Many patients with high blood pressure are untreated for a long time.
Most patients with high blood pressure are not obviously uncomfortable, that is, asymptomatic. Therefore, many patients find that after high blood pressure, they do not ask for a long time, 3, 5 years, 7, 8 years, or even more than 10 years, no treatment. However, when it comes to feeling unwell and wanting to be treated, either the blood pressure is higher, or the organs are diseased, the heart is hypertrophied, there is protein in the urine, or the kidney function is not good, the fundus bleeding (these are called "target organ damage" of hypertension in medicine), and some even have myocardial infarction, cerebral infarction, cerebral hemorrhage, which is only taken seriously (found that 160 to 170 hypertension has not been treated for 3 years, what was found in the examination?). ）。
There are many such patients in outpatient clinics, even in large cities like Beijing, many medical insurance patients come to the clinic, but also have ventricular hypertrophy, albuminuria. If you go to a remote mountainous area, there are more people with hypertension combined with cerebral infarction, cerebral hemorrhage, and kidney failure for dialysis (hypertension has not been treated for 3 years and has caused heart and kidney damage?). What should I look for when I find high blood pressure? ）。
Therefore, the treatment rate and compliance rate of hypertension in the mainland are still very low. The consequence of this is that there are many cardiovascular and cerebrovascular diseases, and there are many patients with myocardial infarction and stroke.
Some people will feel that the treatment of disease is to cure those who are uncomfortable, and why should hypertension be treated without discomfort?
When there is no serious damage to high blood pressure, many patients do not feel uncomfortable, or sometimes some discomfort, it is also relatively mild. Some headaches, dizziness, bloating, head covering, some neck stiffness, or rapid heartbeat, fatigue, insomnia, etc., rest and rest will pass.
However, there was no discomfort, just no feeling. Whether you have discomfort or not, uncomfortable feelings light or heavy, high blood pressure is there, the damage of high blood pressure is also there, and the various metabolic disorders associated with high blood pressure are still there.
It is clear that high blood pressure can cause cardiovascular disease. High blood pressure, more cardiovascular disease, cerebrovascular disease the most, eight out of ten have hypertension; coronary heart disease is slightly less, but also 50% to 70% of the hypertension; as well as atrial fibrillation, heart failure, renal failure, etc., are closely related to hypertension (hypertensive patients, why is the blood pressure higher and earlier beats, "atrial fibrillation"? ）。
Don't underestimate the increase in blood pressure by only 10/5 mmHg. The study found that for every 10 mmHg increase in systolic blood pressure, the risk of stroke increased by about 50%, and myocardial infarction increased by about 30%, and for every 5 mmHg increase in diastolic blood pressure, the risk of stroke increased by 46%.
Just because the damage of high blood pressure can occur without discomfort in the patient, so with high blood pressure, whether there is discomfort or not, it must be treated.
There is no discomfort in high blood pressure, what is the treatment of antihypertensive treatment?
The treatment is excessive blood pressure and the prevention and treatment of damage caused by high blood pressure.
When high blood pressure, the sympathetic nervous system in the body will be overexcited, the angiotensin system will also be overactivated, people will be nervous and anxious, the tension of blood vessels will also increase, contraction will increase, and the heartbeat will be accelerated and aggravated. The long-term consequence of this is that the endometrium of the blood vessel will be damaged, the blood vessel wall will thicken and harden, calcify, and there will be long plaques, stenosis, and possibly aneurysms. Rapid heartbeat, aggravation (strong contractility), coupled with neuroendocrine hormones, will lead to myocardial hypertrophy, heart enlargement, heart failure, this process can occur a variety of arrhythmias, atrial fibrillation is more common. Under the action of hypertension, the kidneys will be ischemia, damage, proteinuria, decreased kidney function, and finally uremia, which is medically called "end-stage renal disease". In the mainland, hypertension causes the most stroke, and the ratio of myocardial infarction is 5 to 8 to 1, so stroke is the most important risk of hypertension.
Among them, there will be other metabolic disorders, such as hyperglycemia, hyperlipidemia, high uric acid, and hyperhomocysteine. With the blessing of these risk factors, atherosclerosis occurs faster and more severely, the blood pressure is higher and less controlled, and the risk of coronary heart disease, myocardial infarction, cerebrovascular disease, chronic kidney disease, kidney failure or arteriosclerosis occlusion of limbs is greater.
Finally, the complications caused by high blood pressure reach the end stage, that is, organ failure and death.
Lowering blood pressure and controlling other risk factors can significantly reduce or delay the occurrence of complications such as stroke, myocardial infarction, heart failure, and renal insufficiency, and the progression of the disease will be delayed, and severe hypertension will be reduced. Different studies have found that for every 10/5 mmHg reduction in blood pressure, the risk of stroke can be reduced by 30% to 40%, ischemic heart disease can be reduced by about 20%, and cardiovascular death can be significantly reduced.
Therefore, hypertension needs antihypertensive therapy, and lowering blood pressure can benefit, "antihypertensive is the last word.".
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