How terrible is low pressure and high pressure? 5 major causes will increase the low pressure, which is common in young and middle-aged hypertensive patients
During a physical examination, the doctor found that the 37-year-old Mr. Zhang had a diastolic blood pressure of 97mmHg and a systolic blood pressure of 130mmHg. This has exceeded the normal standard of blood pressure, so it is suggested that Mr. Zhang go to the Department of Cardiovascular Medicine for review, suspecting that he may be suffering from high blood pressure.
But Mr. Zhang feels that the diastolic blood pressure is high, but the systolic blood pressure is normal, which cannot be regarded as high blood pressure.
Moreover, I was young and had no symptoms, how could I start taking antihypertensive drugs so early , so I thought about it and forgot it, and went home directly after leaving the hospital.
So if systolic blood pressure is low and diastolic blood pressure is high, is it considered high blood pressure? Will Mr. Zhang's approach bring harm?
1. What does it mean if the diastolic blood pressure is high in physical examination?
When you mention blood pressure, you generally think of high blood pressure. Have you ever heard of "low pressure and high"? First of all, let's understand how systolic blood pressure and diastolic blood pressure are formed.
Imagine a fire hose without water. When the faucet is turned on, a large amount of water pours in, and the water pipe begins to expand, forming a higher pressure, which is equivalent to the systolic pressure. Turn off the faucet, the water pipe returns to its flat shape, and the residual water in it will also generate a certain pressure, which is equivalent to the diastolic blood pressure.
Our heart keeps beating. When blood is pumped out, a large amount of blood rushes to the arteries, just like turning on a faucet. The pressure on the blood vessels is the systolic blood pressure. When the heart stops pumping blood, the dilated blood vessels gradually retract and the blood flows. This is the diastolic blood pressure.
Recently, the diagnostic criteria for hypertension have been revised to 130/80mmHg. In the absence of antihypertensive drugs, the blood pressure is not measured three times on the same day. If the systolic blood pressure is <130mmHg and the diastolic blood pressure is ≥80mmHg, it is pure diastolic high blood pressure. blood pressure. In other words, a simple increase in diastolic blood pressure is also considered high blood pressure .
The reason why the low pressure is high and the high pressure is normal is mainly related to two aspects.
On the one hand, it is affected by the heart rate. Under the circumstances of high stress, mental tension, lack of sleep, too little exercise, etc. , the heart rate increases, so the blood volume in the blood vessels increases in a short period of time, and the resulting pressure becomes greater.
On the other hand, it is related to peripheral vascular resistance. When the blood is too thick, the flow speed slows down, and the blood vessels have to increase the pressure to push the blood forward.
Diastolic hypertension is more likely to target young and middle-aged people aged 25-40, especially those with bad habits such as smoking, drinking, and staying up late .
This is because young people's arteries have better elasticity, blood vessels are easy to expand, and the pressure generated is not high, so the systolic blood pressure is not high, and the diastolic blood pressure is high.
2. Is low pressure and high pressure harmful to human health?
In China, the prevalence of isolated diastolic hypertension among adults is 4.4%, what is the impact of this?
Not long ago, academician Chen Keji of Xiyuan Hospital, Fu Changgeng and others found that patients with isolated diastolic hypertension had a 45% and 44% higher risk of cardiovascular death, stroke, and ischemic stroke than patients with normal blood pressure. , 64% .
In particular, Asian patients with isolated diastolic hypertension, with an average age of less than 55 years, had a significantly increased risk of compound cardiovascular events by 28%.
Simple high diastolic blood pressure is the initial manifestation of high blood pressure. If left unattended for a long time, it often turns into ordinary high blood pressure and eventually damages the heart, brain, kidney and other organs .
For young and middle-aged patients, how should diastolic blood pressure be controlled? Do the following 2 points.
First, when blood pressure is mildly elevated, interventions are made by improving lifestyle .
First of all, limit sodium and salt. The total amount of salt eaten per day should not exceed 6 grams, and the intake of cholesterol and saturated fat should also be controlled. You can eat more fresh vegetables, fruits and beans.
In addition, do aerobic exercise 5-7 times a week, at least 30 minutes each time, to control your weight and waist circumference. But also to control drinking, it is best to quit smoking and drinking. Finally, pay attention to mental health, relieve mental stress, and seek professional help if necessary.
Second, drug treatment is recommended for those whose blood pressure cannot be corrected after good lifestyle control .
At present, there is no uniform drug for the treatment of diastolic hypertension, and there is no specific drug. Wang Chenggang, deputy chief physician of the emergency department of Beijing Anzhen Hospital, pointed out that it is recommended to take sartan or puril antihypertensive drugs, as well as beta-receptor blockers in clinical practice.
Xiao Jiu reminded that medication needs to follow the doctor's advice, insist on medication and monitor blood pressure.
3. How to deal with changes in the diagnostic criteria of hypertension?
On November 13, the "Clinical Practice Guidelines for Hypertension in China" jointly formulated by the National Center for Cardiovascular Diseases, the Chinese Medical Doctor Association and other institutions was officially released, and many adjustments were made.
1. Changes in diagnostic criteria for hypertension
Reduced from the original ≥140/90mmHg to ≥130/80mmHg.
2. Simplify the classification of hypertension and adjust it to a dichotomous method
Grade 1 hypertension is systolic blood pressure 130-139 mmHg or/and diastolic blood pressure 80-89 mmHg, and systolic blood pressure ≥ 140 mmHg or/and diastolic blood pressure ≥ 90 mmHg is grade 2 hypertension.
3. Start drug therapy earlier
When blood pressure ≥ 140/90mmHg, drug therapy should be initiated. When the blood pressure is ≥130/80mmHg, if it is accompanied by clinical complications or target organ damage, it should also be treated with medication.
4. Down-regulation of blood pressure control goals
For people over 65 years old, blood pressure should be controlled at < 130/80 mmHg, and hypertensive patients aged 65-79 should also be controlled within this range. For the elderly aged 80 and over, the systolic blood pressure should be lowered to less than 140mmHg, preferably < 130mmHg if conditions permit.
5. Use antihypertensive drug combination therapy earlier
When the blood pressure is ≥140/90mmHg, it is recommended that patients use combination drugs for initial treatment, and it is recommended to use a single-tablet compound preparation, that is, ACEI/ARB + CCB or ACEI/ARB + diuretics.
Why make such a modification? In this regard, Guo Yifang, vice president of Hebei Provincial People's Hospital, explained:
On the one hand, it is based on medical research at home and abroad. On the other hand, people whose blood pressure is between 130/80 mmHg and 140/90 mmHg belong to the "prehypertensive" group, but most of them have not received intervention and have potential cardiovascular diseases. disease risk .
Therefore, the adjustment is also to strengthen prevention, so that more people can pay attention to blood pressure earlier and treat symptoms in a timely manner .
How to treat patients between 130/80 mmHg and 140/90 mmHg?
Hu Dayi, Chief Physician of the Department of Cardiovascular Medicine at Peking University People's Hospital, pointed out that although the standard adjustment has increased the number of hypertensive patients, these people do not necessarily need to take medication immediately .
There are five prescriptions for controlling high blood pressure, which are exercise prescription, nutrition prescription, mental and psychological sleep prescription, smoking cessation and alcohol restriction prescription, and drug prescription . Patients should first adjust from these 5 points and try to restore blood pressure to the ideal range.
Therefore, the low-pressure high that is prone to occur in young and middle-aged people is also high blood pressure and requires timely intervention. According to the latest guidelines, the diagnostic criteria for blood pressure have been adjusted. In the future, blood pressure ≥ 130/80mmHg is considered high blood pressure. Everyone should pay more attention to their blood pressure.
references:
[1] Isolated Diastolic Hypertension and Risk of Cardiovascular Events： A Systematic Review and Meta-Analysis of Cohort Studies With 489，814 Participants. Front Cardiovasc Med. 2022 Jan 5;8：810105.
[2] The diagnostic criteria for hypertension have changed! Quickly compare and self-examine. Popular Science China. 2022-11-14.
[3] Do you need to take care of simple diastolic blood pressure? The doctor said so. Guangdong Health Online. 2021-07-21.
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