Hello everyone! I am Dr. Xu of Cardiovascular Medicine, spreading the correct scientific knowledge and escorting your cardiovascular health!
November 13th "China's Clinical Practice Guidelines for Hypertension" was announced, and the diagnostic standards for Hypertension in China were downgraded from ≥140/90mmHg to ≥130/80mmHg.
Previous blood pressure 130-139/80-89mmHg is called "pre-hypertension" or "critical hypertension".
According to national survey data, among adults aged 18 and above in my country, 23.2% of people with systolic blood pressure 130-139mmHg and/or diastolic blood pressure 80-89mmHg account for 23.2%, and the number of hypertensive patients in my country will increase by 243 million. The population in this blood pressure range is mainly middle-aged and young people aged 18-54.
So, according to this calculation, the number of hypertensive patients in my country will be close to 500 million, and on average, one in every three people has hypertensive patients.
, the new diagnostic standard for hypertension, has caused a lot of heated discussion. Some netizens commented that after waking up after sleeping, they found that they were under high blood pressure. There are also patients in the
clinic who come to consult, and their blood pressure is 107/83mmHg. She said that the diagnosis standard for hypertension was changed to above 130/80. So is she considered hypertension? Do you want treatment?
Regarding this matter, Dr. Xu believes that everyone should look at it more rationally. Dr. Xu will explain to you today the background of the adjustment of blood pressure diagnostic standards and whether blood pressure of 130-139/80-89mmHg requires antihypertensive drugs.
According to the meta-analysis of results from previous clinical studies, although the group of people with systolic blood pressure of 130-139 mmHg and/or diastolic blood pressure of 80-89 mmHg has not yet met the previous diagnostic criteria for hypertension, their cardiovascular and cerebrovascular damage has occurred, and the risk of cardiovascular and cerebrovascular events such as stroke is significantly higher than that of healthy people.
The treatment for antihypertensive treatment in this group of people can significantly reduce the relative risk of cardiovascular disease.
Therefore, the modification of the diagnostic criteria for hypertension this time is equivalent to moving the defense line of cardiovascular and cerebrovascular diseases forward, which helps to reduce the incidence and mortality of cardiovascular and cerebrovascular diseases in my country.
Therefore, it is more important to remind the population with blood pressure of 130-139/80-89mmHg to pay great attention and start to prevent cardiovascular and cerebrovascular diseases.
prevention is greater than treatment, reminding this group of people to start paying attention to improvements in their lifestyle, including low-salt diet, exercise, weight control, quitting smoking and limiting alcohol.
So, what everyone is very concerned about is that my blood pressure is 130-139/80-89mmHg. Do I need to take antihypertensive drugs?
It should be said that most people do not need to take antihypertensive drugs.
According to statistics, among adults over 35 years old in my country, 22.7% of people with blood pressure of 130-139/80-89mmHg need antihypertensive medication.
These people are at high risk for cardiovascular disease in the future and require early intervention. Many doctors are already doing this in clinical practice.
mainly includes the following three groups:
. Patients with clinical comorbidities.
For patients with coronary heart disease , heart failure , diabetes, renal insufficiency with proteinuria, cerebral infarction, etc., the blood pressure is 130-139/80-89mmHg. It is recommended to take antihypertensive drugs, which helps to delay the progress of the disease and reduce the risk of cardiovascular and cerebrovascular events.
2. Patients with target organ damage. Although the blood pressure is only 130-139/80-89mmHg, patients with target organs such as heart, brain, kidney, eyes or blood vessels have damage.
Hypertensive heart damage includes ventricular wall thickening, left atrium enlargement, cardiac insufficiency, coronary heart disease, premature beat, atrial fibrillation, etc.
Brain damage caused by hypertension includes cerebral infarction, transient cerebral ischemia attack, cerebral hemorrhage , etc. Renal damage caused by hypertension includes proteinuria, renal insufficiency, etc.
Eye damage caused by hypertension includes fundus retinopathy, blurred vision, etc.
Vascular damage caused by hypertension includes internal media thickening, vascular sclerosis, vascular plaque, etc.
3. Patients with ≥3 cardiovascular risk factors.
Card-related risk factors include smoking, obesity, elevated low-density lipoprotein cholesterol, low high-density lipoprotein cholesterol, abnormal blood sugar, unhealthy diet, lack of exercise, family history of early cardiovascular diseases, etc. Among the risk factors above
, there are 3 or more people with blood pressure of 130-139/80-89mmHg, and they are considered to take antihypertensive drugs.
In addition, for people with low risk of cardiovascular disease, that is, people with blood pressure of 130-139/80-89mmHg, who are only accompanied by 0-2 cardiovascular risk factors, they do not need to take antihypertensive drugs for the time being, but they need to undergo 3-6 months of lifestyle intervention. If the blood pressure is less than 130/80mmHg, continue to observe the blood pressure and do not need to take antihypertensive drugs.
However, if the systolic blood pressure is still ≥130mmHg and/or the diastolic blood pressure is ≥80mmHg, consider starting antihypertensive drug treatment.
Therefore, in general, the diagnostic criteria for hypertension have been lowered to 130/80mmHg, which is more important to remind the population of 130-139/80-89mmHg, which will attract attention, attract sufficient attention, and prevent it.
Because most people do not need to take antihypertensive drugs, simply by improving their lifestyle, they can reduce their blood pressure to below 130/80mmHg, thereby reducing the risk of cardiovascular and cerebrovascular diseases in the future.
For people with cardiovascular and cerebrovascular diseases, target organ damage, and ≥3 cardiovascular risk factors, it is recommended to improve their lifestyle and initiate antihypertensive drug treatment, which will help prevent the risk of cardiovascular and cerebrovascular events in the future.
At present, there are also different sounds, and the diagnostic criteria for hypertension are still 140/90mmHg.
In fact, for the group of people with blood pressure of 130-139/80-89mmHg, whether it is to diagnose hypertension, pre-hypertension, critical hypertension, or normal high value, Dr. Xu believes that the most important thing is to remind everyone to pay attention to it, to prevent further increase in blood pressure, improve lifestyle, lower blood pressure, and prevent events.
is currently very consistent with the target value of hypotensive patients with hypertension. As long as it can be tolerated and there is no discomfort, it is best to reduce it to below 130/80mmHg. The target value of
, which also indirectly reflects the abnormal blood pressure of 130-139/80-89mmHg, which has certain risks.
Therefore, Dr. Xu reminds people whose blood pressure is in this range to pay attention to it, establish and maintain a healthy lifestyle, and prevent incidents.
I am Dr. Xu Hongxin, Chief Physician of the Department of Cardiovascular Internal Medicine, Wuhan University People's Hospital!
The location and time of the clinic: Every Monday morning and Friday afternoon, the Shouyi Campus of Wuhan University People's Hospital!
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The content I shared with you today is over here. Pay attention to health and Dr. Xu, Cardiovascular. See you next time!
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