140/90 mmHg! Professor Zhang Xinhua, President of the World Hypertension Federation, talks about the prevention and treatment of hypertension.
Have the diagnostic criteria of hypertension been adjusted in China? The National Health Commission clearly issued the diagnostic criteria for hypertension: the diagnostic criteria for hypertension in adults are that the blood pressure exceeds 140/90mmHg three times on different days. The diagnostic criteria of adult hypertension have not been adjusted by the state. These include lowering the diagnostic criteria of hypertension and changing the diagnostic criteria of hypertension to ≥ 130ex80 mmHg. There is no scientific basis for lowering the diagnostic criteria for hypertension. Individuals with normal blood pressure need to prevent hypertension through a healthy lifestyle. Patients with diagnosed hypertension need to take medicine to help control their blood pressure while implementing a healthy lifestyle. Elevated blood pressure can increase the risk of cardiovascular and cerebrovascular disease and death. At present, no country in the world regards routine clinic blood pressure (130/80mmHg) as the diagnostic cut-off point for adult hypertension. Antihypertensive drugs not only can not effectively reduce cardiovascular risk.
Have the diagnostic criteria of hypertension been adjusted in China? On November 15th, the National Health Commission made a clear announcement on the diagnostic criteria of hypertension: with regard to the diagnostic criteria of hypertension, the main points of publicity and education, prevention and treatment guidelines and clinical pathways issued by the national health administration in 2005, 2010 and 2017 were all clear: the diagnostic criteria of hypertension in adults were that blood pressure exceeded 140/90mmHg three times on the same day. At present, the diagnostic criteria of adult hypertension have not been adjusted by the state.
November 13, by the National Cardiovascular Disease Center, the Chinese Physicians Association, the Hypertension Professional Committee of the Chinese Physicians Association, the Cardiovascular Branch of the Chinese Medical Association and the Hypertension Professional Committee of the Cross-Strait Medicine and Health Exchange Association, the guidelines for Clinical practice of Hypertension in China were issued.
The guidelines give 102 recommendations on 44 important clinical issues for the prevention and control of hypertension. These include lowering the diagnostic criteria of hypertension and changing the diagnostic criteria of hypertension to ≥ 130ex80 mmHg. According to the new diagnostic criteria, the number of patients with hypertension in China will increase from 245 million to nearly 500 million.
In the past, China adopted the recommendations of the "China guidelines for the Prevention and treatment of Hypertension", which has continued the diagnostic standard of hypertension of 140 mmHg. According to the guidelines for the Prevention and treatment of Hypertension issued in 2018, hypertension is divided into three categories: grade 1, grade 2 and grade 3. When the blood pressure is 80-89 mmHg/130~139 mmHg, it is not judged as hypertension, which belongs to the normal high value. This is similar to the standard that has been used worldwide for more than 20 years.
Professor Zhang Xinhua, president of the World Hypertension Federation, said that lowering the diagnostic criteria for hypertension has no scientific basis, is not in line with China's national conditions, and is not beneficial to patients and society.
Individuals with normal blood pressure need to prevent hypertension through a healthy lifestyle, and individuals with elevated blood pressure need to control their blood pressure through a more active and healthy lifestyle. Patients with diagnosed hypertension need to take medicine to help control their blood pressure while implementing a healthy lifestyle, and adjust the treatment plan according to blood pressure changes in order to keep the patient's blood pressure under long-term control.
Prospective epidemiological cohort studies tell us that elevated blood pressure can increase the risk of cardiovascular and cerebrovascular disease and death, but does not prove that drug treatment can reduce this risk.
Randomized controlled intervention studies can provide evidence of the effect of intervention. For example, cohort studies found that high density lipoprotein cholesterol was negatively correlated with cardiovascular and cerebrovascular diseases, and triglyceride levels were positively correlated with cardiovascular and cerebrovascular diseases. however, increasing high density lipoprotein cholesterol or reducing triglyceride through drugs did not reduce the incidence and death of cardiovascular and cerebrovascular diseases.
Professor Liu Lisheng, former chairman of the China Hypertension Federation, also said that at present, no country in the world regards routine clinic blood pressure 130/80mmHg as the diagnostic cut-off point for adult hypertension. Antihypertensive drugs not only fail to reduce cardiovascular risk, but increase the incidence of adverse reactions in the adult population with moderate and low risk of cardiovascular risk at 130: 139 and 80: 89 mmHg. In addition, the use of 130x80 mmHg as the diagnostic cut-off point for hypertension will artificially increase the number of patients with hypertension by nearly 300 million, which will inevitably have a major impact on our society and medical security system.
Professor Zhang Xinhua believes that at present, our country should maintain the original diagnostic standard of hypertension (≥ 140 mmHg), actively promote daily outpatient screening of hypertension, measure blood pressure, improve the awareness rate, diagnose and treat patients with hypertension in time and help them reach the standard for a long time, which is an important measure to quickly and effectively reduce the disability and death caused by cardiovascular and cerebrovascular diseases and reduce the medical burden. (reporter Ji Wei)
Source: workers' Daily