5. Is blood pressure 90/60mmHg all year round, and even sometimes 80/50mmHg is hypotension? Do you need treatment?
It is normal to maintain this blood pressure level for many years. Not hypotension. People with this blood pressure level have a lower risk of stroke. No medication, no treatment required. Sometimes these patients have symptoms such as fatigue, dizziness, palpitations, etc., which are easily attributed to “low blood pressure”, which is actually not related to blood pressure, but may be related to lack of sleep and anxiety/depression.
6. Elevated blood pressure related to mental mood.
I have treated patients who have never had high blood pressure but experience acute agitation or anxiety During an attack, blood pressure suddenly rises. Because the sympathetic nerves are excited, accompanied by rapid heart rate and sweating, some doctors were first suspected of pheochromocytoma, but they found nothing. So give the patient a bottle of short-acting antihypertensive medicine with fast onset of antihypertensive effect, and instruct the patient to take one tablet when the blood pressure is high. Not only does it cure the symptoms but not the root cause, on the contrary, some patients after using this antihypertensive drug drop their blood pressure too fast and too low, and their heart palpitations and dizziness are even worse. Two-heart medicine is very important for the treatment of high blood pressure. Anxiety/depression, sleep disturbances including trouble falling asleep, early awakenings, and sleep apnea can all cause blood pressure to fluctuate.
7. If the blood pressure is high, don’t “taboo drugs”.
Some young and middle-aged people find high blood pressure and are concerned about taking blood pressure-lowering drugs. not come down. Especially when there are no obvious symptoms, they are more resistant to medication. In fact, the antihypertensive drugs currently used clinically are safe and effective, and the side effects are controllable. Most hypertensive patients require long-term adherence to medication. If high blood pressure is discovered for the first time, the increase in blood pressure is not severe, the systolic blood pressure is between 140-150mmHg and/or the diastolic blood pressure is between 90-100mmHg, and there is obesity, lack of aerobic exercise, heavy drinking, and willingness to change their own An unhealthy lifestyle, a balance between eating and moving, and weight control can reduce the weight by 10% from the original basis. You can change your lifestyle seriously without taking medication. If blood pressure is still high after six months, medication should be started. Changing lifestyles requires a process. I suggest that these young and middle-aged patients should not resist medication and can change their lifestyles while taking medication. The effect of changing the lifestyle has come out, and then try to reduce the dose of the drug. The possibility of stopping the drug is not nonexistent, I have had such a case. However, if the blood pressure has reached or exceeded 160/100mmHg at the initial diagnosis, the drug should be taken as soon as possible, and the lifestyle should be changed at the same time.
8. Some hypertensive patients have higher blood pressure in cold winter and lower blood pressure in summer.
According to changes in blood pressure, the amount or dosage of drugs can be adjusted, and the amount or type of drugs can be appropriately reduced in summer .
9. If hypertensive patients also have diabetes (this is very common), in addition to careful control of blood pressure and blood sugar , even if the test sheet shows that the bad cholesterol is within the reference range and there is no upward pointing arrow, a small dose of statin should be taken at the same time.
Reduce bad cholesterol below 2.6mmol/L. This can significantly reduce the risk of stroke and myocardial infarction than blood pressure and blood sugar alone. Here’s a reminder that diabetic patients over the age of 40 who do not have high blood pressure and do not have significantly increased bad cholesterol should also take low-dose statins. Hypertensive patients over 65 years old, without diabetes, but smoking, microalbuminuria in urine examination, atherosclerotic plaques in carotid arteries, and low bad cholesterol, also need to take low-dose statins.
10. The control of hypertension cannot be limited to drugs, but also requires five prescriptions for chronic disease prevention and control.
Medication prescriptions, exercise prescriptions, psychological sleep prescriptions, nutrition prescriptions, and smoking cessation and alcohol restriction prescriptions.