Symptoms are not obvious! Beware of high blood pressure among young and middle-aged people

Text/Yangcheng Evening News All Media Reporter Zhang Hua

Picture/Provided by respondents

Hypertension has long been considered a “disease of old age.” In recent years, young and middle-aged people with high work pressure, often staying up late, and having a lot of entertainment are becoming the “new darlings” of hypertension. still low. In addition, there are a large number of young and middle-aged people with prehypertension (normal high value, 130-139/85-89 mm Hg), if they are allowed to develop, they will become an important source of the surge of hypertensive population in the future.

On the National Hypertension Day on October 8, Wu Shaorong, Deputy Chief Physician of the Department of Cardiovascular Medicine of the First Affiliated Hospital of Jinan University, pointed out in an interview with reporters that, unlike hypertension in the elderly, young and middle-aged hypertension Hypertensive disease has its own characteristics. We should identify hypertension early, adopt a healthy lifestyle to improve blood pressure control and reduce the risk of cardiovascular disease.

Wu Shaorong, Deputy Chief Physician, Department of Cardiovascular Medicine, The First Affiliated Hospital of Jinan University, ward rounds

What are the characteristics of hypertension in young and middle-aged people?

Why does high blood pressure prefer middle-aged and young people? Professor Wu Shaorong pointed out that high-salt and high-fat diet, lack of exercise, overweight or obesity, excessive mental stress, and lack of sleep are the main causes of hypertension in young and middle-aged people. In addition, the increase of estrogen will cause vasodilation, which is conducive to the decrease of blood pressure, so when women reach menopause, the decrease of estrogen level will lead to the increase of blood pressure level.

Wu Shaorong also pointed out that there are 7 characteristics of hypertension in young and middle-aged people:

1. The symptoms are not typical. Most young and middle-aged hypertensive patients have no obvious symptoms except that some patients are diagnosed with hypertension due to dizziness, headache or other symptoms.

2. Most patients have mild hypertension.

3. The sympathetic nerve activity was significantly increased. A pooled analysis of 78 studies showed that 64% of hypertensive patients aged <40 years had sympathetic hyperactivation compared with normotensives in the same age group; while hypertensive patients aged ≥40 years had hypersympathetic hyperactivity relative to normotensives. The proportion of activation was only 23%, suggesting that sympathetic nerve activity was significantly increased in young hypertensive patients.

4. The proportion of overweight/obesity and metabolic abnormalities was high, and the sympathetic nerve activity was further enhanced.

5. Diastolic blood pressure is mainly elevated. Studies have shown that even with low systolic blood pressure (<120 mmHg), the risk of cardiovascular death increases significantly with increased diastolic blood pressure.

6. The proportion of family self-measured blood pressure is low.

7. Poor treatment compliance and low blood pressure control rate.

Wu Shaorong, Deputy Chief Physician, Department of Cardiovascular Medicine, The First Affiliated Hospital of Jinan University

What are the misunderstandings about hypertension in young and middle-aged people?

It is generally believed that if blood pressure exceeds 140/90mmHg three times on different days without the use of antihypertensive drugs, hypertension can be diagnosed, and lifestyle intervention and drug treatment can be started. It is worth noting that when the pulse pressure difference between high and low pressure is greater than 60mmHg, it will cause damage to blood vessels. From the perspective of protecting target organs (heart, kidney, brain, etc.), blood pressure should also be actively controlled. Professor Wu Shaorong also found many misunderstandings about hypertension in clinical practice.

Myth #1: You don’t need medication.

Many patients have been diagnosed with high blood pressure, and have experienced dizziness, headache and other discomforts, but they refuse to take medicine, but they have a soft spot for some health care products. The reason is that the concept of “drugs are three parts of poison” is deeply rooted, and they are afraid of the toxic side effects of drugs. In addition, it is wrong to think that “high blood pressure drugs are addictive”, and you can’t stop taking them.

Wu Shaorong said that long-term clinical practice has proved that most of the commonly used antihypertensive drugs are safe and effective, and the side effects are reversible and mild. Antihypertensive drugs are not drugs and have no addictive properties.

Myth 2: No pain, no medicine.

Patients with high blood pressure should not mistakenly think that if there is no feeling, no discomfort, no harm and no need for treatment. Wu Shaorong believes that, in fact, asymptomatic hypertension is equally dangerous.

Mistake 3: Not taking medicines as prescribed.

After a period of treatment with antihypertensive drugs, the patient’s blood pressure dropped to normal, and the drug was stopped on his own. As a result, the blood pressure increased again after a short time, and then the drug was started again. Professor Wu Shaorong pointed out that such a vicious cycle not only fails to achieve the therapeutic effect, but also damages important organs such as the heart, brain and kidney due to the large fluctuation of blood pressure.

Mistake 4: Taking medication without measuring blood pressure.

The symptoms of hypertension and blood pressure levels are related to a certain extent, but they are not necessarily consistent with the severity of the disease. The severity of symptoms cannot be used to estimate the level of blood pressure and determine the dosage of antihypertensive drugs. .

Wu Shaorong emphasized that it is often wrong to estimate blood pressure based on self-feelingWrong, it is easy to delay treatment.

Wu Shaorong answers patients’ questions

How to self-manage hypertension in young and middle-aged people?

At present, the new version of my country’s hypertension guidelines advocates the new concept of “moving the threshold forward” in the diagnosis and treatment of hypertension. People with “high normal” blood pressure, such as those with a high risk of cardiovascular disease within 10 years, should also receive early intervention. On the basis of lifestyle improvements, drug treatment should be initiated if necessary.

The important risk factors of hypertension in Chinese population are high-sodium and low-potassium diet, overweight and obesity, excessive drinking, long-term mental stress and other lifestyle interventions can reduce blood pressure and prevent or delay the onset of hypertension. Reduced risk of cardiovascular disease occurs.

As a result, the guidelines clearly state that lifestyle interventions should be undertaken at all times and in any hypertensive patient, including those with high blood pressure.

In addition, experts also emphasized that the blood pressure target must be clearly defined, and blood pressure should usually be reduced to <140/90mmHg. If tolerated, most patients can further reduce it to <130/80mmHg. Limit salt to 5 grams a day, quit smoking and limit alcohol, eat at least half a catty of vegetables every day, and exercise for half an hour every day. Measure blood pressure correctly and take medicine as directed by your doctor. For patients with hypertension and metabolic diseases, comprehensive management of obesity (less than 90 cm for men and less than 85 cm for women), dyslipidemia, elevated blood sugar, etc. (For more news, please pay attention to Yangcheng Pie

Source | Yangcheng Evening News·Yangcheng Pie

Editor | Chen Hui