. The sharply increased intra-abdominal pressure and blood pressure will affect the cerebral artery and coronary artery and cause the occurrence of cardiovascular and cerebrovascular diseases; therefore, patients with cardiovascular and cerebrovascular diseases such as hypertension often suffer from cerebral hemorrhage and , myocardial infarction and other accidents during stool in the morning.
Facts have proved that constipation is a common comorbidity symptom for patients with cardiovascular and cerebrovascular diseases such as hypertension, coronary heart disease, and is also a major risk factor for accidents in patients with cardiovascular and cerebrovascular diseases. However, we often only pay attention to changes in blood pressure and disease, but do not pay enough attention to constipation.
1. Chronic constipation Definition
Spontaneous defecation is less than 3 times a week, often accompanied by dry and hard stool, difficulty in defecation, blockage of the anus and rectum during defecation, or need auxiliary defecation, at least 6 months; the main causes of chronic constipation are:
1. Chronic functional constipation
Chronic functional constipation refers to primary persistent constipation caused by non-systemic diseases or intestinal diseases, also known as habitual constipation or simple constipation, mainly caused by intestinal dysfunction, constipation is difficult to discharge, or the defecation interval is extended, and once every 2 to 3 days. For a few people who are used to defecation every 2 to 3 days and do not have difficulty defecation, it cannot be called constipation. can be divided into the following four categories according to anal rectal function and colon dynamics: slow-transmission constipation, outlet obstructive constipation , mixed constipation, normal transmission constipation.
2. Chronic constipation caused by organic diseases
includes
organic intestinal diseases: such as intestinal nerves, muscle lesions, congenital megacolons; inflammatory diseases of the intestinal tract, such as Crohn's disease , intestinal tuberculosis , ulcerative colitis; intestinal tumors, such as colorectal cancer;
parenteral diseases: prostate cancer , uterine fibroids;
neurological diseases: stroke and its sequelae, spinal cord injury, Parkinson's disease , myasthenia gravis , electrolyte disorder , amyloidosis
endocrine and metabolic diseases : such as hypothyroidism, hyperthyroidism, diabetes , rheumatoid immune diseases;
cardiovascular and cerebrovascular diseases: hypertension, coronary heart disease, stroke, etc.
3, drug-related constipation : constipation caused by the use of various drugs: including antibacterial drugs, calcium antagonists, bismuth agents, antihistamines, diuretics, opioids and morphine analgesics, psychiatric drugs, anticholinergic drugs , etc.
2. The impact of constipation on cardiovascular and cerebrovascular diseases
Related studies show that in my country, the incidence rate of chronic constipation in adults is between 4% and 6%, and with the increase of age, the incidence rate gradually increases. The incidence rate of constipation in the elderly over 60 years old can reach 22%, and the incidence rate is higher in women than men. Constipation not only affects the quality of life, but also plays an important inducing role in the occurrence of diseases such as acute myocardial infarction and cerebrovascular accidents. Excessive defecation may lead to worsening of the condition or even death.
1. Constipation can lead to poor blood pressure control
Many factors can lead to constipation, but constipation can also cause blood pressure to be difficult to control due to the pain during defecation and the adverse emotions it causes, causing blood pressure to be unstable;
2. Constipation can induce cerebral hemorrhage
When constipation patients defecate excessively, their blood pressure will rise sharply. When the pressure exceeds the ability of the blood vessel wall to withstand, it will cause blood vessels to rupture and cerebral hemorrhage.
3. Constipation can induce acute myocardial infarction
Defecation excessively during constipation can lead to increased oxygen consumption of myocardial muscles, resulting in insufficient blood supply of myocardial and insufficient blood supply of cerebral blood vessels; excessive pressure of defecation can lead to excessive increase in abdominal pressure, which increases the return of the heart in a short period of time, increasing the heart (pre) load; at the same time, it reduces lung capacity and reduces oxygen intake, thereby inducing severe myocardial ischemia and hypoxia and brain blood supply of , leading to acute myocardial infarction or acute cerebrovascular accidents.
4. Constipation can lead to a variety of cardiovascular and cerebrovascular diseases
. Related studies show that constipation is a risk factor for various cardiovascular and cerebrovascular diseases. Chronic constipation can induce increased blood pressure, transient cerebral ischemia , angina pectoris, coronary heart disease, stroke , myocardial infarction, and can also induce acute attacks or aggravation of a variety of cardiovascular and cerebrovascular diseases, including: rapid or malignant arrhythmia, angina pectoris, AMI, acute left heart failure, pulmonary edema, cardiac function deterioration, shock, hypertension crisis and sudden death. Related studies show that if women experience severe constipation, the incidence of cardiovascular and cerebrovascular diseases will increase by 23%; 30% to 60% of stroke patients have constipation. The incidence of cardiovascular and cerebrovascular diseases in people without constipation is much lower;
3. Why are cardiovascular patients more likely to suffer from constipation?
1. Effects of cardiovascular disease on gastrointestinal function
Patients with cardiovascular disease often have the habit of exercise less before they get sick, and the patient should not exercise a lot afterwards. At the same time, they are affected by anxiety and other emotions, which can easily lead to weakening of gastrointestinal function and cause Difficulty in defecation; on the other hand, cardiovascular disease can cause gastrointestinal ischemia or congestion in the patient, causing weakening of gastrointestinal function, affecting the patient's appetite, leading to loss of appetite, and further causing excessive consumption of fiber, leading to constipation;
2. Some commonly used drugs for cardiovascular blood vessels can cause constipation
Cardiology patients can cause constipation due to long-term use of diuretics: on the one hand, diuretics can cause hypokalemia, causing depression of intestinal peristalsis, causing constipation; On the one hand, the diuretic effect of diuretics can dehydrate tissues, resulting in reduced water in the large intestine and dryness in the intestine, causing or aggravate constipation; calcium ion antagonists can inhibit intestinal smooth muscle, relax the intestinal wall, weaken intestinal peristalsis, and slow down the movement of colon , thereby causing or aggravate constipation; patients taking β-blockers may experience adverse reactions in the digestive tract, including constipation;
that is: Patients with cardiovascular and cerebrovascular diseases often suffer from constipation due to long-term bed rest, accompanied by adverse emotions such as mental anxiety and depression, reduced diet, taking certain drugs, weakened gastrointestinal motility and other factors, etc.
4. How should patients with cardiovascular diseases deal with constipation? What are the common drugs for treating constipation?
is introduced in detail in the next article;
