At 3:30 in the morning, a World Cup match between Mexico and Poland was in full swing. The next morning, sitting on the lazy sofa, drinking beer and eating snacks, feeling excited. During the intermission, when he was lifting up from the ground to prepare to go to the bathroom, he suddenly felt darkness in front of him, and his heart was about to jump out of his chest.
Young people stay up late, and the more they endure, the more they become more addicted. /TuChong Creative
He remembered the sensational news a while ago. The "China's Clinical Practice Guidelines" lowered the original diagnostic standard for adult hypertension from 140/90mmHg to 130/80mmHg. His blood pressure happened to be within this range, and overnight, he became a high blood pressure group.
As a post-90s generation, he never expected that he had committed a problem that the elderly had. In the future, as long as he felt a little uncomfortable, he would remind him that there was a hidden mine in his body.
In fact, it is an indisputable fact that hypertension is getting younger and younger.
According to this "guide", , Shanghai 10th People's Hospital, Zhang Yi, deputy chief physician of the Department of Cardiology, said: After the standards are lowered, the domestic hypertensive population is likely to double from the current 250 million people to nearly 500 million people.
Hypertension Standard
has increased and decreased
On November 13, the "China Hypertension Clinical Practice Guidelines" jointly formulated by National Cardiovascular Disease Center , Chinese Medical Association , etc., believes that the diagnostic threshold for hypertension in Chinese adults should be lowered from "≥140/90mmHg" to "≥130/80mmHg", which has aroused heated discussions in society and academia.
latest hypertension standard has caused many people to be "shocked". /@Lychee News
When I saw this news, I quickly took out my physical examination report the following morning. His blood pressure was 137/88mmHg. According to the previously used hypertension diagnostic standard in China, 140/90mmHg, this result is still within the reference range of the physical examination form notes. According to the new standards, he happened to enter the camp of "new high-pressure people".
However, on the evening of November 15, the National Health Commission responded that at present, the country has not adjusted the diagnostic standards for adult hypertension. The second morning suddenly became confused - what is the healthy blood pressure? Is the blood pressure between 130-139mmHg/80-90mmHg considered high?
needs to know that the "guidelines" and the standards proposed by the Health Commission are different considerations. The former is a recommendation for scientific research, while the latter is an implementation standard proposed considering the actual medical situation.
According to the report of First Financial , Wang Jiguang, chairman of China Hypertension Alliance and director of Shanghai Hypertension Research Institute, said that the diagnostic standard of 130/80mmHg was proposed by the United States in 2017. At present, no country has followed up with this standard. He believes that lowering the diagnostic standard does not meet the national conditions of my country's hypertension control, and will significantly increase the disease burden of hypertension prevention and control.
Blood pressure is formed by atrial contraction and dilation to promote blood flow.
In fact, the standard for hypertension is not static. In China, the standard in 1977 was 160/95mmHg, and it was not adjusted to 140/90mmHg until 1997. Why does the standard keep changing? Research on hypertension has been a medical problem to this day. With the deepening of scientific research and the changes in the social environment, standards are also changing.
According to Cambridge World History of Human Diseases, over the past many centuries, the only way people estimate blood pressure is through perception of pulse.
In ancient China, pulse diagnosis has always been one of the important methods to judge diseases; while the West believes that a high and tight pulse is a sign of kidney problems. It was not until 1896 that blood pressure monitor was invented that people gradually gained a preliminary understanding of the relationship between hypertension and cardiovascular disease.
pulse has always been one of the main ways of controversial diagnosis.
But the first person to discover that hypertension is associated with death was an insurance company in the United States.
In the 1930s, American insurance companies conducted statistics on the assessment of population lifespan values and found that people with blood pressure value of 140/90mmHg had a mortality rate of 120/80mmHg after 20 years, while people with blood pressure value of 160/95mmHg had a mortality rate of 2.5 times higher than people with blood pressure value of 120/80mmHg. Therefore, insurance companies recommend that applicants whose blood pressure levels continue to be higher than their peers should be further reviewed.
But this matter was valued by the medical community, and it will take until 1945 US President Roosevelt died of cerebral hemorrhage. When something happened to him, his blood pressure was as high as 300/190mmHg, which directly caused a cerebral hemorrhage. Roosevelt's death shocked the academic and medical circles. The National Center for Heart, Lung and Blood Research launched a cardiac research project during this period.
1957, this study finally found that if the blood pressure reaches 160/95mmHg, the risk of stroke will be increased by more than 2 times, and the risk of coronary heart disease will be increased by 3 times. After 20 years of research and controversy, it was not until 1978 that the World Health Organization (WHO) adopted the value of 160/95mmHg, and regarded it as the world's first hypertension standard. However, since then, the controversy continues.
latest blood pressure measuring instrument . /TuChong Creative
1998, the 7th World Health Organization/International Hypertension Alliance Hypertension Conference was held in Japan, and the second generation of hypertension diagnostic standard was determined to be 140/90mmHg, which has been used to this day.
, chief physician of the Department of Cardiology at Guangdong Provincial People's Hospital, said in response to an interview with " Beijing News " that the definition of hypertension of 140/90mmHg is based on evidence from multiple randomized controlled trials , and must be met. "The treatment of patients with these blood pressure values is beneficial", and "the benefits clearly exceed the risks brought by treatment" and "the proportion of the number of people who need treatment in the total population is appropriate."
. Regarding the new standards set by the "guidelines", many scholars believe that this standard means that when blood pressure reaches this value, drug treatment can be started. This guide should actually be regarded as a goal of blood pressure regulation and is not used as a critical point for treatment and medication.
Blood pressure and modern life
Recalling the half month of working from home, I lived a life that was reversed every day and night the next morning. The day begins at three or four in the afternoon, and it starts to sleep until dawn every day. While sleeping, it will respond to customer messages as it wakes up and promote work. At first he felt quite comfortable, but a few days later he suddenly felt like he was in a daze.
In 2017, at the International Public Health Innovation and Development Forum, a report on "The Epidemiology and Prevention and Control of Hypertension in China" mentioned that
62% of stroke deaths were directly caused by hypertension, and 49% of myocardial infarctions were directly caused by hypertension. Hypertension can increase the risk of coronary heart disease by 20%, and the risks of ischemic and hemorrhagic stroke by 39% and 54%, respectively. In addition, with the increase of blood pressure, the incidence of ischemic heart disease and stroke tends to increase linearly.
The harm of hypertension has gradually become known.
2017 China Hypertension Annual Meeting Survey data shows that the prevalence of hypertension among men aged 25-34 has exceeded 20%; a "White Paper on Cardiovascular and Cerebrovascular Health of Middle-aged and Young People" in 2019 shows that the proportion of people at high risk of cardiovascular disease aged 20-29 has reached 15.3%, and the young group is already one of the groups at risk of hypertension.
Why do you get high blood pressure at a young age? In fact, in the guidelines for the prevention and treatment of hypertension, there are two types of hypertension: primary and secondary. Among them, 90% of patients cannot find the exact cause of primary hypertension .
In the book "The Story of the Human Body: Evolution, Health and Disease", Human Evolution scientist Daniel Lieberman believes that from an evolutionary perspective, the outbreak of hypertension, diabetes , and heart disease are essentially mismatch diseases caused by the mismatch between the human body and the environment.
Agricultural revolution and industry have brought leap forward to human society. People can not only have enough food, but the development of modern medical care also greatly improves their lifespan. However, compared with the long evolutionary history of human beings, the industrial revolution of has only 200 years of history, and the life changes brought about by the human genes are earth-shaking. Human genes have to face a rapidly changing environment, so many unfit health problems have emerged.
In layman's terms, the evolution of the human body cannot keep up with the speed of social development. We belong to the Paleolithic body, and may not be enough to adapt to such a hugely changing modern life.
The evolution of human bodies cannot keep up with the rapid changes in society./《2001 Space Odyssey Project》
is like cervical spondylosis , lumbar disc herniation , etc. is the cost of human walking upright, and hypertension is also a disease caused by modern lifestyles. For example, in the current academic discussion, modern life problems such as excessive salt (sodium) intake, excessive drinking, smoking, staying up late, long-term mental stress, lack of exercise, and overnutrition may all be important causes of hypertension.
For Chinese people, compared with the whole world, a major influencing factor of national hypertension is that their sodium salt intake has always remained high, and the salt content brought by Chinese cooking methods exceeds the standard, which is far more than twice the recommended amount of 6g per day by the World Health Organization (WHO).
But the deeper reason is probably the combined role of the individual and the environment. The second morning, he worked as a salesperson. Staying up late to watch football, drinking beer and junk food was just a retaliatory act to relieve stress. The greater the psychological pressure, the more I feel that I need compensation. Even if I don’t sleep, I just complain to each other in a group chat with my friends, and I don’t want to go to bed early; my work is becoming more and more meaningless, so I just want to master the carnival of selflessness for a moment.
Young people are under increasing pressure. /Unsplash
Such a lifestyle is just a microcosm of countless young people.
Peking University A paper on population research, "China's population transformation, economic development and chronic disease growth" pointed out: We often focus on the role of individual-level risk factors on health, but in fact, macroscopic socioeconomic and material environmental factors are upstream factors that play a fundamental decisive role.
With the rapid development of society, high blood pressure has gradually come to young people.
Happy life is locked
When night gradually falls, a group of strong and laughing old men will grow out of thin air on the open spaces in each city. At this time, there were always young people with tired expressions watching in dismay, and the next morning was one of them.
Now that I think of my body that has been in bulk, I can't help but feel a clearer sadness the next morning.
Square dance aunt, the envy of young people. /TuChong Creative
Although the National Health Commission denied the definition standard for hypertension on November 15, maintaining the data of 140/90mmHg, that is, according to the actual situation, less than 140/90mmHg, generally do not receive drug treatment. But this does not mean that there is no problem below 140/90mmHg.
In 2008, a famous American hypertension expert proposed to subdivate the pre-hypertension into two levels: the blood pressure level of grade 1 is 120-129/80-84mmHg, and the blood pressure level of grade 2 is 130-139/85-89mmHg; " China Hypertension Prevention and Treatment Guidelines " calls the blood pressure in the range of 120-139/80-89mmHg "normal high-value blood pressure".
Even if it is diagnosed but "normal hypertension", some effects of hypertension may occur quietly. Department of Cardiology, Department of Xiangya Hospital, Central South University, mentioned a clinical discovery in the paper "Thinking caused by the Changes in the Diagnostic Standards of Hypertension in the Centennial Hypertension" mentioned a clinical finding that in many early stages of hypertension, damage to multiple target organs such as the heart, brain, kidney, major artery and retinal artery has occurred, ultimately leading to abnormal diseases of the structure and function of the cardiovascular system.
According to the "China Cardiovascular Health and Disease Report 2021", the data on the awareness, treatment rate and control rate of Chinese hypertensive patients are 51.6%, 45.8%, and 16.8%, respectively, which means that half of hypertensive patients do not know their condition.
Zhang Zhiying, a cardiovascular doctor at Beijing Tiantan Hospital, did relevant science popularization on the short video platform. When he was in the telecommunication platform, most of the patients he met said that it would be great if he had known it earlier. In fact, hypertension is a "shadow killer". It often comes quietly, and when the body feels discomfort, it often has harm.
People often regret not realizing the problem earlier. / "The Legend of Zhen Huan"
. The survey data cited by the "Guidelines" also showed that among people aged 35-64, 65% of people with no hypertension had blood pressure in systolic blood pressure in 130-139mmHg and/or diastolic blood pressure in 80-89mmHg, 65% of people with 15 years of hypertension progressed into hypertension.
From this point of view, the downgrading of diagnostic standards is based on the concept of "prevention" and is to give young people some warnings.
After gradually understanding hypertension and its consequences, the second morning made up his mind to change his lifestyle. He thanked the "Guidelines" for adjusting the "Guidelines" so that he could adjust himself in time and put exercise and early bedtime on the agenda. According to the new "guidelines", 80% of lifestyle intervention and 20% of medication can prevent more people from developing serious diseases.
And an article published in the official magazine "JCH" of the World Hypertension Alliance 2020 pointed out that intervention methods such as reducing salt intake and strengthening appropriate exercise are the most economical and practical ways.
Chinese cooking is inseparable from high salt. /TuChong Creative
According to this study, exercising more, every 5kg of weight loss can reduce blood pressure by 6.3/3.4mmHg; and every 4.4g of sodium salt consumed can reduce blood pressure by 5.4/2.8mmHg. With the
method, the rest is a long self-disciplined life.
In a recent video, Dr. Zhang Zhiying still shared with his fans his lifestyle of preventing hypertension. The weather was very cold that day. After a meal of lamb hotpot , he was a little full. That night, he hurried to the swimming pool and swam for thousands of meters in one breath. The high level of self-control ability amazed fans.
The next morning, while giving myself a positive psychological hint, I felt sad that the only chance of indulgence and decompression was about to disappear -
The joy of staying up late to play games, beer and barbecue, all of them have to quit.
References
[1] More than 200 million hypertension in one night? Young people who break the defense may not understand blood pressure at all | Sixiang Studio
[2] Following hair loss, hypertension hits the body of the post-80s and 90s again | Occasionally cured
[3] Debate on the standard of hypertension: a controversy related to 243 million people | Peeling onions
[4] "I suddenly became hypertension", new standard for hypertension is released | Daily Economic News
[5] The blood pressure of 200 million people reversed twice within three days | Huxiu APP
