Hello, Sina netizens!
Moderator: Famous doctors gather to talk about people's health. Good afternoon, audience friends. Welcome to the Celebrity Doctor Hall broadcast live by Sina Health and Medical Forum. At the same time, audience friends can also participate in our interactive platform to raise your questions. This program specially invites Professor Wen Shaojun from Beijing Anzhen Hospital affiliated to Capital Medical University to talk with us about the prevention and treatment of hypertension. Welcome to Professor Wen.
Wen Shaojun: Good afternoon, everyone!
Host: As far as I know, cardiovascular and cerebrovascular diseases are one of the biggest killers that harm human beings, and hypertension is a very serious risk factor and cause. October 8 is the World's Hypertension Day. Its theme is "Know your blood pressure and control your indicators".
It seems that it is very important to know your own blood pressure. First of all, I would like to ask Professor Wen how many hypertensive patients are there in China?
Wen Shaojun: Why did you choose such a topic "Know your blood pressure" on this National Hypertension Day. In 2002, there was a statistic that the incidence of hypertension in adults, that is, adults over 18 years old, was 18.8%. If we calculate our population in 2010, there are about 200 million people, or more than 200 million people now have high blood pressure.
Why let everyone know blood pressure? There is a statistical figure that there are 200 million people with high blood pressure, 130 million people do not know that they are high blood pressure, and there are 70 million people with high blood pressure who know that they have high blood pressure, 30 million people know that they have high blood pressure but have no treatment, and there are still 40 million people. It can really achieve effective treatment within 40 million miles, and only one fourth of the patients can reach the standard of treatment, which means that there are 10 million people who are also well treated for hypertension. In addition, the drugs are also right, which can really meet the requirements of doctors.
Therefore, only one in ten million of the two hundred million people is truly a major force in the treatment of hypertension. Thirty million people did not achieve our goal after treatment. Thirty million people knew that he would not treat hypertension, which is a serious problem.
So now we are talking about three high and three low levels of hypertension in China. High, that is, high morbidity, high disability rate and high mortality. Low, one is that the awareness rate is low. After you know it, the treatment rate will be low. The real control rate is lower, so hypertension is talked about every year, and we will talk about it every year. It is to make everyone pay attention to hypertension.
Host: Professor Wen mentioned a very serious problem just now. Many people know about it but he won't be cured. Why does this happen?
Wen Shaojun: There are several points. One is that some people think hypertension is nothing. For example, in the past ten or twenty years, he has not suffered from the adaptation of some people. The biggest feature of hypertension is that some people call it the silent killer. It sometimes does not reflect in the early and middle stages, or some people have dizziness. It's really good to turn into a killer in the later stage. It's already too late. Host: Just now Professor Wen mentioned the very important concept of "silent killer". What is the definition of hypertension? Many people may also measure high blood pressure. Is high blood pressure hypertension, or is it very close?
Wen Shaojun: Hypertension is spoken by ordinary people. As long as the blood pressure is high, it can be said to be hypertension. For example, we take a wrist type blood pressure gauge at home to measure one, or go to the hospital for physical examination to check with other doctors.
The real diagnosis of hypertension is generally strict. If you wake up at home in the morning with an empty stomach, take a cuff type electronic blood pressure meter to measure your blood pressure for three days, or measure your blood pressure in the morning and evening all over 140/90, which basically shows signs of hypertension, you should go to the hospital for examination.
After arriving at the hospital, our doctor uses the mercury blood pressure gauge to tie your cuff and inflate your blood pressure. The mercury column can see whether your blood pressure is high through auscultation. Now there are simpler instruments in foreign countries, and the blood pressure is basically out when you put your hand in for one second.
In addition, some people said that my normal blood pressure is not high, and there is another way to monitor my blood pressure 24 hours a day. Monitor your blood pressure, put a small box on your back, tie the cuff, measure your blood pressure once every half an hour, and finally draw a curve.
Host: High blood pressure once or twice may not be completely defined as hypertension, which can only be determined after strict testing in professional hospitals.
Wen Shaojun: Yes.
Host: Professor Wen mentioned just now that some people know hypertension but do not control it. What organ damage will this cause?
Wen Shaojun: This is our biggest headache. Some people say that I take Chinese medicine or I control my diet when I find high blood pressure. Some people say that the medicine is highly toxic. In fact, he did not know that if the blood pressure was not well controlled, the problems behind would be very serious. Why is it a killer? And a silent killer? Usually unknown, when it really gets sick, one is to spend a lot of money, the other is to hurt the body seriously.
Host: Just now Professor Wen mentioned that many people have a mentality. China believes that drugs are divided into three parts. Does Chinese medicine have a good effect? Or is it auxiliary?
Wen Shaojun: We are western medicine learned by cardiologists. We have been doing hypertension research for nearly 20 years. We suggest that if you have high blood pressure, you should go to the cardiology department to see a doctor first. Now the medicine is very safe, not very expensive, and also effective. It is suggested to take western medicine first, and some Chinese medicine can be used for conditioning.
In addition, it is not recommended to take folk remedies or use some health preserving soup. I think it is easy to delay my illness.
Host: It was mentioned just now that the occurrence of hypertension has a lot to do with our lifestyle, including diet. How much is the relationship between our hypertension and our diet?
Wen Shaojun: Very big. Hypertension is a combination of two factors, one is genetic factors, and the other is environmental factors. In the whole process of your life, genetic factors cannot change, but environmental factors. For example, what are the environmental factors? Diet, smoking, wine, salt, salt, exercise, mood, we talk about psychology, fatigue, staying up late, there are so many risk factors can affect this.
Host: It can be said that hypertension is a lifestyle disease. There are so many unhealthy lifestyles mentioned just now. What is a healthy lifestyle and a good way to control or prevent hypertension?
Wen Shaojun: One of the most important things is weight. We have an algorithm for weight. Divide your weight by the square of your height, which is called BMI. It is also the simplest thing for ordinary people to see, especially adults to see your belt. If the belt is more than 90 cm for men and 85 cm for women, it is considered obese. If the BMI index is greater than 24, you have obesity, or this risk factor.
Host: Obesity is also the most important risk factor for us.
Wen Shaojun: Yes. There is also, for example, salt. The World Health Organization advocates that adults use 5-6 grams of salt every day. It used to be 6 grams, but now it is more strict to say 5 grams. In particular, northerners have a habit of eating salt desperately because they feel that there is no salt and taste.
According to statistics, the daily intake of salt of northerners or most of the country is 12-15g, 2-3 times higher than the WHO standard. I don't know if this spoonful of salt is used. For example, if you add 2 grams of salt every day, your blood pressure will increase by 2 mmHg. If you add 6 grams of salt, your systolic blood pressure will increase by 6 mmHg. They are 5 or 6 grams. If you eat 15 or 16 grams, your blood pressure will be so high.
The reason is very clear. The salt is mainly sodium chloride, and chlorine has little effect. The amount of sodium ions is as much as the amount of water sucked into the blood vessels. If there is more water, the pressure will be great. In addition, if we add 2 grams of salt, the systolic pressure will rise by 2 mmHg, and the diastolic pressure will rise by 1.2 mmHg. Systolic pressure or high and low pressure as people say are high. If you eat salty food and drink water, the vascular pressure will be high.
Last year Peking University did a study in Tibet, where high blood pressure occurs. He has done two studies. One is that Tibetans have a habit of eating meat. In addition, they eat salty food. The place is salty because of the high mountains and a little cold. There is a lot of hypertension. It can reach 80% for adults, and cerebral hemorrhage is particularly high. Cerebral hemorrhage has the problem of altitude, but it also has the problem of hypertension.
Two experiments have been done. One is to give you the salt. Some of the sodium chloride is replaced by potassium chloride. We call it low sodium salt and salt sodium salt.
At the same time, some hypertension patients were given diuretics to drain out sodium, so the blood pressure dropped by nearly 20 mmHg.
In particular, the elderly must pay attention to the amount of salt. We suggest that you have a small spoon for cooking, 6 grams per spoon. Some people say that I eat very little salt, but you may eat pickles, which are also included, including pickles and soy sauce. It must be low in salt and sodium.
Moderator: Low salt, low sodium, more exercise, less smoke, less alcohol.
Wen Shaojun: Not to smoke less and drink less. If you want to quit smoking, you must quit smoking. Because smoking is very harmful to blood pressure, especially for coronary heart disease. Those with stroke should quit smoking. In fact, we suggest that if there is no severe hypertension and no complications, such as heart, brain and kidney diseases, especially for the elderly in the north, it is good to drink a little wine in cold season. We must remember not to drink too much wine.
Moderator: Control the amount of wine.
Wen Shaojun: Yes. We don't think the amount of wine is very scientific, and we also give advice to you. Why? You must have a certain amount. Some people say that everyone drinks every day, and the alcohol content is 25g. Some people say that it is 50ml when converted to white wine, and some people say that 100ml is a small cup. Red wine may be a little more than 200ml, and beer 300ml. This should be good for your health. Some elderly people, especially in the north in winter, drink some wine to promote circulation.
Host: Professor Wen mentioned just now that it is a silent killer, and its serious problem is that it causes many dangerous complications. What is the most dangerous complication? Wen Shaojun: If hypertension is not well controlled, important complications may occur five or ten years later. The main thing is that our most important organs are the brain, heart, kidney and one fundus is the eye. There are two kinds of brain, one is ischemic stroke, which is cerebral thrombosis. Another is hemorrhagic stroke, which is cerebral hemorrhage. The incidence of stroke in China is very high. Hypertension in China is not mainly coronary heart disease, but stroke.
In the past two decades, heart disease in the United States has declined and stroke has declined, while stroke in China has increased and heart disease has risen. But in contrast to the United States, China has more stroke than heart disease, and the United States has the opposite. Heart disease is more common than stroke in America. So it is more important to control blood pressure.
Host: A friend mentioned that, for example, the size of each person's personality, is there an inevitable link with the incidence of hypertension?
Wen Shaojun: Very relevant. In fact, there is a psychological balance in the risk factors we are talking about, or if the person's personality is relatively calm, you can face it when you get sick, and the disease will be slightly mild. Some people are either very introverted or very extroverted. For example, some people have problems and hold their breath. This situation is either depression or hypertension. Their blood pressure cannot be controlled and they have a bad rest. There are also some people who can't control their emotions. They are angry everywhere, and are willing to see injustice everywhere, or become angry when something happens. This is especially easy to cause heart problems. The blood pressure was high at first, but I didn't take medicine properly and lost my temper again. You think it's either cerebral hemorrhage or cerebral thrombosis, or myocardial infarction.
Moderator: It is helpful for us to keep a peaceful attitude. What is the difference between hypertension in children and hypertension in the elderly?
Wen Shaojun: These two special groups are very large in China. We say children with hypertension are 1-18 years old, and they will become adults after 18 years old. The elderly are 60 years old, and some countries now turn the elderly from 65 to 80 years old. In general, children with hypertension should first ask about heredity, that is, whether your child's parents have hypertension. If both parents have high blood pressure, the genetic background will fall on you.
Moderator: Heredity is a very important factor.
Wen Shaojun: Yes. When we talk about heredity and other factors, the approximate ratio is 4:6. If your parents have high blood pressure, you have 40% heritability. The remaining environmental factors, such as eating, smoking, drinking, inactivity and obesity.
In addition, most of children's hypertension is what we call secondary hypertension. It is the child who has kidney problems or other problems. Therefore, children with high blood pressure, especially high blood pressure, must go to the hospital to have a good check, not just to give a few pills to eat.
Compere: There is another kind of hypertension called pregnancy hypertension. What is it like?
Wen Shaojun: There are two cases of pregnancy induced hypertension. One is that you have high blood pressure before pregnancy, and then the blood pressure slowly rises 20 weeks after pregnancy. This is called pregnancy associated hypertension. For example, her blood pressure is still high after giving birth, and she may have to take medicine for life.
Another is called pregnancy induced hypertension, which means that your blood pressure was not high before, nor in early pregnancy. After 20 weeks, your blood pressure began to increase, and then dropped within 12 weeks after giving birth. This is called pregnancy induced hypertension.
There are two ways to go. One is that there will be no hypertension in the future. The other part is to wait until old age to develop hypertension, but there was a period of time when the blood pressure was not high, both of which should be treated. And they should be treated by professional doctors.
Moderator: Attention must be paid.
Wen Shaojun: Yes. It is known that it is very valuable to have a baby now, so some people do not take medicine when pregnancy hypertension occurs, which is actually bad for adults and children. If you want to take medicine, you should also take the right medicine. There are two types of blood pressure lowering drugs that can't be taken during pregnancy. This must be paid special attention. If you take drugs, your child's cardiovascular system will not develop well.
Host: Thank you, Professor Wen. In addition to live broadcast, the Hall also opened an interactive platform to invite friends to participate in real-time interaction. Now different netizens have put forward their questions. Let's take a look at some of them.
Wen Shaojun: Good.
Netizen: I am 42 years old and engaged in financial work. I found high blood pressure at the beginning of the year. After detection, only transaminase and cystine exceeded the normal value. Later, liver B ultrasound showed mild fatty liver. At present, the drugs taken are telmisartan tablets, felodipine sustained-release tablets and bilosol tablets. But now the diastolic pressure is high, often above 100, and the high pressure is between 130-145. What should I do?
Wen Shaojun: He actually said that the new thing to check for hypertension is homocysteine, so his cysteine is high. Chinese people, especially men, are mostly hypertensive with increased cysteine level, which we define as type H hypertension. Because the capital letter of cysteine is H. Introduce a new concept called treatment of type H hypertension.
If you want to treat it medically, you should first find the reason. Why is the homocysteine high? In its metabolism process, we also talk about genes. We say that there is a tetrahydrofolate reductase, and this enzyme has a problem. There is a TT type gene, which may be too professional.
That is to say, there is a genetic problem, and there is also a problem of high hemiacid. This treatment is a very simple method. Antihypertensive drugs, especially two types of antihypertensive drugs plus folic acid B12 and B6, can control the blood pressure and type H hypertension at the same time.
The medicine he used may not be enough. It's better to find a professional doctor to make adjustments. For example, Termisartan is not good. Now there is olmesartan. When some drugs are used in combination, a small amount of diuretics can be added. This is no problem. Professional doctors have basic skills in it.
Netizen: 39 years old, has suffered from hypertension for five years. Now taking Lotensin, I often drink because of my work relationship. When I drink, my blood pressure reaches 150/100 for several consecutive days, and my reaction is relatively large. If I don't drink for a period of time, my blood pressure is more than 100-60 low, and my cervical spine is a little sour. What should I pay attention to at ordinary times?
Wen Shaojun: He has found his own reason, which is the relationship between drinking and working. Pay attention to your work. You should be lazy when drinking. I can't be lazy at work, but I must drink less when I drink. I said that I have high blood pressure and now I take medicine. It's very uncomfortable to have high blood pressure, so I try my best to mean it.
If this is not enough, you can only do this. You should add some medicine after drinking or before drinking, and add some other dosage under the guidance of the doctor.
Netizen: How to reduce blood pressure?
Wen Shaojun. Now the drug is basically safe and has undergone large-scale clinical medication. There are 200 million people in China, and 40 million people take medicine all the year round. If there is a problem with these drugs, everyone knows it. Nowadays, the medicine is more and more safe and the dosage is smaller and smaller. So it is recommended to monitor blood pressure, and take medicine if necessary, and go to the hospital to find a regular doctor.
Another is that everyone's blood pressure fluctuates in 24 hours or every year. Some people say that I measure the blood pressure at the current level, and then it changes again. Finally, I measure another level, and then say that the blood pressure meter is inaccurate. In fact, the blood pressure is either fluctuating or not. It is on demand. People are very advanced animals with very sophisticated control systems. Blood pressure is the control system. Once you exercise your blood pressure, it will go up and down. When you exercise your blood pressure, the control system will fail and the balance will be disturbed.
For example, some people, especially in the north, have high blood pressure when they are cold. Why go up when it's cold? The heart rate is fast, the weather is cold, and the blood vessels need to contract. At this time, the pressure is high. The blood vessels become thinner after beating hard inside. If you really have high blood pressure at this time, you must take medicine.
For example, some people say this in summer, when their blood pressure fluctuates, and you take medicine. Generally, medication for hypertension should be adhered to. Under the guidance of doctors, many people or most people will eat for a lifetime. But for people like this, when the winter is high and the summer is warm, the blood vessels become loose and the heart rate slows down. At this time, his blood pressure drops. This can be reduced as needed under the guidance of a doctor, for example, in summer. If it is very low, you can stop for a period of time to eat in winter.
For example, one patient at my outpatient clinic said to prescribe more medicine for me today. I jokingly said that it would be easier for you and me to give you the medicine for one year, but it can't be given like this. You should always go to the hospital for reexamination and adjust the medicine.
Host: The patient must maintain timely communication with the doctor, and must go to the regular cardio cerebrovascular department to comply with the doctor's advice.
Wen Shaojun: Yes.
Host: Let's talk about diagnosis. Many netizens said, how to prevent and treat hypertension in the early stage?
Wen Shaojun: Take your blood pressure regularly and have a physical examination every year. You'd better take a test when you feel uncomfortable.
Compere: You mentioned that you often measure blood pressure. Many friends bought sphygmomanometers and measured their blood pressure at home. How to measure blood pressure correctly? Which is the best way to measure blood pressure?
Wen Shaojun: The best pillar for professional doctors is our mercury type sphygmomanometer. Doctors use stethoscope to measure. Early detection at home is to use the electronic sphygmomanometer that we bought. We recommend that you buy a sphygmomanometer with a cuff. Now many kinds of sphygmomanometers can be used.
The wrist type blood pressure meter was relatively accurate in early youth. The elasticity of blood vessels changed with age, and the blood vessels became stiff. At that time, the wrist type blood pressure meter was not particularly accurate. If this person often travels on business, and some white-collar workers have some leaders or bosses, it may not be good for him to take a cuff on business trips. The general monitoring is OK.
Moderator: But it is suggested that the cuff should be the most accurate.
Wen Shaojun: Many patients go to the hospital to tell the doctor that my blood pressure is high, but they can't tell what the situation is. In this way, there is also a problem with the doctor's medication. I don't know how much medicine I give you affects your blood pressure. So suggestion: if you find that you have high blood pressure, you'd better take a piece of paper at home, date, morning, evening, including blood pressure and heartbeat for a few days. After testing in the morning and evening under quiet conditions, pay attention to one person's drinking and not eating too much. In that case, you can take it to me after testing. My blood pressure has been high and my heart is beating fast this week. The doctor can give you a correct medication guidance by giving you another test according to your situation.
Host: Professor Wen mentioned three points before. One is waking up and fasting. In this case, the measured blood pressure will be more accurate. You should keep records and show them to the doctor so that the doctor can prescribe medicine more accurately.
Wen Shaojun: Many elderly patients record their blood pressure completely before they come to see the doctor. Some elderly people also record their blood pressure at noon very carefully to tell you about it. According to his blood pressure, the doctor fine tuned his medication. Some are always high, we may need to add medicine.
Compere: If we have found that we have high blood pressure, what tests should we continue to do?
Wen Shaojun: I just said that hypertension itself is not terrible, but its complications. Others have high blood pressure, but it is not because of the primary condition, but because of other problems. Go to the hospital cardiologist to do other examinations, do ECG to see whether the heart is good, whether there are premature beats, atrial fibrillation, and evaluate the condition of your heart.
Also check your heart color ultrasound to see if your heart is normal in size. We call the new room wall thick, enlarged, and the door tightly closed. This is to do color ultrasound. In addition, we should check the urine routine to see if there is a problem with the renal function, and exclude the secondary pathological changes of the kidney. See if there are problems such as kidney function, liver function and myocardial enzymes.
It is also very important to check blood fat and blood sugar. We call them biochemical items, at least four. If you don't know your blood pressure well, you should carry a 24-hour blood pressure monitor.
Host: Another friend said, why do some patients with hypertension need to measure their blood pressure regularly?
Wen Shaojun: We also suggest that patients should monitor while taking medicine. Because the elderly, in addition to high blood pressure, have cerebrovascular problems, heart problems. Doctors in our cardiology department are willing to lower their blood pressure. For example, 110/70 is appropriate. In the elderly, when the heart is comfortable, he is dizzy and the cerebrovascular pressure can not go up, which may lead to cerebral ischemia or cerebral thrombosis.
So there are several advantages to measuring blood pressure. One is that you know whether your blood pressure is effective after taking medicine, and to what extent it will fall. If it falls too low, it is easy to have cerebral thrombosis. If it falls too high, it will be adjusted in time.
Moderator: Audience friends are watching the program of the famous doctor hall live broadcast on Sina Health and Medical Forum. While we are talking, audience friends can ask your questions through the interactive platform and we will answer them on the spot.
Netizen: I have high blood pressure for two years now, and my heart rate is about 56 recently. I always feel dizzy. Is there something wrong with my heart, and my eyes will be empty and my legs will be swollen.
Wen Shaojun: I didn't say how much the blood pressure was, nor the situation of taking medicine. Hypertension patients can be accompanied by many complications. For example, if the patient's blood pressure is relatively high, his heart is relatively large, and his legs are swollen, it is possible that the heart of hypertension has a problem, and he may have cardiac insufficiency. For example, his heartbeat is in his 50s, and there is edema in his lower limbs. It should be suggested to have a heart ultrasound, and people should talk about color ultrasound. I also have a 24-hour ECG. Just now, I said that blood pressure is good, which is good for the heart. Check whether you jump too slowly. If you jump too slowly below 44 and have long intervals, you may need to install a pacemaker.
This is the only way to analyze it, because there are relatively few data. There are also some patients with hypertension who take the drugs of horizon, calcium antagonists, and some calcium antagonists have adverse reactions while lowering blood pressure, including some dry people, and some people have mild edema in their lower limbs, such as socks, which need to be changed.
This patient will see if it is a problem of taking medicine, heart failure or kidney. It is suggested to go to the hospital for further examination, find a professional doctor, take all the information, and the doctor will check before prescribing medicine.
Netizen: My blood pressure difference is relatively small, and I often feel dizzy. Which arm is the best for blood pressure measurement, and the pressure difference between my two arms is about 10.
Wen Shaojun: The systolic pressure and high pressure are different from each other. This is normal in the human body. It doesn't matter that the blood pressure of each person is different. Measure whichever side is OK, as long as it is high, it means high blood pressure.
Host: Does he often feel dizzy?
Wen Shaojun: I said about 120 before, but I didn't say low pressure.
Moderator: 100-125.
Wen Shaojun: 100 is low pressure, so you should take medicine. It is high pressure. We call hypertension high pressure and low pressure, systolic pressure and diastolic pressure. He should take medicine if his diastolic blood pressure exceeds 100.
Moderator: It is better to find a professional doctor to prescribe drugs suitable for his own condition.
Next, we will talk about the treatment of hypertension. A friend said that what should we do if we get hypertension? Maybe we should go to see a doctor in time. What is the main purpose of treating hypertension patients?
Wen Shaojun: It was originally in the 1970s and 1980s for the purpose of treating hypertension. Why is this disease seldom treated? That is to say, as long as there is a drug that can lower blood pressure, it will be achieved. First of all, and our first goal now is to reduce blood pressure, effectively reduce blood pressure, and control blood pressure to a stable state, which is the first.
Second, it is more important to see whether the heart, brain and kidney can be protected after lowering blood pressure. If you have finished lowering your blood pressure, the person will suffer from cerebral thrombosis, enlarged heart, or kidney problems in two years, this medicine must not be good.
So when a drug is evaluated or we choose this drug for treatment, we must first reduce blood pressure. More importantly, it protects the heart, brain and kidney. Doctors should choose from many drugs and do many clinical experiments. What is the ultimate goal? The ultimate goal is to control the blood pressure, protect the heart, and then reduce the incidence of cardiovascular and cerebrovascular events, or reduce the overall mortality, which is our ultimate goal.
For example, it is not terrible that this person has high blood pressure. We give him normal medication, use some more correct drugs, and the combination medication is better. He has no cerebral thrombosis or heart problems for five or ten years. His kidneys are also very good, and the quality of life is also very good, which is to achieve the goal.
Host: Many friends are concerned about whether they have to take medicine for life. If they pause in the middle, can they control hypertension through food without medicine. Or use other methods without food. What are the methods?
Wen Shaojun.
Host: Professor Wen mentioned just now that exercise is very helpful to hypertension. How much exercise is good for it?
Wen Shaojun: We are amateurs in sports. We recommend patients not to do strenuous exercise if they have high blood pressure and cannot control it well. It is better to do aerobic exercise, such as cycling and environmental protection, fast walking, swimming, jogging, and shadowboxing. One thing is to go step by step, and the following sentence is perseverance. If you remember today that it's dangerous to suddenly exercise, we call it exercise experiment. That is to say, if you have high blood pressure, your heart is not clear, and your brain is not clear about the extent of the disease. When I think about it today, I will exercise hard, and tomorrow I will not have time or do not exercise for half a month, which we do not advocate.
Host: I often hear of the word "control blood pressure". What is the best level to control?
Wen Shaojun: According to the guidelines of various countries, including China, hypertension will fall below 140/90 in general. There are several special groups that need special attention. One is that the elderly, especially those over 65 years old with mild cerebrovascular disease, should not be so strict. You don't have to let your blood pressure fall below 140. It may fall to 150, which is more comfortable.
There is also a group of people with complications, such as those with sugar metabolism, kidney disease, and poor heart function. It is better for these people to lower their blood pressure below 138, or some people say 135/85, which is 10 mmHg lower than the standard.
Compere: The goal of controlling blood pressure is different for different people.
Wen Shaojun: Yes.
Moderator: What are the drugs and categories of hypertension treatment?
Wen Shaojun: There are a lot of hypertension drugs available now, but actually there are six categories. Why are there so many kinds? It means that there is no unique effective medicine. If there is one that is particularly effective, just remove all the others.
Why? Because hypertension itself is a comprehensive factor. It does not mean that the heart beats fast or the blood pressure is high, nor does it mean that the blood vessels contract or the blood pressure is high. For example, if there is more water in the blood vessels, the blood pressure is high, if the blood vessels are tight, the blood pressure is high, and the heart beats hard or jumps more often, many factors are put together.
So we have five kinds of drugs to solve these problems. For example, we use diuretics, vasotension or vasoconstriction when we have too much water. We use angiotensin converting enzyme inhibitors, or receptor antagonists. People call me taking drugs like sartan or pril. One is calcium antagonist. In addition, in order to prevent the heart from beating too fast, there is also a kind of tissue agent called b e t a.
In addition, there is an innovation to combine several medicines. My steamed bread is not enough to add a bowl of rice. He puts steamed bread and rice together, which is equal to six categories of medicines.
Moderator: Once the control of hypertension is stable, can we stop or suspend medication in this situation?
Wen Shaojun: We suggest that under the guidance of doctors, we stick to medication, regularly review, and adjust under the guidance of doctors. In general, most patients with hypertension should take medicine for life.
Some people came and said that my blood pressure is normal now. I explained to him that your blood pressure is normal. It's not your disease. It's the medicine that works.
There are also some patients whose blood pressure is very high when they come. They haven't come for a period of time. They say that I have something to do with myrrh at home and I haven't taken it. This is very dangerous. You can control it well when you take medicine. If you don't take blood pressure suddenly, cardiovascular and cerebrovascular diseases will easily occur.
I also joked that if there is no food in your house, do you have to go to the grain store to buy it three days in advance? Just like this, your medicine is going to run out. If you can't, go to a small place to get some medicine first. Be sure to take medicine continuously. If not, your blood pressure will fall after taking medicine today, and will rise after two days without taking medicine. It's even worse to toss yourself around.
Compere: Hypertension patients with diabetes are not special. What should they pay attention to in their treatment?
Wen Shaojun: Diabetes is a very large group in China. Many elderly people have high blood pressure, dyslipidemia and blood sugar problems, which is a very difficult complication. Generally speaking, we should study each person's situation more carefully and give individualized treatment to diabetic patients. After each patient has finished the examination, they should choose a few drugs, not just a few drugs at random. Generally, we use several drugs, one of which is the antithrombotic drug aspirin. One way to reduce blood sugar is to reduce it very well. If the blood sugar of the elderly is high and oral control is not good, it is recommended to take insulin as far as possible.
When glucose metabolism is combined with hypertension, it is better to use Puli, which is called ACEI. There are also sartans, which protect the blood vessel wall and the kidney better than the heart and brain.
Netizen: Female, 38 years old, weighs 65kg and is 160cm tall. In June, he was hospitalized due to an acute attack of hypertension. At that time, the doctor asked for coronary angiography, but he was afraid of the risk of not doing it. Now I often have chest pain and chest tightness, and take aspirin for a long time. Do I need to take other medicines? If you want to lose weight, what kind of exercise is suitable for you, will it affect your condition, and what should you pay attention to when exercising?
Wen Shaojun: Does she hurt when she moves.
Host: I often have chest pain and tightness.
Wen Shaojun: This kind of exercise should be checked first, not weight loss exercise first. He said that there was pain after special activities, so we should do an experiment. When it hurts, we should take medicine, and it will be better soon. This is hypertension combined with coronary heart disease. When you have coronary heart disease, because the hospital asked him to do coronary angiography for a certain reason, she didn't say that the ECG might be ischemic, and the doctor considered whether she had early coronary heart disease.
In this case, do not exercise. It is recommended to go to a regular hospital for a detailed examination. If she is unwilling to do coronary angiography, because coronary angiography is invasive and needs to be hospitalized first, she can do coronary CT first to see if there is stenosis in the heart vessels, or do isotope examination.
Netizen: Is foot soaking effective in reducing blood pressure?
Wen Shaojun: Because I haven't done this experiment, but in theory, especially for the elderly, it's cold weather. Some people have seen whether it has decreased. I didn't do this because I didn't do it. Where do I think this is? After soaking feet, the distal lower limb blood vessels dilated, and the blood flow in the whole body was relatively smooth, unlike when the blood vessels were stretched hard when it was very cold, which might reduce blood pressure. It is unscientific to treat hypertension in this way and plays an auxiliary role.
For example, some people, especially in the northern region, have their feet soaked in winter, and then sleep well. Some people say they put some Chinese medicine in it. I think it's not bad to have feet soaked in Chinese medicine. But I can't say that it is to lower blood pressure or treat hypertension, which I think is unscientific.
Whoever is interested can do an experiment.
Host: No matter what, this is definitely helpful for our health, but we can't rely on it to cure hypertension. Finally, we would like to talk about prevention. If we are the family members of hypertension patients, what suggestions do we have for their families?
Wen Shaojun: First of all, hypertension is a disease, and there are two factors affecting it. One is the genetic factor, which is what your parents gave you and branded you when you were born. This genetic factor accounts for about 40%, and the remaining environmental factors account for 60% of the impact on hypertension, that is, you eat, drink, smoke, drink, do not exercise, obesity, and mood.
In these two cases, heredity has no way. For example, just joked that there are two candidates. Do you have a house or a car? How does it look? What's the situation at home. In fact, we should ask whether our parents have high blood pressure. If there is hypertension in both men and women, the probability of hypertension is high, which is hereditary.
In addition, prevention should focus on its risk factors. There is no way for heredity, you can't choose this, but what you choose is environmental change, that is, you should live healthily.
There are four cornerstones of cardiovascular health, also known as the Victoria Declaration. One is reasonable diet. You should be able to eat reasonably. Just now I said don't eat too much, don't eat too salty, drink less, don't drink too much, and don't smoke. In terms of diet, you can eat anything, meat and eggs, but you should eat less.
Hong Zhaoguang said "One, two, three, four, five, red, yellow, green, white and black". In fact, he told everyone that the more miscellaneous you want to eat, the better, but you should eat less. It is needless to say that everyone knows about smoking cessation and alcohol restriction, proper diet, smoking cessation and alcohol restriction, proper exercise, and psychological balance.
Host: The most important thing is to balance the psychology, and the second is to cooperate with a healthy lifestyle. Because of the time, we will no longer answer the questions of our friends one by one. Thank you very much, Professor Wen, for being a guest of our famous doctor's hall. Thank you for your constant attention and questions. Today's program is over. Famous doctors gather to talk about people's health. See you next program.
Wen Shaojun: OK, thank you.