Hypertension: Understanding, Management and Treatment
Hypertension is a common chronic disease that affects hundreds of millions of people worldwide. Although hypertension itself may not cause serious health problems immediately, long-term uncontrolled hypertension can significantly increase the risk of serious diseases such as heart disease, stroke, and kidney disease. Therefore, correctly understanding hypertension and mastering effective management and treatment strategies are crucial to improving patients' quality of life and preventing complications.
1. Definition and classification of hypertension
Hypertension refers to the pressure on the blood vessel wall when blood flows in the blood vessels that is continuously higher than normal. Under normal circumstances, blood pressure fluctuates with factors such as physical activity and emotional changes, but if blood pressure remains at a high level for a long time, it will put a burden on blood vessels and the heart, and then cause a series of health problems.
Hypertension is usually divided into two types: primary hypertension and secondary hypertension. Primary hypertension is the most common type, accounting for more than 90% of patients with hypertension. Its cause is not yet fully understood, but it is closely related to genetic factors, lifestyle, environmental factors, etc. Secondary hypertension is hypertension caused by other diseases, such as kidney disease, endocrine disorders, sleep apnea syndrome, etc. Secondary hypertension can often be effectively controlled by treating the primary disease.
2. Causes of Hypertension
The formation of hypertension is a complex process involving the interaction of multiple factors. The following are some common causes:
(I) Genetic factors
Hypertension has a certain family genetic tendency. If there is a hypertensive patient in the family, especially a direct relative, then the individual's risk of developing hypertension will increase significantly. Genetic factors may affect the blood pressure regulation mechanism, making some people more susceptible to environmental factors and high blood pressure.
(II) Lifestyle factors
▸Dietary factors: A high-salt diet is one of the important risk factors for hypertension. Excessive salt intake can lead to water retention in the body and increase the pressure on the blood vessel wall. In addition, a high-fat, high-cholesterol diet may also lead to atherosclerosis, further aggravating hypertension.
▸Lack of exercise: Long-term lack of exercise can slow down the body's metabolism and increase weight, while also causing a decrease in vascular elasticity and increasing the risk of high blood pressure.
▸Smoking and drinking: Smoking can cause blood vessels to constrict and increase the burden on the heart, while long-term heavy drinking can increase blood pressure and aggravate damage to the heart and blood vessels.
▸Stress factors: Long-term mental stress, anxiety and tension can put the body in a state of stress, leading to high blood pressure. If this stress response is not relieved for a long time, it may keep blood pressure at a high level.
(III) Other factors
As we age, blood vessels gradually lose their elasticity, and blood pressure rises accordingly. In addition, chronic diseases such as obesity, diabetes, and hyperlipidemia also increase the risk of hypertension. These diseases interact with each other to form a vicious cycle, further increasing the burden on the cardiovascular system.
3. Symptoms of hypertension
The symptoms of hypertension vary from person to person and are often not obvious. Many patients may not feel any discomfort in the early stages of high blood pressure, which is why hypertension is called the "silent killer." However, as the disease progresses, some symptoms may gradually appear, including:
Headache: Usually occurs in the morning, located at the back of the head or temple, and may be accompanied by nausea and vomiting.
Dizziness: Patients may feel dizzy, especially when standing up or changing position suddenly.
Palpitations: Rapid or irregular heartbeats, which may be accompanied by chest tightness and shortness of breath.
Tinnitus: Persistent tinnitus may be a sign of high blood pressure.
Nosebleed: When blood pressure rises suddenly, it may cause blood vessels in the nasal cavity to rupture and bleed.
Blurred vision: High blood pressure may cause retinal vascular disease, affecting vision.
It is worth noting that these symptoms do not necessarily mean that you have high blood pressure, but if the above symptoms occur, especially with high blood pressure, you should seek medical attention in time.
4. Diagnosis of hypertension
The diagnosis of hypertension mainly relies on blood pressure measurement. Doctors usually use a sphygmomanometer to measure blood pressure multiple times at different times to ensure the accuracy of the results. If the blood pressure is measured three times on different days without taking antihypertensive drugs, and the systolic blood pressure (high pressure) is ≥140 mmHg or the diastolic blood pressure (low pressure) is ≥90 mmHg, it can be diagnosed as hypertension.
In addition to blood pressure measurement, the doctor may also perform a series of tests to assess the impact of high blood pressure on the body. These tests include:
Blood test: Test indicators such as blood lipids, blood sugar, and kidney function to understand whether there are other metabolic diseases.
Electrocardiogram: Check the electrical activity of the heart to assess whether there is myocardial hypertrophy or arrhythmia.
Echocardiogram: Evaluate the structure and function of the heart through ultrasound imaging to understand the impact of hypertension on the heart.
Fundus examination: Observe changes in retinal blood vessels to understand the impact of hypertension on small blood vessels.
Urine test: Detect indicators such as urine protein to assess whether kidney function is impaired.
These examinations help doctors fully understand the patient's condition and develop personalized treatment plans.
5. Treatment of hypertension
The goal of hypertension treatment is to control blood pressure within the normal range, reduce the risk of complications, and improve the patient's quality of life. Treatment strategies usually include lifestyle adjustments and drug therapy.
(I) Lifestyle adjustments
Lifestyle changes are the basis of hypertension treatment and are essential for controlling blood pressure and preventing complications.
Dietary adjustments: Reduce salt intake to no more than 5 grams per day. Increase the intake of fruits, vegetables, whole grains and low-fat dairy products, and reduce the intake of saturated fat and cholesterol. You can refer to the "DASH diet", which is a dietary pattern that has been proven to help lower blood pressure.
Weight control: Overweight and obesity are important risk factors for hypertension. By eating a reasonable diet and exercising, keeping weight within a healthy range can significantly lower blood pressure.
Increase exercise: At least 150 minutes of moderate-intensity aerobic exercise per week, such as brisk walking, jogging, swimming, etc. Exercise can not only help control weight, but also enhance cardiovascular function and lower blood pressure.
Quit smoking and limit alcohol: Smoking can cause vasoconstriction and increase the burden on the heart, while drinking a lot of alcohol can increase blood pressure. Quitting smoking and limiting alcohol consumption are essential for controlling blood pressure.
Manage stress: Long-term mental stress can lead to high blood pressure. Relieving stress through meditation, yoga, deep breathing, etc. can help control blood pressure.
(II) Drug treatment
For patients whose blood pressure cannot be controlled after lifestyle adjustments, drug treatment is necessary. Common antihypertensive drugs include:
▸Diuretics: Reduce blood pressure by increasing urine excretion and reducing excess fluid in the body.
▸Beta-blockers: Lower blood pressure by slowing heart rate and reducing the contractility of the heart.
▸Calcium channel blockers: Relax blood vessel walls and reduce vascular resistance, thereby lowering blood pressure.
▸ACE inhibitors and angiotensin receptor antagonists (ARBs): Lower blood pressure by dilating blood vessels and protecting the heart and kidneys.
▸Alpha-blockers: Relax blood vessel walls and lower blood pressure, and are often used in patients with prostate hyperplasia.
Doctors will choose the appropriate drug combination for treatment based on the patient's specific situation, such as blood pressure level, complications, other diseases, etc. Patients need to strictly follow the doctor's instructions, take medicine on time, and have regular checkups to ensure the effectiveness of the treatment.
6. Prevention and management of hypertension
Hypertension is a preventable and controllable disease. The following measures can effectively prevent the occurrence and progression of hypertension:
(I) Regular physical examinations
Regular blood pressure measurement is the key to preventing hypertension. It is recommended that adults measure their blood pressure at least once a year, especially those with a family history of hypertension or other risk factors. Early detection of elevated blood pressure and timely intervention can effectively prevent the occurrence of hypertension.
(II) Healthy lifestyle
Maintaining a healthy lifestyle is the basis for preventing hypertension. Measures such as a reasonable diet, moderate exercise, smoking cessation and alcohol restriction, and stress management can not only prevent hypertension, but also improve overall health and reduce the risk of other chronic diseases.
(III) Active treatment of related diseases
Hypertension often coexists with other chronic diseases such as diabetes and hyperlipidemia. Active treatment of these diseases and control of blood sugar and blood lipid levels can reduce the risk of hypertension and also help reduce the overall risk of cardiovascular disease.
(IV) Patient education
Patients with hypertension need to understand the nature of the disease, the importance of treatment and lifestyle. Through patient education, patients can better manage their condition, improve treatment compliance, and reduce the occurrence of complications.
Hypertension is a common chronic disease. Although it may not cause serious health problems immediately, long-term uncontrolled hypertension can cause serious damage to the body. By correctly understanding hypertension and adopting scientific management and treatment strategies, patients can effectively control blood pressure, reduce the occurrence of complications, and improve the quality of life. Whether in prevention or treatment, a healthy lifestyle is the key. I hope that every hypertensive patient can stay away from the troubles of hypertension and enjoy a healthy and happy life through active lifestyle adjustments and reasonable drug treatment.
