Qianjiang Evening News·Houri News Reporter Zhang Bingqing Correspondent Fang Xu Chen Dan
"Why did I become hypertension overnight? Please help me see if I want to take medicine?"
Early this morning (November 14), Zhejiang University Second Hospital Department of Cardiovascular Internal Medicine Chen Wenai Chief Physician As soon as I entered the hospital, a colleague couldn't wait to ask her for consultation with the physical examination report.
The day before, the "Chinese Medical Association" , the "Chinese Medical Association" , the "Chinese Medical Association" Hypertension Professional Committee, the Chinese Medical Association's Cardiovascular Branch, and the "Chinese Medical Association's Medical Association's Medical Association's Hypertension Professional Committee jointly issued the "China Hypertension Clinical Practice Guidelines" (hereinafter referred to as the "Guidelines").
According to the new "Guidelines", the diagnostic criteria for adult hypertension in in China was downgraded from ≥140/90mmHg to ≥130/80mmHg ( mmHg ) . This means that the "pre-hypertensive" population with the original blood pressure value in the range of 130/80mmHg~140/90mmHg turned into "hypertensive" patients.
Image source: Visual China
This colleague recently tested his blood pressure and measured 136/86mmHg, which is exactly in this range. Overnight, he went from a "pre-hypertensive" group to a "hypertensive" patient, which was unacceptable for a while, and he didn't know how to deal with it.
The diagnostic criteria for hypertension have been adjusted
The country is expected to increase more than 200 million hypertensive patients
"For the people, this news may be quite shocking, but industry insiders have foreseeed it." Director Chen Wenai said.
Because the diagnostic criteria for hypertension have been adjusted, the diagnostic criteria for adult hypertension in 1977 was ≥160/95mmHg, and in 1997 it was changed to ≥140/90mmHg, which is also the most well-known standard. In 2017, the American Society of Cardiology and the American Heart Association modified the diagnostic criteria for hypertension to blood pressure ≥130/80mmHg.
In the past five years, Chinese experts have also begun to conduct a large number of prospective cohort studies of . The research results show that the risk of cardiovascular disease in the range of 130/80mmHg to 140/90mmHg is 30% to 90%, and the risk of cardiovascular disease is 11% lower for every 5mmHg reduction in blood pressure.
Therefore, the downregulation of the diagnostic criteria for hypertension can allow more people to pay attention to blood pressure from an earlier stage and lower blood pressure, which can further significantly reduce the occurrence of cardiovascular and cerebrovascular complications.
Director Chen Wenai said that national survey data shows that adults over 18 years old with blood pressure in my country are about 243 million with blood pressure in the range of 130/80mmHg~140/90mmHg. The data should now increase, and these groups need to be included in management.
Don’t need to rush to take antihypertensive drugs
It is important to adjust your lifestyle
As one of the more than 200 million new patients with hypertension, Director Chen Wenai’s colleague was so anxious that he didn’t sleep well last night. “I still think I am quite young. Do you have to take antihypertensive drugs like my dad?”
In fact, whether you need to take medicine or not depends on a comprehensive evaluation by a professional doctor.
According to the new "Guidelines", adults whose blood pressure is in the range of 130/80mmHg~140/90mmHg, if they have the following clinical comorbidities, they need to initiate drug treatment, including: 1, cerebral hemorrhage , ischemic stroke , heart failure , atrial fibrillation, coronary heart disease and other cardiovascular and cerebrovascular diseases ; 2. target organ damage, that is, long-term increase in blood pressure leads to damage to the heart, brain, kidney and other organs; 3. More than three cardiovascular disease risk factors , such as older age (male over 45 years old, female over 55 years old), smoking, hyperlipidemia, hyperglycemia , etc.
"If these clinical comorbidities do not exist, it is generally not recommended to take medicine immediately. It can be regulated through exercise, diet and other aspects. Re-examination will be conducted after 3-6 months. If the blood pressure has not dropped to the normal value, the clinician will evaluate whether the medicine is needed."
Colleagues tested blood pressure more than 130/80mmHg for the first time in the physical examination some time ago. Director Chen Wenai suggested that he adjust his diet structure first and increase the amount of exercise. In the near future, blood pressure will be measured once every day before breakfast and dinner, and then re-examination will be conducted after a period of time.
China's hypertensive population has weak awareness
New standard can awaken the awareness of the whole people
"In the past five years, the international medical community has been lowering the diagnostic standards of hypertension. The fundamental purpose is to increase the attention of the whole people to control hypertension."
As the deputy chairman of the Cardiovascular Branch of the Chinese Medical Association and a famous cardiovascular expert in my country, Professor Wang Jianan of Zhejiang University Second Hospital is very supportive of the issuance of this new standard.
He said that during clinical diagnosis and treatment, doctors often encounter patients or families who have a vague understanding of hypertension. They think that their blood pressure is a little higher but there is no symptoms and do not need treatment. Some people even think that taking medicine may have side effects and are afraid of taking medicine for life. Data shows that the awareness rate of hypertension among Chinese people is only 51.6%, the treatment rate is only 45.8%, and the control rate is as low as 10.8%.
Professor Wang Jianan emphasized that no symptoms are more terrible than symptoms. Asymptomatic patients do not pursue treatment and cannot control them in time, which may bring many sequelae. Regarding patients' concerns about taking medicine, the side effects of cardiovascular drugs and blood pressure-lowering drugs are currently very low, and blood pressure is more harmful to the human body. Some patients and their families pay too much attention to the side effects brought by taking medicine rather than the harm caused by hypertension itself.
"Hypertension is the culprit of atherosclerosis, and it is also the culprit of further causing stroke and myocardial infarction . So I think that this time, the Chinese Cardiovascular Society lowers the diagnostic standards for hypertension is very conducive to awakening the awareness of the whole nation, and I am very supportive. Of course, establishing a healthy lifestyle, reasonable diet control of weight, strengthening aerobic exercise, quitting smoking and limiting alcohol, and maintaining a long-term peace of mind are also one of the important factors that promote blood pressure drop."
Picture source: Visual China
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