Do you really know about high blood pressure? What are the symptoms and dangers of high blood pressure? When to start taking antihypertensive drugs?

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Hypertension, the most common cardiovascular disease in the world today, has a high prevalence, long course, high death and disability rates, and is known as the "silent killer". According to the latest hypertension survey data in China, the prevalence of hypertension among adults aged 18 and above is 23.2%, with 243.5 million people suffering from the disease, and one in five adults is a hypertensive patient. It is important to understand what hypertension is as we are often surrounded by elders and friends and relatives who have hypertension.

What is hypertension?

Before we get to know hypertension, let's understand what blood pressure is. Just as water flowing through a water pipe exerts pressure on the walls of the pipe, blood flowing through the blood vessels of the human body exerts pressure on the walls of the blood vessels. The blood vessels in human body are divided into arteries, capillaries and veins, arteries are responsible for transporting the blood from the heart to the capillaries all over the body. The veins are the greenish-purple strip of blood vessels seen on the back of our hands.

Do you really know about high blood pressure? What are the symptoms and dangers of high blood pressure? When to start taking antihypertensive drugs?

What we usually call blood pressure is the pressure of blood against the walls of the arteries. Generally, human blood pressure is measured at the brachial artery of the upper arm as the standard, and the unit of pressure is usually expressed in millimeters of mercury (mmHg) or kilopascals (kPa) (1 kPa = 7.5 mmHg).

As the flow of blood is maintained by the heartbeat, when the heart contracts to pump blood into the arteries, the arteries bear the greatest pressure, the pressure measured at this time is called "systolic pressure", commonly known as "high pressure"; when the heart is diastolic, due to the elastic retraction of the arteries When the heart is in diastole, the blood can still continue to flow forward, and at this time the pressure on the arteries drops to the lowest, called "diastolic pressure", commonly known as "low pressure". If the systolic pressure is 120mmHg and diastolic pressure is 80mmHg measured by a blood pressure monitor, it can be expressed as 120/80mmHg.

The ideal blood pressure should be <120/80 mmHg, with systolic blood pressure of 120-139 mmHg and diastolic blood pressure of 80-89 mmHg being normal high values. Hypertension is defined as a systolic blood pressure ≥ 140 mmg and/or diastolic blood pressure ≥ 90 mmHg measured in a hospital or clinic. hypertension is diagnosed when the blood pressure is ≥ 140 mmHg and/or diastolic blood pressure ≥ 90 mmHg measured three times in a hospital or clinic, on non-same day, without antihypertensive medication.

What are the symptoms of hypertension?

Symptoms of hypertension vary from person to person. Some people with hypertension do not have any symptoms, and many of them find elevated blood pressure accidentally during a physical examination or when they go to the hospital for other diseases. Headache, dizziness, swelling at the back of the neck, lack of concentration, memory loss, numbness in the limbs, increased nighttime urination, palpitations, chest tightness, weakness, and insomnia are common symptoms of hypertension. When the above symptoms appear, do not be careless and take a blood pressure measurement to see if there is an increase in blood pressure.

Here we need to remind you that patients with hypertension, whether they have symptoms or not, if left untreated, long-term elevation of blood pressure can cause damage to the heart, brain, kidneys and other vital organs. With the development of the disease, patients can develop heart failure, renal insufficiency, cerebrovascular accident, aortic coarctation and other complications, and shortness of breath, edema, hemiplegia, aphasia, impaired consciousness, severe chest pain and other serious symptoms, and even endanger the lives of patients. Therefore, hypertension should not be taken lightly even if there are no symptoms, and treatment must be given in a timely manner under the guidance of a doctor.

What are the dangers of hypertension?

Hypertension is a chronic and progressive cardiovascular syndrome, and elevated blood pressure is only one of its main features. Long-term elevated blood pressure can cause changes in the structure and function of the heart and blood vessels, which can eventually lead to the failure of the heart, brain, kidneys and other target organs, resulting in serious consequences.

(1) Heart:When blood pressure rises, the resistance of heart contraction increases, and if the heart works under high load for a long time, cardiomyocyte hypertrophy and ventricular wall thickening can occur. With the prolongation of elevated blood pressure, it can eventually lead to heart enlargement and heart failure. Long-term hypertension also predisposes the arteries to atherosclerosis, increasing the risk of coronary heart disease. Hypertension-induced myocardial hypertrophy, heart failure and coronary heart disease are all high-risk factors for sudden death, thus increasing the risk of sudden death in patients.

(2) Kidney:Long-term hypertension can lead to sclerosis of small renal arteries and renal failure in severe cases. The latter in turn can aggravate the increase in blood pressure, thus forming a vicious circle, and many patients have to undergo hemodialysis or kidney replacement treatment, which brings a heavy burden to the family and society.

(3) Brain:When there is a sharp rise in blood pressure, it can cause cerebral blood vessel rupture and cerebral hemorrhage. Long-term hypertension can cause atherosclerotic narrowing of the cerebral arteries and the carotid and vertebral arteries, which are responsible for blood supply to the brain, causing cerebral insufficiency, cerebral infarction and dementia. Patients with cerebral hemorrhage or cerebral infarction may experience hemiplegia, aphasia, difficulty swallowing, unstable walking, and even serious consequences such as coma and death.

(4) Aorta:Long-term hypertension can cause sclerosis and dilatation of the aorta directly connected to the heart, and the aorta, which has lost its elasticity, can be easily torn and ruptured by the impact of high pressure blood flow. Once the aortic intima becomes ruptured, blood flow can quickly enter the middle layer of the arterial wall through the rupture to form a hematoma and keep advancing, forming an aortic coarctation.

(5) Eye:Long-term hypertension can also cause lesions in the retinal arteries of the eye, such as fundus arteriosclerosis, retinal hemorrhage, optic disc edema, patients may have blurred vision, serious blindness.

In short, the harm of hypertension is systemic, it is the most important risk factor of cardiovascular disease, with high death and disability rates, and its harm should not be underestimated.

How is hypertension treated?

The treatment of hypertension includes non-pharmacological treatment and pharmacological treatment.

(1) Non-pharmacological treatment:Hypertension is associated with poor lifestyle, and improving lifestyle is an effective way to prevent and treat hypertension and reduce the risk of cardiovascular disease, as well as a basic measure of hypertension treatment. By following a healthy diet, reducing alcohol intake, reducing dietary sodium intake, regular physical activity, not smoking, maintaining a good state of mind, and ensuring adequate sleep, blood pressure can be reduced to normal in some patients with mild hypertension without the need for anti-hypertensive drugs. It is also important for hypertensive patients who are already taking anti-hypertensive drugs for treatment to have concurrent lifestyle interventions, which not only help good control of blood pressure and reduce the use of drugs, but also significantly reduce the risk of cardiovascular and cerebrovascular complications.

(2) Drug therapyAnti-hypertensive drugs should be actively administered along with lifestyle improvement in the following cases: 1. Those whose blood pressure is still high after 3-6 months of lifestyle improvement; 2. Those whose systolic blood pressure is ≥ 160mmHg or diastolic blood pressure is ≥ 100mmHg or more; 3.those who have developed damage to the heart, brain, kidney and other organs.