May 17, 2022 is the 18th “World Hypertension Day” with the theme of “Precise Measurement, Effective Control, Healthy Longevity”.
Improvement, the average life expectancy of the Chinese population has gradually increased. But sometimes we can’t help but ask: Living conditions are getting better now, but why are there more and more chronic diseases?
Taking hypertension as an example, the latest survey data show that the prevalence of hypertension in adults in my country is 27.5%, but the control rate of hypertensive patients is 27.5%. Only 11.0%[1]. That is to say, almost 1 in 4 adults suffers from high blood pressure, and only 1 in 9 hypertensive patients has well-controlled blood pressure!
Hypertension is more than just high blood pressure, it is a major cause of heart disease, stroke, kidney disease and death risk factors. The tricky thing about high blood pressure is that there are not many obvious symptoms in the early stage, but it eats away the cardiovascular system over time. Plan ahead to prevent problems before they happen.
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What are the ways to control blood pressure strong>
Regular blood pressure measurement can help us understand our blood pressure and is an indispensable link. Measuring blood pressure is not difficult, but it is also a technical task. There are many details in blood pressure measurement that need to be paid attention to. Only by covering everything, can a more accurate measurement result be obtained.
When measuring blood pressure, pay attention to the following aspects: the room is quiet, the temperature is suitable, and 30 minutes before the measurement, avoid smoking, drinking coffee, eating and drinking. Exercise, stay seated and relax for 3 to 5 minutes.
If you suspect that your blood pressure is unstable, you can measure your blood pressure for 3 to 7 days for identification. For hypertensive patients with relatively stable blood pressure, it should be measured at least once a month, and the measurement needs to be measured once in the morning and once in the evening.
When measuring blood pressure for the first time, you need to measure the left and right upper arms respectively, and then measure the side with higher blood pressure or the non-dominant arm. Only accurate measurement can provide a good basis for subsequent diagnosis and treatment.
Speaking of treatment, there are currently three main clinical methods for treating hypertension: one is traditional drug therapy, the other is diet therapy, and the third is It’s sports rehabilitation. As a non-drug treatment method, exercise rehabilitation therapy has become a hot research topic. In the future, exercise rehabilitation will play an increasingly important role in the treatment of hypertension.
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Exercise can improve blood pressure
The latest survey by the State Sports General Administration shows that, The regular exercise rate of Chinese residents is 33.9%, and the regular exercise rate of people aged 20 to 69 is only 14.7%.[2] > The target ratio of 40% of people who regularly exercise as mentioned in the “Healthy China 2030” Planning Outline is still a certain distance away.
The rate of regular exercise in adults is at a low level, and lack of physical activity has become an important cause of many chronic diseases. At the same time, changes in indicators such as cardiorespiratory endurance, flexibility, muscle strength, muscle endurance, and body composition are not optimistic, which further reflects the importance of exercise.
Long-term scientific exercise can not only improve physical fitness, make people refreshed, but also to a certain extent Help improve blood pressure. If hypertensive patients can adhere to reasonable exercise training, control salt and alcohol, and lose weight, the stability of blood pressure will be greatly increased, and the amount and dosage of antihypertensive drugs can be reduced to a certain extent.
Research found that regular exercise in hypertensive patients was associated with a lower risk of cardiovascular death and all-cause mortality. Therefore, it is recommended that non-hypertensive people (in order to reduce the risk of hypertension) or hypertensive patients (in order to reduce blood pressure), in addition to activities of daily life, accumulate 30 to 60 minutes of moderate-intensity exercise every day (4 to 7 days a week) ( such as walking, jogging, cycling, swimming, etc.) [3]. The form of exercise can take aerobic, resistance and stretching exercises, etc., aerobic exercise can be the main exercise, and anaerobic exercise can be used as a supplement.
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Assessment before exercise
Patients with hypertension must undergo a comprehensive medical examination and rehabilitation function assessment before exercise training to Determine whether the patient is suitable for exercise training and determine which intensity of exercise training is appropriate. It is recommended that men over the age of 50 and women over the age of 60 undergo a primary assessment of cardiovascular risk screening before exercise.
Patients with mild to moderate hypertension can choose the exercise method and intensity that suits them, but not all patients with hypertension are suitable for exercise. For patients with blood pressure over 180/110mmHg, hypertensive crisis/emergency/serious complications, concomitant heart failure, unstable angina, and blood pressure fluctuations during exercise, the Strenuous exercise is not recommended. Secondary hypertension is also a contraindication to exercise rehabilitation.
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Exercise prescription varies from person to person< /strong>
Specifically, pre-exercise risk stratification should be performed in patients, and cardiopulmonary exercise testing should also be performed in high-risk patients. For example, the patient has no complex ventricular arrhythmia during exercise, no symptoms of angina pectoris, stable hemodynamics, and only has obvious shortness of breath and mild dizziness during high-intensity exercise. etc., generally can be determined as low risk or moderate risk, you can choose the exercise rehabilitation therapy that suits you.
If the above symptoms are very obvious, even the patient has a history of sudden death/cardiac arrest, and the blood pressure in the cardiopulmonary exercise test is lower than that before exercise by more than 10mmHg , peak blood pressure during exercise ≥ 240/120mmHg, arrhythmia, etc., it means high risk. At this time, the choice of exercise rehabilitation needs to be extremely cautious, and it is necessary to seek the advice of a doctor, and conduct it under the professional guidance of the doctor and necessary medical monitoring.
An exercise prescription should include: exercise frequency (frequency), exercise intensity (intensity), exercise time (time) and exercise type (type of exercise). ) 4 elements, namely the FITT principle. The situation of hypertensive patients is complex and changeable, and some are accompanied by complications, such as hypertension with diabetes, hypertension with coronary heart disease, etc. Therefore, the “exercise prescription” also varies from person to person.
Take a 60-year-old hypertensive patient with diabetes as an example, the goal is to control blood pressure at 130/ 80mmHg or less, while also lowering the patient’s blood sugar level. His exercise method can choose aerobic exercise such as cycling, jogging and swimming. The exercise time is 30 to 60 minutes, 4 to 7 times a week. Just keep doing moderate-intensity exercise. Moderate-intensity exercise requires that the exercise heart rate is 60% to 70% of the maximum heart rate, and the maximum exercise heart rate is 220-age.
The patient is 60 years old this year, so the maximum heart rate during exercise is 220-60=160 beats/min, and moderate-intensity exercise means the heart rate is 96 during exercise. ~112 beats/min. Of course, this is a rough estimate, and a more accurate heart rate range for moderate-intensity exercise has to be determined by cardiopulmonary exercise testing. Patients should exercise at least 1 hour after meals, do a 10-minute warm-up preparation before exercise, and carry sugar cubes with them for timely consumption to avoid hypoglycemia during exercise. Do 5 minutes of stretching after exercise.
For another example, a 65-year-old patient with hypertension and coronary heart disease (who underwent stent surgery), his blood pressure control target is 140. /90mmHg or less. It is recommended that he choose forms of aerobic exercise such as treadmills and jogging, supplemented by resistance training. Aerobic exercise is mainly moderate-intensity, about 30 minutes each time, and exercise 4 to 7 days a week. Resistance training can be done by lifting dumbbells and equipment training, etc., each group of 10 to 15, 3 to 5 groups each time, 2 to 3 times a week. Do a “tidying up exercise” after training, which is to relax for at least 5 minutes. If you experience symptoms such as chest tightness, shortness of breath, asthma or fatigue during exercise, stop the activity immediately until the symptoms disappear.
What about post-exercise fatigue? For people with high blood pressure, exercise can also easily cause fatigue, at least the feeling of their heart beating more intensely. However, as long as the heartbeat is not particularly fast and tolerated, there is no need to worry. Some people with high blood pressure worry that exercise can cause joint or muscle damage. In fact, maintaining the correct posture and intensity of exercise can enhance muscle strength and help protect joints.
Studies have shown that the occurrence and development of hypertension are directly related to the daily habits of patients. Exercise rehabilitation in hypertensive patients can effectively lower blood pressure, inhibit the over-activated renin-angiotensin-aldosterone system, reduce sympathetic nerve excitability, reduce blood pressure fluctuations, improve bad mood, reduce blood lipid and blood sugar levels, and increase nitric oxide in the body It can also increase the activity of telomerase and protect the structure of telomeres, thereby affecting the health of the human body, thereby achieving the goal of longevity and health.
Hypertension is a preventable, controllable and treatable disease, even cardiovascular medicine One of the most effective diseases. Everyone must be confident that as long as they actively strengthen exercise, improve their diet, and follow the doctor’s prescription, they will surely achieve the effect of “accurate measurement, effective control, health and longevity”.
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References:
1. Zhang Mei, Wu Jing, Zhang Xiao, et al. Study on the prevalence and control of hypertension among Chinese adult residents in 2018 [J]. Chinese Journal of Epidemiology, 2021, 42(10): 1780-1789
2. China Cardiovascular Health and Disease Report 2020 Summary[J].Chinese Journal of Circulation,2021,36(06):521-545
3. Guidelines for the Prevention and Treatment of Hypertension in China (2018 Revised Edition)[J] .Chinese Journal of Cardiovascular, 2019,24(01):24-56
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