When measuring blood pressure, not only pay attention to systolic blood pressure and diastolic blood pressure, but also pay attention to whether the pulse pressure increases Or reduce it, let’s discuss the meaning of pulse pressure with you today.
1
Definition
First define the concept, pulse pressure = systolic blood pressure – diastolic blood pressure. Systolic blood pressure is the blood pressure at which the ventricular systolic blood pressure reaches its highest value in mid-systole, and diastolic blood pressure is the blood pressure at which the ventricular end-diastolic blood pressure is at its lowest value.
When blood pressure rises, blood flow increases. Under normal circumstances, the pulse pressure of a normal person is 20 to 60 mmHg, with an average of about 40 mmHg. If it is greater than 60 mmHg, it means that the pulse pressure is too large; If it is less than 20 mmHg, it means that the pulse pressure is too small.
Excessive or low pulse pressure is harmful to health and requires treatment, especially if the pulse pressure is too high.
2
Factors strong>
Pulse pressure is affected by many factors, the common pathological factors are as follows:
1) Increased pulse pressure
The middle-aged and elderly people are affected by age and disease , arteriosclerosis occurs, and the self-regulation ability of vascular elasticity is reduced. When the heart contracts, the aorta cannot expand accordingly to buffer the pressure during cardiac ejection, resulting in an increase in systolic blood pressure; and when the heart is diastolic, the aorta’s elastic return ability is weakened , the blood flow that should be sent back to the heart is not adequately returned to the heart, resulting in a decrease in diastolic blood pressure and ultimately an increase in pulse pressure. Specific diseases are as follows:
① Isolated systolic hypertension: Isolated systolic blood pressure Elevated, diastolic blood pressure is not high, common in elderly patients, with arteriosclerosis, increased pulse pressure.
② Arteriosclerosis: During arteriosclerosis, the arterial wall becomes stiff, the function of the elastic reservoir is weakened, and the peripheral resistance increases. Pulse pressure increases.
③ Hyperthyroidism: During hyperthyroidism, the body is in a state of hypermetabolism, with increased stroke volume, increased blood pressure, and increased pulse rate. pressure increases.
④ Aortic insufficiency: During aortic insufficiency, blood backs up into the ventricle, resulting in a stroke-to-beat output As the volume increases, the blood in the aorta decreases and the pulse pressure increases.
⑤ Severe anemia: In severe anemia, the body is in a hyperdynamic state, with increased stroke volume and increased pulse pressure. big.
⑥ Patent ductus arteriosus: Due to the presence of a patent ductus arteriosus, blood from the aorta is shunted to the pulmonary artery, resulting in Stroke volume increases and aortic blood decreases, and pulse pressure increases.
2) Reduced pulse pressure
< p>Decreased pulse pressure can be seen in isolated diastolic hypertension patients. Due to the increased sympathetic excitability of the patient (high stress, mental stress, lack of sleep, etc.), the heart rate becomes faster, and the small blood vessels on the body surface spasm, resulting in low systolic blood pressure, relatively high diastolic blood pressure, and decreased pulse pressure. Common in young and middle-aged hypertensive patients.
In addition, in patients with severe aortic valve stenosis, due to severe valve stenosis, the stroke volume, systolic blood pressure, and pulse pressure are reduced. Small; people who are fatter, do less exercise, and have a lot of stress have an increase in peripheral small blood vessel resistance, which will also lead to a decrease in pulse pressure.
3
Hazards p>
In recent years, epidemiological investigations and clinical follow-up studies on the relationship between pulse pressure and cardiovascular disease have found that the increase in pulse pressure is a significant factor Arteriosclerosis andincreased risk of cardiovascular diseaseis one of the hallmarks.
The pulse pressure difference increases, the blood flow shock is large, and the small blood vessels are easily damaged, thus affecting the tissue function. Vascular disease mortality is also higher.
Recent studies also found that with the increase of pulse pressure difference, cognitive function has a tendency to decline, and pulse pressure difference and Linked to increased risk of Alzheimer’s disease, dementia, and stroke. And increased pulse pressure can aggravate retinopathy in patients with type 2 diabetes.
Meanwhile, the pulse pressure difference can also be used as a reference for the selection of antihypertensive drugs in elderly hypertensive patients , effectively reducing the pulse pressure difference may further improve the prognosis of hypertensive patients. Therefore, pulse pressure difference is a good predictor of adult cardiovascular and cerebrovascular diseases.
4
Treatment
First try to find the cause of the increase or decrease in pulse pressure, and treat it according to the cause. For example, high blood pressure needs to be actively lowered; patients with arteriosclerosis need anti-arteriosclerotic therapy such as lipid-lowering; patients with valvular disease need to solve valvular diseases such as valve replacement.
pulsepressure reductionalso with < span>About unhealthy lifestyle, improving your lifestyle is the top priority. really cannot bechanged or changedPost-diastolic blood pressure is still high, you can take antihypertensive drugs.
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Then patients with increased pulse pressure and decreased pulse pressure should choose antihypertensive drugs What’s the difference?
Elderly hypertensive patients with increased arterial stiffness, volume load and large arterial stiffness, Most of them are characterized by increased systolic blood pressure and large pulse pressure difference.. CCB, ACEI, ARB, diuretics and single-piece fixed compound preparations can be used as initial or long-term antihypertensive therapy. Maintenance medication.CCB is commonly used.In young and middle-aged hypertensive patients, unlike the elderly hypertensive patients, peripheral small blood vessel resistance increases, but large arteries are more elastic No obvious abnormality.Clinicalmainly elevated diastolic blood pressure, small pulse pressure< /span>.
The five major classes of antihypertensive drugs (including diuretics, beta-blockers, CCBs, ACEIs, and ARBs) are It can be used as an initial treatment option for young and middle-aged hypertensive patients. Given that most of them have SNS or RAS activation,β-blockers, RAS blockers (ACEI or ARB)In such patients, the effect of reducing blood pressure (especially reducing diastolic blood pressure) is definite and can be used first.
Planning: lySubmission: xiangfeiteng@ dxy.cnTitle image: Zhanku Hailuo