Professor Yang Xinchun, Director of Heart Center of Beijing Chaoyang Hospital, Deputy Director of Heart Center of Beijing Chaoyang Hospital hypertension Professor Zhong Jiuchang, the head of the discipline, jointly pointed out that to manage hypertension well, we should start from the morning every day, especially the blood pressure at 6 to 10 o'clock every day!
Many people don't manage their blood pressure well in the morning
"Not every patient with hypertension has dizzy , headache and other symptoms. Many patients with hypertension never have symptoms and never know that they have this disease. They often fall ill and are sent to the hospital. When the high pressure is 160, they know they have high blood pressure. " Professor Yang Xinchun, standing member of the Cardiovascular Branch of the Chinese Medical Association and deputy leader of the Hypertension Group, and director of the Department of Cardiology of Beijing Chaoyang Hospital, said that there are many problems in self-management of hypertension patients at present.
Research shows that more than 60% of the patients whose blood pressure has been controlled in the consulting room have not controlled their blood pressure in the morning; 94.9% of the patients with uncontrolled blood pressure in the consulting room had uncontrolled blood pressure in the morning. At present, many hypertensive patients in China do not take medicine without dizziness, do not regularly monitor their blood pressure, and stop taking medicine at will. This not only brings hidden dangers to patients' health, but also becomes a long-standing problem of Chinese style hypertension management, which leads to poor control of blood pressure and eventually leads to serious cardiovascular and cerebrovascular diseases. Once hypertension patients cannot effectively control their blood pressure, resulting in stroke and other diseases, they may die or become bedridden and disabled due to hemiplegia, which is a heavy blow to patients and their families.
Blood pressure peaks in the morning
The number of hypertensive patients in China is about 270 million, and at least half of the 3 million cardiovascular deaths every year are related to hypertension. Early morning blood pressure management is the weak link of hypertension management in China, and also the pain point for many years. Professor Yang Xinchun said that for most patients with hypertension, their blood pressure will reach the highest peak in the day in the first few hours (usually between 6:00-10:00) after waking up in the morning and starting daily activities.
In addition to its own pathophysiology and other factors, the reason for improper blood pressure management in the morning of patients is also the problem of drug use. Many patients can not control their 24-hour blood pressure with antihypertensive drugs. If the patient takes short-term antihypertensive drugs and so-called "long-term drugs", the efficacy cannot last for 24 hours. The drug concentration is low before taking the drug the next morning, the efficacy is weak, and the blood pressure cannot be well controlled, leading to blood pressure fluctuations. The morning before taking the medicine is also the high incidence period of cardiovascular and cerebrovascular diseases, miocardial infarction Cardiogenic sudden death and cerebral apoplexy Cardiovascular and cerebrovascular diseases often occur in this period. From the perspective of treatment, the key point to control morning blood pressure is to choose real long-term molecular antihypertensive drugs.
It is very important to reach the blood pressure standard in the morning
"At present, blood pressure management has gradually changed from the traditional focus on the amount of blood pressure reduction to the focus on the quality of blood pressure reduction. The blood pressure in the human body is constantly changing within 24 hours. Even in healthy people with normal blood pressure, the blood pressure will show a more obvious day and night pattern, which is manifested in the obvious drop of blood pressure in the first few hours of sleep, and the obvious rise of blood pressure in the morning. If the blood pressure in the morning obviously rises too much, it belongs to a pathological state and is harmful to the human body. " Professor Zhong Jiuchang, member of the Hypertension Expert Committee of the National Cardiovascular Center and deputy director of the Heart Center of Beijing Chaoyang Hospital, pointed out that while blood pressure reduction seems simple, it is actually a very complex problem. It is necessary to consider the circadian pattern of blood pressure of hypertensive patients and consider the morning blood pressure, night blood pressure and drug blood concentration 24 hours after taking the drug. It is the absolute principle to achieve the goal of lowering blood pressure, reaching the goal early and reaching the goal of blood pressure in the morning.
Professor Zhong Jiuchang suggested that hypertension patients should measure their blood pressure first thing when they get up in the morning. In addition, for patients with poor blood pressure control in the morning, it is better to get up 3-5 minutes after getting up and take a long-term antihypertensive drug once. This is not only conducive to controlling morning blood pressure, but also convenient for long-term antihypertensive drugs with good compliance.
The focus of blood pressure management is at the grass-roots level
Hu Yunling, director of the medical office of Beijing Chaoyang Hospital, pointed out that the management of blood pressure in the morning is a very important concept and a starting point for blood pressure management. At present, most patients with hypertension are followed up in community hospitals for a long time. The focus of blood pressure management in the morning is at the grass-roots level, and community hospitals will have more room to play in this regard. Hypertension is a disease that needs long-term management and regular monitoring of blood pressure. The original intention of establishing blood pressure management mode is to sink excellent medical resources to the grass-roots level, and effectively strengthen the training of community doctors at the grass-roots level and the health education of hypertension patients. Health Times reporter Yang Xiaoming
