1 Age and gender
In the process of infant development into adulthood, blood pressure rises rapidly. In adulthood, the upward trend of blood pressure slows down, but gradually increases with age. Data show that the incidence of hypertension in people over 40 years old is 3.4 times that of people aged 15 to 39 years. Systolic blood pressure rises by 4 mmHg every 5 years from age 35 years, and diastolic blood pressure rises from age 30 years and increases by 1.5 mmHg every 5 years.
2 Climate change heat and cold
According to the survey, the prevalence of hypertension in cold areas is significantly higher than in warm areas.
In terms of individuals, blood pressure also fluctuates with the change of hot and cold weather, and the fluctuation is particularly large in patients with high blood pressure. After the "May Day" Labor Day, the weather gradually warms up, and the blood pressure has a gradual downward trend; in the high temperature season of July and August, the blood pressure drop is more obvious, if the original blood pressure level is only mildly increased, the blood pressure may drop to the normal range at this time; after the "Eleventh" National Day, the weather gradually turns cold, and the blood pressure gradually rises; after November, with the invasion of the cold current, the temperature drops significantly, and the blood pressure rises more obviously; December, January and February are the lowest temperatures of the year, and the blood pressure level is also the highest.
3 circadian rhythms
Changes in blood pressure during the day and at night are rhythmic. Affected by sleep and activity, blood pressure decreases during sleep and rises during activity. If daytime activity, night sleep, the normal rhythm of blood pressure is two peaks and one valley, spoon type: that is, the daytime blood pressure fluctuations at a higher level, from 8 p.m. blood pressure gradually decreases, to 2 to 3 o'clock at night to the lowest valley; blood pressure rises rapidly before waking up in the morning, and the first few hours after waking up in the morning (6 to 9 o'clock in the morning, when the sympathetic function condition shifts from inhibition to excitement) Blood pressure reaches or approaches the highest peak, this phenomenon is medically called "blood pressure morning peak"; then blood pressure continues to fluctuate at a higher level. A second peak may occur at 4 to 6 p.m.; it gradually decreases, with a maximum difference of up to 40 mmHg; and blood pressure begins to rise again after waking up in the morning.
4 Mental and physical activity
Exercise, full meals, anger, agitation, dreams, stool, and blood pressure may rise during sexual intercourse, while rest, quietness, peace of mind, and blood pressure are stable and normal. People with normal blood pressure or patients with high blood pressure may have increased blood pressure after being mentally stimulated, and the increase in blood pressure in patients with hypertension is more pronounced.
Anxiety and depression, especially during acute episodes of anxiety (panic), can have a sense of near-death and a sharp rise in blood pressure. Excessive attention to blood pressure, frequent daily self-testing of blood pressure, will also lead to significant fluctuations in blood pressure. I often say "Pay attention, don't overdo it." ”
In a quiet state, due to the low metabolic rate in the body, the heart rate slows down, the heart drainage is small, the blood pressure is low; on the contrary, when people are active, the body metabolism increases, the oxygen consumption increases, the heart rate is correspondingly accelerated, the heart output increases, and the blood pressure increases accordingly. But long-term adherence to aerobic exercise is beneficial for lower blood pressure and slower heart rate. Patients with coronary heart disease whose blood pressure does not rise in exercise tests but decreases suggests a left trunk or equivalent lesion may be preferred for bypass surgery. Long-term mental tension and excessive fatigue may also cause cerebral cortex dysfunction, stimulate the vascular motor center, strengthen arteriolar contraction, increase peripheral vascular resistance, and increase blood pressure.
American cardiologists Friedman and Rosenman pointed out when studying the relationship between heart disease and personality: when calming down, the catecholamine values in the blood of people with types A and B personalities are not much different; but in the case of stress, type A personality (with strong self-motivation, continuous sense of time urgency, insatiability, impatience, extroversion, easy agitation, etc.) is significantly higher than that of type B personality (no competition, no competitive pressure, no external interference, easy to control their emotions, etc.). Repeated excitation of the sympathetic nervous system of type A personality tends to cause increased myocardial contractility, accelerated heart rate, increased cardiac output, vasoconstriction or spasm, and eventually increased blood pressure.
A survey in Shanghai found that the incidence of hypertension in mental workers is higher than that of manual workers, and the incidence of hypertension in people with busy and tense work is higher than that of people with relatively slow work rhythms.
5 lifestyles
(1) Smoking has become an important cause of high blood pressure.
Smoking is harmful to the human body, is also one of the risk factors for hypertension, and increases complications and mortality in patients with hypertension. Smoking can increase blood pressure and increase the heart rate. Nicotine in smoke excites the vascular movement center, causing arterioles to contract, increasing peripheral resistance, resulting in increased blood pressure; niacin and carbon monoxide produced by smoking accelerate atherosclerosis and thrombosis; smoking stimulates the sympathetic nervous system, promoting catecholamines and vasopressin secretion increase, causing increased heart rate, increased blood pressure and arrhythmias. Long-term large-scale smoking causes continuous contraction of arterioles, and over time the walls of arterioles thicken and gradually harden, causing hypertension.
(2) Drinking alcohol aggravates high blood pressure.
A large number of epidemiological findings show that the blood pressure level of drinkers is higher than that of non-drinkers. After controlling for factors such as age, weight, and smoking, the amount of alcohol consumed and the amount of alcohol consumed were significantly and positively correlated with blood pressure. The more alcohol you drink per day, the more likely you are to develop high blood pressure. Heavy alcohol consumption can cause a sharp increase in blood pressure and even lead to cerebral hemorrhage or sudden death. In addition, the length of the alcohol history is also associated with high blood pressure.
(3) Excessive salt intake is an important cause of hypertension.
Compared with a daily salt intake of less than 6 grams, the daily salt intake greater than 12 grams increased the risk of hypertension by 14%, and the daily salt intake greater than 18 grams increased the risk of hypertension by 27%. In people over the age of 50 and with familial hypertension, blood pressure is more sensitive to changes in table salt intake. The onset of hypertension is associated with excessive salt intake in 30% of patients. The World Health Organization aims to achieve a daily salt intake of less than 5 grams per person worldwide by 2025. Blood pressure in overweight and obese people is also sensitive to table salt.
A high-salt diet may also change the change of blood pressure during the day and night, becoming high day and night, which greatly increases the risk of cardiovascular and cerebrovascular accidents. In addition, a high-salt diet can increase the risk of kidney disease and worsen diabetes.
(4) The effect of fat on blood pressure.
The higher the content of saturated fatty acids in the diet, the lower the ratio of unsaturated fatty acids to saturated fatty acids, and the more likely it is to cause high blood pressure. Saturated fatty acids reduce the production of prostaglandins in the body, which have the effect of lowering blood pressure. Animal fats contain a lot of saturated fatty acids, so eating animal fats often can adversely affect blood pressure.
(5) Overweight or obesity with high blood pressure.
An unhealthy lifestyle can easily lead to overweight or obesity, which increases the risk of high blood pressure. Years of research have shown that there is a correlation between weight and blood pressure in both children and adults. People who gain weight fast over a period of time also have a rapid rise in blood pressure. Obese people are eight times more likely to develop high blood pressure than people of normal weight. The blood pressure of obese people can decrease with weight loss.
(6) The incidence of hypertension in urban areas is higher than in rural areas.
Obesity is only one of the risk factors for high blood pressure, as long as you have "physical fitness and environment", both fat and thin have the risk of developing high blood pressure. People living in the city have a fast pace of life, lack of exercise, heavy environmental pollution, overwork, staying up late, lack of sleep, and high-fat, high-salt food intake, so the incidence of urban hypertension is higher than in rural areas.
6 drugs
Drug-induced hypertension is an increase in blood pressure caused by drugs.
Drugs that are likely to cause increased blood pressure include: glucocorticoids (dexamethasone, hydrocortisone, prednisone, etc.), oral contraceptives, ephedrine, phenylmethasone, wheezing, soda. Temporary use of hormones does not significantly increase blood pressure, small doses of use for a period of time will not cause significant changes in blood pressure, long-term use of hormones in large doses can cause drug-induced hypertension.
About 10% of women of childbearing age who take oral contraceptives experience abnormally elevated blood pressure. High blood pressure caused by contraceptives usually occurs within 2 to 5 years after taking the drug, and in some cases, it occurs within a few weeks after taking the drug. High blood pressure caused by contraceptives is usually mild to moderate. After discontinuation of the drug, blood pressure can gradually drop to normal. The larger the dose of the contraceptive pill and the longer it lasts, the greater the risk of developing high blood pressure. Therefore, there is a predisposition to hypertension ((1) there is a family history of hypertension. (2) There was original nephropathy or occult nephropathy. (3) Women who are obese, older, smokers, have a history of diabetes and dyslipidemia) should avoid oral contraceptives. Patients with thromboembolic disease or chronic hypertension due to other causes should also be contraindicated from oral contraceptives.
7 Other
Blood pressure must rise slightly to ensure a blood supply to the head while standing.
(2) Blood pressure usually rises during meals.
Digestive organs to work, abdominal organs blood vessels dilation so that the blood flow is sufficient to ensure the need, limb blood vessels to ensure the supply of visceral blood, it is necessary to make the blood vessels contract, to provide protection for the urgent need, which is one of the reasons why it is not suitable for strenuous activities after meals.