10 common sense tips for high blood pressure care

1. There is no need to deliberately pursue "perfect blood pressure" for young people. Different ages have different blood pressure control goals. 2. Measure blood pressure on both hands. If the difference is too large, be alert to vascular problems. 3. Antihypertensive drugs cannot be stopped on your own. Stopping them must be evaluated by a doctor. 4. The impact of hidden high-sugar drinks on blood pressure is no less than that of salt. Don't just focus on limiting salt for blood pressure control. 5. For antihypertensive exercise, choose gentle brisk walking and Tai Chi. There is no need to blindly pursue high intensity. 6. Don't believe that "natural antihypertensive medicines" can replace prescription drugs, and folk remedies can only be used as supplements. 7. Insomnia and constipation can cause blood pressure to rise suddenly. Minor problems should also be taken seriously. 8. The impact of mood swings on blood pressure is far greater than expected. Don't be too excited. 9. Check urine microalbumin at least once a year to screen for hypertension and kidney damage early. 10. Don't take antihypertensive drugs casually if you feel dizzy. Measure your blood pressure first and then deal with it.

Next, I will share with you the details behind these common senses. They are all real situations that I have encountered in clinical and community free clinics for so many years, so that you can avoid pitfalls.

Let me first talk about the "perfect blood pressure" misunderstanding that many people struggle with - I recently saw a 72-year-old man. In order to lower his blood pressure to the standard line of 120/80mmHg, I secretly added half a tablet of antihypertensive medication. As a result, when I woke up in the morning, I stood up and fell down and broke my head. Nowadays, academic circles have different opinions on the target of lowering blood pressure in the elderly. The guidelines of the Chinese Geriatrics Society recommend that elderly people over 80 years old are fully qualified if their systolic blood pressure is controlled at 140~150mmHg. There is no need to force yourself to meet the standards of young people. On the contrary, it is easy to cause orthostatic hypotension, which is not worth the gain.

Many people always focus on their left hand when measuring blood pressure, thinking that the value is close to the heart. I met Uncle Zhang at the last community free clinic. The left hand measured 132/82mmHg and felt it was quite stable. I then tested his right hand and it directly jumped to 150/94mmHg. He was so frightened that he went to the hospital for a checkup that day. The result was that the right subclavian artery was mildly stenotic. In fact, under normal circumstances, it is normal for the blood pressure difference between the left and right arms to be 5~10mmHg. If the difference exceeds 20mmHg for a long time, you need to be alert to the problem of blood vessel stenosis. It is recommended to measure both sides every time and use the higher value as a reference.

When it comes to taking medicine, I really want to advise everyone that antihypertensive medicine cannot be stopped once the blood pressure is normal. The most dangerous patient I have ever encountered was a 42-year-old patient. After taking antihypertensive drugs for a month, his blood pressure was stable at 130/80. He felt he was better, so he stopped taking the medicine. In just 3 days, it soared to 180/110. He was so dizzy at home that he could not stand. When he was sent to the emergency room, he almost had cerebral edema. Of course, some studies now believe that patients with mild hypertension who have stabilized their blood pressure through lifestyle intervention for more than half a year can gradually reduce or even stop taking medication under the evaluation of a doctor, but they definitely do not stop on their own. This must be kept in mind.

Many people only know how to control blood pressure by abstaining from salt. In fact, the impact of invisible invisible sugar on blood pressure is no less than that of salt. The freshly squeezed juices, pearl milk tea, and even sparkling water that are advertised as sugar-free are either added with a large amount of fructose or use sugar substitutes. The academic community is still controversial about the impact of sugar substitutes. Some studies believe that long-term intake of large amounts of sugar substitutes will damage the elasticity of the vascular endothelium and increase blood pressure. I have an aunt next to me who is very strict about salt control. She only uses a limited spoonful of salt when cooking every day. However, she drinks two bottles of iced black tea every day and her blood pressure cannot be lowered. Later she gave up sweet drinks and it stabilized in less than a month. Of course, this does not mean that salt does not need to be controlled, but for people who usually like to drink sweet drinks, quitting sweet drinks first may be more effective than limiting salt. If you are an elderly patient with hyponatremia, you should not limit salt too much, otherwise you will suffer from fatigue and dizziness.

When it comes to lifestyle intervention, many people who have high blood pressure exercise hard and run five kilometers every day. In fact, it is really unnecessary. There was a patient who ran five kilometers every morning after being diagnosed with high blood pressure. As a result, his blood pressure rose to 170 after the run, and he almost had an accident. Currently, doctors in different disciplines give different exercise recommendations: Doctors in the cardiovascular department generally recommend doing moderate-intensity exercise, such as jogging and swimming, as long as the heart rate is controlled at (170-age) ； However, geriatric doctors generally recommend that patients with coronary heart disease and insufficient blood supply to the brain should choose more gentle exercises such as brisk walking and Tai Chi. There is no need to pursue exercise intensity. Moving is better than not moving.

Don't believe those "natural antihypertensive medicines" spread in the circle of friends, such as celery juice, apocynum tea, and antihypertensive insoles. Those who say they can replace antihypertensive drugs are all lies. There was a patient who took "pure natural antihypertensive capsules" for half a year, and his blood pressure dropped. Later, his liver function transaminase was three times higher. When he sent it for testing, he discovered that cheap antihypertensive drug ingredients were secretly added to the capsules, and the dosage was increased randomly. Of course, there are some ingredients in foods such as celery and onions that help control blood pressure. It’s okay to eat more of them on a daily basis, but they really shouldn’t be taken as medicine. You shouldn’t take less than one sip of the prescription medicine you should take.

You may not know that minor problems such as insomnia and constipation have a much greater impact on blood pressure than you think. Last time, there was an elderly patient who suffered from insomnia for three consecutive days. His blood pressure soared from 130 to 160. He couldn't keep it down even after taking twice the usual amount of medicine. Later, he was prescribed some sleep aids. After a good sleep, his blood pressure became normal the next day. There are also constipated elderly people. When squatting on the toilet and exerting force, the abdominal pressure rises, and the blood pressure can jump up in a short time. I have encountered several cases of sudden strokes in the toilet. They were all caused by constipation and squatting for too long. Eat more dietary fiber, use some antiseptics when necessary, and don't hold it in.

There are also emotional issues, so don’t take them seriously. Last year, there was an old man in the community who played mahjong all over the place. He fainted when he was excited. When he was sent to the hospital, his blood pressure was over 200. It was a cerebral hemorrhage. When people are emotionally excited, the sympathetic nerves are excited, blood vessels constrict, and the blood pressure rises immediately. Especially for people with high blood pressure, don't get angry at every turn, stay up late to watch football games, or compete in mahjong. It's really not a mistake.

Many people who have high blood pressure only know how to measure blood pressure and forget to do regular check-ups. It is recommended to check urine microalbumin at least once a year. This is the most sensitive indicator for screening early kidney damage in hypertension and can be detected 3 to 5 years earlier than urine protein in routine urine tests. If protein is detected in the urine routine, the kidney damage is already quite serious. Don’t be too troublesome. Take a blood test and do a urine test. It doesn’t cost much and can detect major problems in advance.

Finally, I would like to remind everyone, don’t take additional antihypertensive drugs when you feel dizzy. Many people think that dizziness is caused by high blood pressure, so they should quickly take an extra antihypertensive drug. In fact, dizziness may be caused by insufficient blood supply to the brain. Too low blood pressure can aggravate cerebral ischemia, and in severe cases can induce cerebral infarction. When you feel dizzy, sit down and measure your blood pressure. If it is indeed high, you can add more medicine under the guidance of your doctor. If your blood pressure is not high or even low, lie down and drink some warm water. If it is still not relieved, call 120 immediately.

In fact, high blood pressure is a chronic disease. There really aren’t that many bells and whistles when it comes to care. It’s just about taking more snacks. Don’t listen to wind and rain. If you’re unsure about anything, ask your doctor. It’s more reliable than any folk prescription.~