With the new concept of blood pressure lowering

Question
With the new concept of blood pressure lowering
Answer
According to World Health Organization estimates that the world has high blood pressure in patients with more than 500 million and is increasing, and strengthening prevention and treatment of high blood pressure to improve the level of human health, prolonging life is extremely important. With hundreds of high blood pressure and hypertension in depth study of evidence-based medicine evaluation of research results to prevention and treatment of high blood pressure in some concept of change. Old concepts: emphasis on diastolic blood pressure (low pressure) is increased. New ideas: to pay more attention to systolic blood pressure (high pressure) increase caused by cardio-and cerebro-renal target organ damage and so on. With age, especially over the age of 55 years of age, systolic blood pressure will continue to rise,And diastolic blood pressure has been declining, and even the original systolic pressure, diastolic blood pressure were also increased in patients with isolated systolic hypertension may become. Therefore, more than 50% of elderly patients with hypertension were systolic hypertension. Higher systolic blood pressure and increased pulse pressure (systolic pressure - diastolic blood pressure = pulse pressure) on the cardio-and cerebro-renal target organ damage, etc., increased diastolic blood pressure than simply more serious. According to statistics, in patients with isolated systolic hypertension, both men and women, the incidence of cardio-cerebral vascular disease and normal blood pressure who are 2.5 times. Therefore, as far as possible to reduce the systolic blood pressure is too high in the treatment of hypertension is particularly important. Old concepts: 1 ~ 2 times manometry will identify targetsFor normal blood pressure. New concepts: focus on step-down quality, long-term effective control of blood pressure. Patients with no risk factors in general, blood pressure should be controlled at lt;140/90 mm Hg; diabetes and chronic kidney disease in patients with blood pressure control should be lt;130/80 mm Hg, if controlled at lt;120/75 mm Hg while better (especially the 24-hour urine proteinHome alone 1 or 2 times standard pressure is not enough, need to pay attention to the quality buck. This includes the following two aspects: to maintain the circadian rhythm changes in normal circumstances, the law of the human body for the diurnal variation of blood pressure during the day high, low at night. Before and after morning awakening from the beginning of a rapid increase in blood pressure (morning peak phenomenon), 10 at 12:00 and reached the peak, and remain at a relatively high level, to sleep the night before and after the steady decline in the early morning of 3 to 5 o#39;clock the lowest blood pressure, the so-called quot;dipper blood pressure. quot; However, some blood pressure in hypertensive patients showed non-dipper blood pressure, such a situation of greater target organ damage, in particular, was particularly prevalent in the elderly hypertension, severeHypertension and target organ damage significantly. Reduce this type of nocturnal blood pressure in hypertensive patients is particularly important in order to restore the normal circadian blood pressure changes. To this end, conventional antihypertensive agents during the day by taking use of it might be better to read at night. Effectively control the phenomenon of this morning is to reduce the peak cardiovascular and cerebrovascular complications of the key. Epidemiological and clinical research has shown that, due to the rapid increase in blood pressure in the short term, the early morning cardiovascular and cerebrovascular events is high time. According to statistics, 35% ~ 40% of stroke, myocardial infarction and sudden cardiac death occurs at this time segment. Therefore, effective control of early morning blood pressure is extremely important. Patients should be able to chooseEffective control of blood pressure in the early morning hours of antihypertensive drugs, it is best to wash up after antihypertensive agents on the service, which will take over after breakfast is more effective to control the phenomenon of the morning peak. Old concepts: focus on blood pressure. New concepts: blood pressure is the last word, yet in a comprehensive way. There is no doubt that the key is the step-down treatment of high blood pressure and blood pressure targets, but often associated with high blood pressure in patients with dyslipidemia, diabetes, metabolic syndrome, coronary heart disease and other risk factors. Thus, in step-down at the same time, targeted to take Tiaozhi treatment, weight loss, control diabetes, so the importance of prevention and treatment of coronary heart disease, high blood pressure most important matter in order to minimize the risk of humanHarm. (Editor: Wang Hai-e)