You don't see, there are so many patients who die of cardiovascular diseases every year, so the rational use of cardiovascular diseases is the eternal theme of the whole society, and the drug treatment of hypertension is the key. In fact, high blood pressure can greatly increase the risk of heart, brain, kidney, and eye lesions, and only 14% of the world's 1.4 billion people suffer from high blood pressure, but only 14% of them have stable blood pressure, which is really shocking. According to the data of the "China Cardiovascular Health and Disease Report" in 2019, there were more than 245 million hypertension patients in mainland China at that time, but the awareness, treatment and control rates of hypertension were still at a low level of 51.6%, 45.8% and 16.8% respectively, which was not much better than the world level. The current situation could be even worse.
In fact, high blood pressure is not terrible and can be prevented and controlled. Studies have shown that for every 10mmHg drop in systolic blood pressure or 5mmHg drop in diastolic blood pressure, the risk of death will decrease by 10~15%, the risk of stroke will be reduced by 35%, the risk of coronary heart disease will be reduced by 20%, and the risk of heart failure will be reduced by 40%. In other words, for cardiovascular and cerebrovascular diseases, hypertension should be actively prevented and treated, but the treatment of hypertension is by no means as simple as mechanically lowering systolic blood pressure and diastolic blood pressure values.
Non-pharmacological treatments
It is well known that a diet high in sodium and low potassium, overweight, and obesity are important risk factors for hypertension. In addition, excessive alcohol consumption, smoking, and long-term mental stress can also lead to the occurrence and development of hypertension. In fact, lifestyle interventions (non-pharmacological treatments) are the cornerstone of cardiovascular disease prevention in patients with hypertension and multiple risk factors.
Eat a balanced diet
In the diet, the intake of foods rich in saturated fat and cholesterol should be minimized, and the intake should be mainly fruits, vegetables, low-fat dairy products, whole grains rich in fiber, and protein from plant sources.
Studies have shown that with the increase of body mass index (BMI value, weight [kg]/increase [m] squared, in kg/m2), the risk of hypertension in the overweight or obese group is 1.16~1.28 times higher than that in the normal group, so it is necessary to maintain the weight within a healthy range (BMI: 18.5~23.9kg/m2, waist circumference < 90cm for men, 85cm < for women).
Studies have also shown that sodium intake is positively associated with increased blood pressure. In order to prevent or effectively control blood pressure, the daily sodium intake should be less than 5g, and do not eat or eat less pickled vegetables, ham, bacon and other pickled products with high salt content, and reduce the use of salt in cooking (it is recommended that household salt should be low in sodium salt) or condiments (such as soy sauce, monosodium glutamate). In addition, potassium intake may lower blood pressure, so you should increase your potassium intake in your daily life and eat more potassium-rich foods, such as fresh vegetables and fruits.
You know? Drinking more than 4 (medium) cups of coffee a day may raise your blood pressure. If you're a big fan of coffee, tea, or other caffeinated beverages, you should consider cutting them back. In fact, tea and coffee as part of a balanced diet are very effective, and it's important to note that these beverages aren't your main or only source of fluids, and warm water is still appropriate.
Quit smoking and limit alcohol
Long-term smoking can cause your arteries to narrow, which can keep your blood pressure rising. If an artery becomes blocked, it can even lead to a heart attack or stroke. If you smoke and have high blood pressure, your arteries will narrow faster and your risk of heart or lung disease will increase dramatically. If you are worried about withdrawal symptoms when you quit smoking, you can try smoking cessation medications, such as nicotine patches, bupropion hydrochloride extended-release tablets, etc.
Regular excessive alcohol consumption can increase blood pressure, and the best way to reduce high blood pressure is to keep it at the recommended level of moderate alcohol consumption, with a daily alcohol (ethanol) intake of no more than 25g for men and 15g for women, and alcohol is forbidden for pregnant women. In fact, alcohol restriction was significantly associated with a drop in blood pressure, with an average decrease of 67% in alcohol consumption, a 3.31 mmHg decrease in systolic blood pressure, and a 2.04 mmHg decrease in diastolic blood pressure. In terms of non-pharmacological treatment, it is important to quit smoking and limit alcohol.
Exercise in moderation
Being active and exercising regularly keeps your heart and blood vessels in good shape, which reduces your chances of getting sick. Exercising regularly can also help you lose weight and also help control your blood pressure.
It is worth mentioning that exercise must be moderate, on the premise that it does not feel tired after exercise and does not affect work and study, and mainly aerobic exercise, anaerobic exercise can be used as a supplement, 4~7 days a week, a total of 30~60 minutes of moderate-intensity exercise every day, such as walking, jogging, cycling, swimming, etc. Do not do strenuous exercise for a short period of time or maintain long-term excessive exercise, which will be too much and will cause many health risks.
Relieve stress
Nervousness can activate the sympathetic nerves, which can raise blood pressure. In some patients, blood pressure rises and heart rate increases in the doctor's office, consultation room, or in the presence of medical staff, a condition known as "white coat" hypertension.
Excessive work, stress in life, anxiety, depression, social isolation, etc., can lead to increased mental stress. A meta-analysis has shown that the risk of hypertension in people with mental stress and mental symptoms is 1.18 times (95% confidence interval 1.02~1.37) and 1.55 times (95% confidence interval: 1.24~1.94) of the normal population. That is, in order to prevent and treat high blood pressure, mental stress should be reduced as much as possible, especially to avoid long-term mental stress.
It's easy to say, but it's so hard to relieve stress and calm your mind. If necessary, mental stress can be reduced through psychotherapy or taking medications to relieve anxiety and tension, such as buspirone, lorazepam, etc. High blood pressure is known to significantly increase the risk of serious health problems, including heart disease, heart failure, stroke, kidney disease, and more. When high blood pressure is clearly diagnosed, there is a risk that anxiety can be triggered, which is particularly likely to occur in individuals who are overly "worried" about their health.
In fact, high blood pressure and anxiety can occur at the same time, but at the same time one condition can also lead to the other. In fact, it is completely unnecessary to associate these two "difficult brothers", as mentioned earlier, high blood pressure can be prevented and controlled, such as worrying about a blood pressure of 141mmHg as soon as it is measured, and it is ignorant and ridiculous to go up to 139mmHg.
Illustration (original): Wang Fang Comic Studio
Author: Shi Haoqiang, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine