Comment immediately | the real problem behind hypertension

The Chinese Hypertension Clinical practice Guide 2022, jointly developed by the National Cardiovascular Disease Center and the Chinese Association of Physicians, has been released. Aiming at the common problems in the diagnosis and treatment of hypertension, the diagnostic standard of adult hypertension in China has been lowered from 140/90mmHg to 130/80mmHg. Lowering the diagnostic criteria reflects the concept of moving the line of defense forward and strengthening initial prevention, otherwise we will miss the key opportunity to reduce the harm of cardiovascular disease and other diseases caused by hypertension. The number of patients with hypertension in China is expected to reach about 613 million, with more than 300 million new patients with hypertension. Few people actively intervene in blood pressure, so it is not easy to take a wait-and-see attitude and monitor blood pressure from time to time. The diagnostic standard of hypertension in China, from 160/95mmHg in 1977, reflects that the understanding of hypertension is deepening, and the current concept of health has changed greatly to pay attention to the intervention in the whole process of the disease, and the diagnostic standard of hypertension is lowered.

Recently, the "China Hypertension Clinical practice Guide 2022" jointly developed by the National Cardiovascular Disease Center and the Chinese Physicians Association has been released, which gives more detailed evidence-based recommendations for common problems in the diagnosis and treatment of hypertension. What is particularly noticeable is that the diagnostic standard of hypertension in adults in China has been lowered from 140/90mmHg to 130/80mmHg.

Some experts interpreted that this revision of the standard is not only supported by sufficient international and domestic evidence-based medicine, but also young and middle-aged people with blood pressure levels of 130 mmHg and / or 80 mmHg. Lowering the diagnostic criteria reflects the concept of moving the line of defense forward and strengthening initial prevention, otherwise the key opportunity to reduce the harm of cardiovascular and other diseases caused by hypertension will be missed.

The difference in 10mmHg seems small, but it is enough to set off a heated discussion in the society. Because this 10mmHg covers a huge population of hundreds of millions of people. According to the previous diagnostic criteria, there are about 300 million patients with hypertension in China. After the implementation of the new standard, the number of patients with hypertension in China is expected to reach about 613 million, with more than 300 million new patients with hypertension. Many people may express a feeling: how did I become a hypertensive patient when I woke up at night?

This part of the new patients, in the past as "prehypertension" or "critical hypertension", belong to the sub-health population. Such being the case, the urgency of treatment will not be too strong, there are few people who actively intervene in blood pressure, it is not easy to hold a wait-and-see attitude and monitor blood pressure from time to time, and there is no lack of people who are indifferent to the disease-like state. Since it is clearly defined as hypertension in the future, their attitudes and practices towards blood pressure will have to make major changes to take precautions with a more positive attitude.

Of course, it is inevitable that some people are confused: why not still use the standards of the past?

First of all, this adjustment has experienced a rigorous medical evidence-based process and has a strong theoretical and clinical practice basis. Secondly, the diagnostic standard of hypertension in China has evolved from 160/95mmHg in 1977 to 140/90mmHg in 1997 to 130/80mmHg in 1997, which not only reflects the deepening of the understanding of hypertension, but also means that the society is making continuous progress, the living standard is constantly improving, and the requirements for health are rising.

What is more, it should be noted that great changes have taken place in the current concept of health, from paying attention to diagnosis and treatment in the past to paying attention to intervention in the whole process of the disease, from "treating a disease" to "treating a disease without a disease."

This adjustment conforms to the trend of shifting the focus of health intervention forward. As far as hypertension itself is concerned, many complications caused by the disease have become the number one "health killer", such as hypertensive heart disease, hypertensive encephalopathy, hypertensive nephropathy, retinal arteriosclerosis, cardiovascular and cerebrovascular accidents, and so on. the disability rate and mortality rate are very high, bringing a heavy financial and care burden to many families.

The diagnostic standard of hypertension is reduced by "10". In the short term, more early patients can get standardized diagnosis and treatment, and in the long run, the incidence of hypertension is bound to be greatly reduced.

This is a special mobilization for individuals, and no one should stay out of it. Since then, individuals should pay more attention to and intervene in their own blood pressure. Not only those who already suffer from hypertension should take the initiative to receive standardized diagnosis and treatment, but those who do not have the disease should also be more active in disease prevention. Strengthening physical exercise, abandoning bad lifestyles, strictly controlling oil and salt, and learning to control emotions should be implemented in action as soon as possible.

In addition, there will be a large increase in the number of patients with hypertension in a short period of time, and the demand for diagnosis and treatment will increase accordingly. The medical system should also be prepared to mobilize more resources to provide patients with better guidance on diagnosis, treatment and prevention. The public health department should adapt to this change and provide comprehensive and thoughtful services to residents in the aspects of pre-prevention of hypertension, guidance of daily life, free drug distribution and so on.

Only with the joint efforts of many parties can the diagnostic criteria of hypertension be lowered and the level of social health be generally improved.