Hypertension is the main risk factor for organ damage such as the heart, brain, kidney and systemic atherosclerosis. The ultimate goal of treating hypertension is to reduce the occurrence of the above-mentioned organ damage and its associated adverse events . The results of clinical experiments in large specimens in recent years have shown that when hypertension requires the patient's blood pressure to be controlled at a suitable level (below 140/90mmHg) and maintained for a long time, cardiovascular and cerebrovascular events and related deaths can be reduced.
The prerequisite for treating hypertension is to change your lifestyle and avoid risk factors. Patients with mild hypertension and normal high blood pressure do not even need to take medicine to restore normal blood pressure, while patients with moderate and severe hypertension can assist in drug treatment and prolong the duration of drug action. Specific measures include: reduce sodium salt intake (daily salt intake is less than 6 grams), increase potassium intake in moderation; eat a reasonable diet, do not overeat, and be picky about food; control weight, lose weight for obese and overweight people; quit smoking and limit alcohol, avoid passive smoking; exercise appropriately; reduce mental stress, combine life and work, and maintain a calm mind.
High blood pressure progresses slowly. It usually takes more than ten years or even decades from the early stage to the late stage. In the long years, patients must have a correct understanding of the condition and be mentally prepared for long-term treatment. The pathogenesis of hypertension is very complicated and there is a long treatment process. Don’t worry or pessimism after getting sick. You must establish good belief in life and confidence in fighting against the disease, strive to change your personality defects, and actively cooperate with doctors to achieve good results, thereby improving the quality of life and prolonging your life.
Before starting treatment of hypertension, experienced doctors will communicate well with the patient and choose a personalized treatment plan suitable for the patient through medical history collection, physical examination and clinical examination results. Patients should adhere to the established treatment plan for a long time at the beginning of treatment. Even after blood pressure is controlled, they should continue to treat it. Some patients do not trust the treatment plan designated by the doctor, think that the doctor is alarmist, afraid of trouble, often forget the time of taking medicine or fear of side effects caused by some drugs. Taking medicine is often irregular, eating and stopping, and the blood pressure jumps backward, which requires the patient's attention.
Currently, there are many types of blood pressure-lowering drugs commonly used in clinical practice, including the following categories: calcium channel blockers, angiotensin converting enzyme inhibitors, angiotensin II receptor blockers, diuretics , beta blockers, renin inhibitors, alpha blockers, central sympathetic agonists, post-range god sympathetic inhibitors, vasodilators, etc.
The antihypertensive mechanisms of different types of antihypertensive drugs are different. When choosing antihypertensive drugs, doctors will consider the following factors: the patient's age, gender, living environment, the severity of hypertension, whether they are combined with other diseases, such as diabetes , hyperlipidemia, coronary heart disease , etc., possible adverse reactions of the drug, drug costs and adverse effects testing costs, etc. Most patients (at least 3/4) need to use 2 or more antihypertensive drugs combined to achieve the purpose of lowering blood pressure.
Most patients can successfully tolerate the treatment of antihypertensive drugs. However, any antihypertensive drug can cause adverse reactions. Once adverse reactions occur, the patient should inform the doctor so that the drug dose can be adjusted or other drugs can be switched to. Generally, in order to control blood pressure, the use of antihypertensive drugs is not a deadline.
antihypertensive treatment goal is to reduce blood pressure below 140/90mmHg. For patients with diabetes, renal disease, coronary heart disease, and angina pectoris, blood pressure should be reduced to below 130/80mmHg. At the same time, diastolic blood pressure should be avoided below 65mmHg, especially in the elderly and patients with coronary heart disease or angina pectoris.
Finally, in clinical practice, more comprehensive and detailed screening examinations should be performed: young patients with moderate and severe blood pressure; symptoms, signs or laboratory examinations have suspicious clues, such as weakening or missing limb pulse asymmetry, rough vascular murmurs heard in the abdomen, etc.; combined drug treatment effect is poor, or blood pressure has been well controlled during the treatment process, but has increased significantly in the near future; patients with malignant hypertension .These conditions may be secondary hypertension of . Although secondary hypertension accounts for only 5%, compared with the huge number of people with hypertension, the absolute number of people is quite large. Treating the causes of hypertension as early as possible can improve the cure rate of secondary hypertension and prevent the disease from continuing to progress.
(Tomorrow update: Hypertension Ten: Daily Health Care)
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