High blood pressure care points

The primary goal is to stabilize blood pressure within an individualized standard range for a long time, and at the same time, try to avoid risk factors that induce damage to target organs such as the heart, brain, kidneys, blood vessels, etc. There is no universal template for all nursing plans. They must be adjusted based on your own basic diseases and body tolerance. Do not blindly copy other people's experience.

Not long ago, I met a 62-year-old Uncle Zhang at a community free clinic. He had been diagnosed with high blood pressure for three years. He heard from his neighbors that taking antihypertensive medicine for a long time would harm his liver and kidneys. He secretly stopped taking the medicine and replaced it with "celery seed antihypertensive powder" bought online. He usually doesn't even dare to add too much salt. But half a year ago, he suddenly felt dizzy and couldn't stand. When he was sent to the doctor, he found that his blood pressure had soared to 180/110, and soft plaques had grown in the carotid arteries. If it were too late, the blood vessels might be blocked.

In fact, there have been different opinions in the academic circles on whether to take medicine early for high blood pressure. One school of thought believes that as long as it is mild hypertension (systolic blood pressure 140-159mmHg, diastolic blood pressure 90-99mmHg) discovered for the first time, and there is no history of hyperlipidemia, diabetes, or family history of premature cardiovascular and cerebrovascular diseases, lifestyle intervention can be done for 3-6 months first, and there is no need to rush to take medicine. ； The other group believes that as long as the blood pressure exceeds the standard line of 140/90mmHg, early medication can reduce vascular damage early, and the probability of subsequent reversal is higher. Nowadays, most clinical trials will use the middle judgment standard: if you have no other underlying diseases and can strictly control your mouth and move your legs, you will be given an adjustment period of 3 months. If the reexamination does not meet the standard, you will be prescribed medicine immediately. ； If you have problems with high blood sugar and high uric acid, don't wait, just eat what you need. The current mainstream antihypertensive drugs have very low side effects, which are much less harmful than long-term high blood pressure.

Many people feel that taking medicine is "dependent" and they only rely on lifestyle to regulate blood pressure, which only leads to more pitfalls. Let’s talk about “eat less salt” that everyone is most familiar with. There used to be an aunt who only put half a spoonful of salt in her cooking every day. It is reasonable to say that she has already met the standard of less than 5 grams per day. Let me also mention the low-sodium salt issue that has been a hot topic recently: not everyone is suitable for eating low-sodium salt. People with normal kidney function and no hyperkalemia can switch to low-sodium salt, which can indeed reduce sodium intake without changing the taste. However, if your glomerular filtration rate is already lower than 30ml/min·1.73m², or you usually take potassium-sparing antihypertensive drugs, low-sodium salt will easily cause an increase in blood potassium, which is not worth the loss.

After talking about eating, let’s talk about moving. Many people ask if people with high blood pressure can do morning exercises? This is also a question with no standard answer. If your blood pressure is well controlled in the morning and your systolic blood pressure is basically below 135, it’s perfectly fine to go for a walk or do Tai Chi when it’s cool in the morning. ； But if you have a "morning blood pressure peak" and your blood pressure often exceeds 150 when you open your eyes without taking medicine, don't join in the excitement in the morning. The sympathetic nerves are already excited. If you move too violently, it's easy to have an accident. Don’t focus on completing the “150 minutes of moderate-intensity exercise per week” mentioned in the guide. I have seen many people who don’t exercise at all on weekdays. Suddenly they run 5 kilometers on the weekend, and their blood pressure soars to 170 on the spot. Instead, it is better to rest for an hour after dinner every day, go downstairs and walk slowly for thirty or forty minutes. The long-term effect is much better.

Many people also make the mistake of over-monitoring. There was a patient in his 40s who was too nervous after being diagnosed with high blood pressure. He had to measure his blood pressure more than a dozen times a day. Whenever he saw the value was 5 or 6 mmHg higher than usual, he panicked and secretly added half a pill. As a result, the blood pressure fluctuated at the end of the measurement, and he was so anxious that he couldn't sleep. In fact, blood pressure naturally fluctuates, just like your heartbeat will speed up when you run two steps. If you have just drank hot water, held back your urine, or had a quarrel with your family, the measured value will definitely be high. As long as a single fluctuation does not exceed 20mmHg, you don’t need to take it seriously. You usually measure once in the morning and once in the evening, and take the average of the two measurements each time. It is enough to save the values ​​​​for three days a week to show to the doctor.

To put it bluntly, high blood pressure is not a scourge, but a "chronic disease partner" that you need to get along with for a long time. You don't have to always think about finding a cure, and don't take it so seriously that you don't take it seriously until complications occur. No matter how good someone else's anti-hypertensive diet or exercise program is, it's not as good as regular visits to the hospital for review and a program that is suitable for you together with the doctor. After all, the ultimate goal of care is to be stable, not uncomfortable, and have fewer problems.