Hello, Sina netizens!
Host: Famous doctors gather to talk about people's health. Good afternoon, all Sina netizens. Welcome to the famous doctor hall broadcast live by Sina Health and Medical Forum. I'm Cui Yinmo. While broadcasting the program, you can also communicate with experts through the interactive platform. Today, I would like to talk about the prevention and treatment of hypertension. Hypertension is a very common chronic disease, which greatly affects the quality of life of patients. In addition, the treatment of hypertension requires patience and a long process, which is also a difficult problem for many people. Today, I specially invited Professor Huang Li, the director of the Department of Cardiology of Integrated Traditional Chinese and Western Medicine of the China Japan Friendship Hospital, to talk to you. Hello, Professor Huang.
Huang Li: Hello, host and netizens. I'm very glad to be a guest of the Medical Forum today. April 7 is the World Health Day. Its theme is to control hypertension and prevent cardiovascular and cerebrovascular diseases. Today is also the past two days of April 9. We are talking about hypertension in newspapers, news and the Internet these two days. Because the incidence of hypertension is also very high now, our country has reached 200 million people, and this trend is still rising. So today we talk about this issue, which is also a key issue in the prevention of cardiovascular and cerebrovascular diseases.
Moderator: Now everyone is actually a focus. First, from a case, what problems do hypertensive patients have to solve. Mr. Zhang in Inner Mongolia is 55 years old. He has suffered from hypertension for five years. He has always taken captopril until now. In the last two years, he felt that his blood pressure could not be controlled and was very unstable. Mr. Zhang was hospitalized. When he was hospitalized, he found that his blood pressure was 150/109, which was diagnosed as Grade II hypertension, and there were left ventricular hypertrophy, heart, brain and kidney damage organic lesions, but his function was still compensatory, Mr. Zhang is particularly puzzled. He thinks that he has always insisted on taking antihypertensive drugs. Why can't he control his blood pressure and how to treat it.
Huang Li: Just now the host said about this case. This gentleman is 55 years old and has suffered from hypertension for five years. That means he suffered from hypertension at the age of 50. After suffering from hypertension at that time, I don't know whether he seriously went to the doctor to see the disease. Three times, it was more than 140/90. The diagnosis was no problem. During the treatment, if he only used captopril, his blood pressure was still 150/90, and still did not reach the standard. If we want to treat hypertension, we must make him reach the standard. Generally, we should reduce it to 140/90. If there is diabetes, kidney damage or coronary heart disease, we should be more strict and control it to 130/80. Captopril is actually a short-term antihypertensive drug. When the blood pressure is extremely high in clinical use, we need to immediately lower the blood pressure of him, and only use this drug when temporarily reducing blood pressure. Now it is no longer used as a routine daily drug in clinical use. Because it is a short-term effect, its duration is very short. When we treat hypertension, it is better to maintain it for 24 hours to make our blood pressure drop very gently, rather than once it drops, which is bad for our cardiovascular and cerebrovascular diseases.
In the past five years, if you have taken antihypertensive drugs and reached the standard, it is to control hypertension. A few days ago, my patient's daughter brought him here. She suffered from hypertension for more than 20 years. Her blood pressure was not well controlled from the first bleeding to the bleeding, and she suffered from cerebral infarction twice. She said that my father had been taking antihypertensive drugs, and she did not know that taking antihypertensive drugs must make it reach a certain standard. There are many kinds of antihypertensive drugs. I don't think Mr. Zhang has seen a doctor very well. As a real clinical hypertensive cardiovascular doctor, I will prescribe drugs for him. If I prescribe this drug here now, I will not prescribe it for him. There are many antihypertensive drugs to choose. The antihypertensive drugs suitable for him are stable antihypertensive drugs for 24 hours. If one antihypertensive drug is not well controlled, we will cooperate again. Sometimes, two kinds and three kinds work together to make the standard below 140/90. If he has kidney damage and diabetes, our standard should be 130/80. This is not a sudden. It will take us two weeks to a month to make him reach this standard, and we need to monitor him frequently. It does not mean that we don't see a doctor or take blood pressure after taking antihypertensive drugs. We think it is OK to take it. This method is wrong.
Moderator: So Mr. Zhang may have used such a drug five years ago, and he always thinks that I am continuously taking drugs to reduce blood pressure.
Huang Li: Yes, but he didn't monitor his blood pressure very well. Maybe he didn't have symptoms for various reasons some time ago. In clinical practice, we also encounter this kind of patient. There is no symptom when we take a blood pressure measurement in the outpatient department. It is a mistake to think that if there is no symptom, there is no disease, or if we take medicine, we can control the blood pressure without pain or distension.
Host: When I introduced you just now, I talked about the integration of traditional Chinese medicine and western medicine. I want to know whether the concepts of traditional Chinese medicine and western medicine have different understanding of hypertension?
Huang Li: Hypertension is named after Western medicine. The increase of arterial blood causes a series of changes in heart, brain and kidney. The name of the disease in traditional Chinese medicine is different from that in western medicine. The name of the disease in traditional Chinese medicine is based on symptoms. The most common name of hypertension patients is dizziness and vertigo. The name of the disease in traditional Chinese medicine is vertigo or headache. His treatment method and understanding of his disease are not the same.
Host: You may know more about western medicine for hypertension. For example, Mr. Zhang just said that he insisted on using western medicine to treat hypertension. Then many people think again that if Mr. Zhang proves that his monitoring may be unfavorable, it will really have no effect on him. If he had used traditional Chinese medicine, would it have cured him?
Huang Li: We said that the development of hypertension has a process. If it is early hypertension, it has not been long since it was discovered. As a hypertension guide, early hypertension is also mentioned, which means that we can spend three months to adjust our life. Because there are many people with early hypertension, it has a certain reason. For example, I now meet many young people in the clinic, and suddenly the blood pressure is very high, because he is very busy with his work and often travels on business. Some people often go abroad for jet lag, work very busy, or add a task to the old board. These two days, he can't sleep after working overtime every day, and he is nervous. Or something happened recently at home. For example, an old man suddenly became ill and worried, or a child became ill and worried. This period of mental stress is a kind of patient.
There are also obese patients who have been overweight since their arrival. They have met in the clinic. One patient is 1.7 meters tall and weighs nearly 100 kilograms. This situation is very fat. He eats salty food every day, eats too much, has too much oil, has high blood lipids, never exercises, drives outside, takes the elevator, eats salty food, smokes and drinks. This is a bad lifestyle, Causes high blood pressure.
In the first three months, we asked him to get rid of his bad habit. After he got rid of his bad habit, some patients would be able to do so because his blood vessels did not harden at the time of first onset, and his blood pressure could return to normal. At this time, we will cooperate with traditional Chinese medicine. Traditional Chinese medicine is used in the early stage of hypertension and pre hypertension. What is prehypertension? Our diagnosis of hypertension is different. When the systolic blood pressure is greater than or equal to 140 and the diastolic blood pressure is greater than or equal to 90, we diagnose hypertension.
Normally, our blood pressure should be 120/80 when it is very standard. We have exceeded the stage of 120-140. The following stage of 80-89 is less than 90. We call it prehypertension. Then some patients with prehypertension will develop into hypertension, and then prehypertension. These patients can completely control and improve their bad living habits, Then, with the help of our Chinese medicine, we can turn his blood pressure from high blood pressure to high blood pressure.
Moderator: In the case just now, Mr. Zhang was diagnosed as Grade II hypertension, which should be a Western medicine statement. Is there a corresponding grading method in TCM?
Huang Li: Traditional Chinese medicine does not treat hypertension. In traditional Chinese medicine, we treat diseases according to syndrome differentiation. Traditional Chinese medicine does not treat hypertension according to its level. In western medicine, the level of hypertension is based on the level of hypertension and the damage it causes to target organs. We define it as low risk, medium risk, and extremely high risk. The thinking mode of traditional Chinese medicine is mainly to treat patients based on syndrome differentiation. Even if we have hypertension, we are also different from each other. There is the situation of fat people I mentioned just now. We see him as fat. We think he is fat, with thick tongue coating. We think he is phlegm wet, and his pulse is slippery. When we look at him, we see him as phlegm wet, We use these drugs to dissipate phlegm and remove dampness.
Others are as nervous as I said just now. Some people have red eyes, red cheeks, and fight with people all day long. For those with the upward trend of liver fire, we clear the liver and remove the fire. Some patients have low back acid, fatigue, and five-star hot flashes. In this case, they nourish the liver and kidney, and their face is dark. The patients are suffering from pain. In this case, we use blood circulation to dissipate stasis. The treatment of patients should be based on syndrome differentiation, which type they belong to, and which method to use according to the diagnosis.
Just now, there was also a time of integration of traditional Chinese medicine and western medicine. I made a survey with graduate students in clinical practice, and many experts and scholars also did some research. It was found that the level of western medicine for hypertension has a certain regularity with the differentiation of symptoms and signs of traditional Chinese medicine. For example, patients such as Grade III hypertension or extremely high-risk patients, extremely high-risk patients complicated with cerebrovascular disease, cardiovascular disease, diabetes, high blood pressure patients such as this kind of target organ damage, mostly belong to the phlegm and siltation of traditional Chinese medicine, yin and yang deficiency this type of bias. Both primary hypertension and secondary hypertension tend to fight against liver fire and liver yang due to yin deficiency of liver and kidney. We found this law by comparing traditional Chinese medicine with western medicine.
Just now, Mr. Zhang has been ill for 5 years. I'm afraid that the effect of this situation is not very good if only treated with traditional Chinese medicine. The treatment of hypertension with traditional Chinese medicine has its own characteristics. One is that the early stage of hypertension I just mentioned can help him restore his blood pressure to normal. The antihypertensive value of traditional Chinese medicine cannot catch up with that of western medicine, which has been studied for many years because of many kinds of drugs. But traditional Chinese medicine also has its own characteristics. First, traditional Chinese medicine has a slow blood pressure drop. Unlike taking antihypertensive drugs, patients reach the standard in a week or two. Traditional Chinese medicine has a process.
Second, there is another characteristic of traditional Chinese medicine, which is very good for relieving symptoms. In our clinical practice, although some patients take western medicine to lower their blood pressure, some patients are uncomfortable and have headaches, some patients do not have dizziness and headache, but have dizziness and headache after taking antihypertensive drugs, and some patients have dizziness and headache, and their blood pressure drops after taking antihypertensive drugs, and these symptoms still appear. The combination of traditional Chinese medicine and traditional Chinese medicine can alleviate these symptoms, which will improve his quality of life and his work.
In some cases, there are some symptoms that can induce and aggravate hypertension. For example, insomnia, the most common form of hypertension, has many patients with hypertension. When they came to see me, they measured their blood pressure. Today, 160/95, they usually controlled well. What happened today, he said that I didn't sleep well last night. This is not one or two. Many patients with hypertension have this. If they don't sleep well, their blood pressure will rise. At this time, we added Chinese medicine to calm his nerves, customized to purge his heart fire, slept well, and naturally his blood pressure fell. The combination of traditional Chinese medicine and western medicine can improve his symptoms.
Another situation is that some patients are unable to get down after using various antihypertensive drugs. As we will also mention later, it is called refractory hypertension. What is refractory hypertension? Because there are many kinds of antihypertensive drugs, we have used three kinds of antihypertensive drugs, including diuretics, but the blood pressure can not be lowered. In this case, if we cooperate with traditional Chinese medicine and integrated traditional Chinese and western medicine to treat it, we can control the blood pressure within our ideal range.
Compere: So the combination of traditional Chinese medicine and western medicine does have its special advantages. It can supplement the aspects that western medicine cannot achieve at present.
Huang Li: Yes.
Host: In fact, when we usually talk about hypertension, we often compare it to an invisible killer. Because patients with hypertension often have a decline in their quality of life, and eventually a disease that may endanger their lives is often not hypertension but related to hypertension. So we want to know what factors in life can make an invisible killer take advantage of?
Huang Li: Why is hypertension called an invisible killer? Some patients with hypertension have symptoms, and some patients have dizziness and headache. But some patients in our hospital have sudden hemiplegia, sudden cerebral hemorrhage or sudden heart problems. But he never knew that he had hypertension. He came here to take a look at the blood pressure, which was very high. He looked at the fundus of his eyes to level 2 and 3, Why is it called invisible killer? Because some patients feel no symptoms. A considerable number of hypertensive patients have no symptoms, so no symptoms does not mean that you do not have the disease. We should often do some physical examinations. I often tell patients in health education that you always have three treasures at home. The first one is a sphygmomanometer. You often measure yourself.
Host: No matter whether you are sick or not.
Huang Li: Of course, we can do some physical examinations every year. The doctor can measure your blood pressure better. The doctor can't measure your blood pressure. You have a sphygmomanometer at home to measure your blood pressure regularly. This can monitor your blood pressure. It doesn't mean that your blood pressure is normal if you have no symptoms. In the case of the two young people I just introduced, he has suffered from cerebral infarction and cerebral hemorrhage. In fact, his blood pressure has not been controlled for a long time, which is why this situation occurs. We should pay attention to monitoring our own blood pressure at ordinary times. If there is a problem, we should see a doctor in time.
Hypertension is not just a matter of increased blood pressure, it is very harmful. It mainly damages what we call target organ damage, which directly damages organs, and one is our brain. Therefore, some patients who often come into contact with know that people who often go on the street to see how someone is limping, that is, they have cerebral infarction caused by hypertension or sequelae caused by cerebral hemorrhage. Therefore, the disability mortality rate caused by hypertension is very high, which is also in this regard. His harmfulness causes our cerebral stroke.
The second is to cause damage to the heart. Because after the blood pressure is too high for a long time, the pressure on the heart is very high, the heart muscle is hypertrophic, and atrial fibrillation, and finally serious heart failure occurs, causing damage to the heart.
The third is the damage to the kidney. It is estimated that some patients can also hear about who goes to dialysis for artificial kidney. In fact, some patients suffer from renal failure caused by hypertension. At the beginning, proteinuria may occur, which will gradually lead to renal function.
So a patient with high blood pressure came to see a doctor, not only to measure blood pressure, but also to give him a comprehensive scan of the whole target organ, to give him a comprehensive check to see whether there is arteriosclerosis in the fundus of the eye, and then to do a B-ultrasound to see whether there is plaque or stenosis in the carotid artery. If some patients want to often have dizziness and headache, When necessary, we should make a rheoencephalogram and a head CT, and pay attention to this situation. We need to do routine cardiology, ECG to see if the heart is damaged, urine and microalbuminuria to see if the kidney is damaged, so it is very harmful to the heart, brain and kidney.
There is another complication we call hypertension. The complication of hypertension is heart, brain and kidney, and another complication is diabetes. So some patients with hypertension have abnormal blood glucose for a period of time, and many patients with diabetes have abnormal blood pressure, because their common pathogenesis is insulin resistance. They have the same pathogenesis. They are easy to become brothers and sisters with diabetes, so patients with high blood pressure are easy to get diabetes. If you have high blood pressure, I often do sugar tolerance experiments in the outpatient clinic, and patients with diabetes must have their blood pressure measured.
It is also easy to combine coronary heart disease, because the damage of vascular endothelium caused by hypertension is very high, and the high blood fat and hyperlipidemia cause arteriosclerosis, which leads to myocardial infarction and angina pectoris in coronary heart disease, or for example, some patients like us suddenly install a stent and bypass, and check what high-risk factors are there, Hypertension is an important factor.
Host: In fact, many patients with diseases, not only those with hypertension, are particularly fond of seeking medical advice when they are ill. They are particularly prone to believe in false advertisements. We often see various false advertisements for the treatment of hypertension in our lives. How can we identify them as ordinary patients?
Huang Li. In this case, if the blood pressure returned to normal immediately after taking the medicine and did not take the medicine for life, it would have won the Nobel Prize. Such false advertisements, for example, often make some pretences. For example, it is very scientific. After some certification, the effect of taking medicine is very good. The cure rate is 100%. After eating it, he will never take medicine again. In fact, there are many ambushes here.
Some patients agree with the doctor, so he took these to me. When I saw that it was fake, I said you should never believe it. However, some patients did not consult the doctor. They listened to someone or took the paper. Some patients made some advertisements in the park and trusted others. I was very impressed. One patient spent more than 6000 yuan on health care products. He thought that his blood pressure could be lowered after eating health care products, but his blood pressure came up after eating them. What did I say? The control was very good some time ago. He said I believe that.
If the patient hears that there is a good way, 100% of what and so on. If you are not sure, you can go to the doctor and ask him to give you a reference to see whether it is true or not. Don't blindly believe in false advertisements. This will make your condition worse, and eventually cause heart damage. It will be very boring to have a stroke again.
I also met some patients who drank mung beans. They stopped all the antihypertensive drugs. They drank mung bean soup every day and their blood pressure went up. They asked me what was going on. It turned out that they had listened to some people's introductions. So I think that the communication network is also very developed now, and there are also many media for newspaper publicity, so all kinds of publicity may come. But we should learn to recognize. If you don't understand, please consult a doctor. After all, we have worked here for so many years, and we know more about how to treat hypertension.
Compere: It is true that there are too many advertisements of various kinds now. Everyone should be clear eyed. My experience is that if your writing is more uncertain, it is actually more unreliable. What about a cure every three days? I think that if you said just now that you have won the Nobel Prize for a long time, at least it will be popularized nationwide, and then you must consult a doctor with a fluke mentality. There are other things like mung beans that sound harmless, but you must not stop taking the medicine.
Huang Li: Yes.
Moderator: Many patients believe in simple methods and think it is too troublesome to take medicine every day. They might as well drink some mung beans. Once they stop taking medicine, their treatment will be delayed.
Huang Li, Don't eat something wrong again. Isn't it more terrible to eat something else?
Host: As you said, sometimes false advertisements are very expensive. At a cost of more than 6000 yuan, our patients still stay away from false advertisements and go to the hospital regularly. Just now I heard that the first thing necessary for patients is a sphygmomanometer. Especially for patients with hypertension, they should also check their blood pressure regularly if they have no problems. But I heard many patients' reactions. He thought that the traditional sphygmomanometer was troublesome, but everyone thought it was accurate. Now there is a very simple electronic sphygmomanometer, and many people think the data is inaccurate. Is there such a difference?
Huang Li.
Second, we sometimes don't listen very accurately at home, so now we have an electronic sphygmomanometer, which is used in our family. This sphygmomanometer is used by many patients in my outpatient department. I would like to give you a suggestion. For example, when the family comes to measure the blood pressure, if you don't feel relieved after the measurement, you can take the sphygmomanometer to the hospital and check it with our mercury staff. Generally speaking, the electronic sphygmomanometer can be five millimeters of mercury lower than our mercury. For example, if you measure 145/35 at home, you measure 140/30 here. A little lower. Some people are nervous when they arrive at the hospital, so the mercury ones that do not use electronic ones can also be compared with ours.
Compere: Look at the difference. Add this.
Huang Li: Yes, you can use it with this. And blood pressure can't be counted on for a week. Some patients take their blood pressure once a month, which is wrong. If your blood pressure is unstable, take it every morning and evening. If this period is stable, you should measure it at least once a week. It refers to that the doctor comes to take the medicine once a night, but takes it occasionally once a month. It can't judge whether your blood pressure is very stable in this month.
There are also many kinds of electronic sphygmomanometers. There are arm type and wrist type. The arm type is more accurate than the wrist type. If we have an electronic sphygmomanometer at home, we'd better use the arm type. Also pay attention to the battery. The battery should be sufficient. Sometimes the battery is almost out of power. At this time, you can't measure it accurately. So we often need to measure it. Don't have any batteries. The old woman and the old woman can't bear to see the battery. The number of the battery that you want to use can't be seen. The blood pressure you measured at that time must be low, so it is not accurate. Therefore, we should also pay attention to that our batteries must be sufficient. After a period of time, we should check to see if it has power. Don't wait until there is no power at all. It must be inaccurate when the power is almost gone.
Compere: So our equipment should be in good condition first to ensure the accuracy of our measurement data.
Huang Li: Yes. Time is also very important when measuring. Sometimes, just after eating, just after drinking coffee, just came from outside to measure directly. The measurement is definitely inaccurate. It is necessary to have a rest, some of them hold their urine, and then come over to measure is not good. It must be quiet and stable when coming over to measure is accurate.
Compere: Find a comfortable state and time for yourself.
Huang Li: Yes.
Moderator: Is it right for the patient to set a time point every day? For him, it is OK to set a time point, or do we suggest that it is better to set a time point every day?
Huang Li: Generally speaking, hypertension has two peaks, one is a peak when it comes together, and the other is a peak when it comes together in the morning. Because the sympathetic nerve is excited when the human body sleeps together, the blood pressure is a peak when it comes together. There is a peak at two or three o'clock in the afternoon. I suggest that if you have retired at home, you should measure at these two points. Of course, if some office workers have no time to measure at 2 or 3 o'clock in the afternoon, which is the right time for work, they should measure at home sooner or later. On Saturdays and Sundays, we should monitor the lunch at noon, so that we can have a record.
Our electronic sphygmomanometer has an automatic record. After you measure it, it has an automatic record. For example, there is no time to record the measurement. For example, if I want to see a doctor one month, it is better to record the number of measurements in it, the date of the month, and the minute of the time. Some patients are more careful and go online directly. Some patients take a piece of paper carefully. When we had a hypertension website in the past, we could input it.
Host: Make a case for yourself.
Huang Li: Yes. If our website can be promoted in the future, it means that you can go up with a little bit, and then I will know how my blood pressure transition is and how much control is.
Also, I want to emphasize that this season is spring, and my blood pressure fluctuates greatly when I am in the clinic. Because in spring, first of all, its climate is unstable. You see, it's very cold after Qingming Festival. To be honest, when I came here in a down jacket.
Host: It snowed a few days ago.
Huang Li: Yes. It didn't snow on March 20. With the change of climate, our blood pressure has something to do with cold and hot. When it is cold, blood vessels contract and blood pressure goes up. When it is hot in summer, blood vessels expand and blood pressure goes down. Generally speaking, blood pressure should be adjusted in two seasons, one is spring. When some patients' blood pressure was relatively stable during this period, he said to me, Director Huang, can I reduce blood pressure medicine now? I said you should not reduce it now. Now is the time of fluctuation, and the climate is unstable. You should not reduce it now. You should hurry to warm up. I will tell you how to reduce it in May and June.
Also, the patient's blood pressure is particularly high during this period. At this time, you should hurry to find a doctor to help you adjust the medicine, add some medicine, and then slowly reduce it when the weather is warm. This is the time of spring.
And when autumn comes to winter, blood pressure also fluctuates. Of course, there is also a theory in Chinese medicine about seasons. Spring is when the liver qi is strong, and blood pressure is easy to fluctuate. We generally regulate blood pressure in two seasons, one is in the beginning of spring, and the other is in the beginning of winter. In Beijing, the spring is getting shorter and shorter, and the short sleeves are put on immediately. After wearing it, many patients feel that when the weather is warm and the blood pressure drops, can you stop the antihypertensive drugs. So sometimes the outpatient also meets patients and automatically stops the antihypertensive drugs. There is accumulation in the body after taking antihypertensive drugs for a period of time. Many patients stop for two days and take blood pressure measurements for three days. It's fine. They will never take blood pressure measurements again. They will not take antihypertensive drugs or take blood pressure measurements. Their blood pressure suddenly rises. This day, they suddenly have a headache. At a glance, their blood pressure is 180, 170. So even if you want to reduce your medication in the summer, you must follow the doctor's advice and not stop taking the medication at once. Especially in the first two days when there is an accumulation, there is still a drug effect here. When you lose the drug, he will not measure it, and the drug will be completely excreted. It is easy to have problems with blood pressure.
Host: Hypertension is often ignored by patients themselves, but its bad effect is still going on in the body. It is said that hypertension is the enemy of cardiovascular system. Only by getting rid of hypertension can we live a long and healthy life and remove many factors that affect our life span. At present, what are the methods of traditional Chinese medicine and western medicine to treat hypertension? In addition to the initial stage you just mentioned, is there any possibility of cure?
Huang Li: If you have hypertension, you should take medicine for life. It doesn't mean that the medicine is unchangeable. After eating it, it will last forever. There are two cases. One is that your blood pressure is not well controlled after eating for a period of time. Like Mr. Zhang just said, you should find a doctor to help you adjust your medicine at this time, because we have six categories of antihypertensive drugs, including calcium antagonists, ACEI, ARB. But there are three different ways to reduce blood pressure, because if it affects blood pressure, one is the contractility of the heart, the other is the caliber of the blood vessel, the inner diameter of the blood vessel, and the blood volume. The six categories of antihypertensive drugs also come from these three reasons. When one antihypertensive drug is not effective, we can add another.
Moderator: For a patient, there may be three kinds of problems, and he may only have one or two of them.
Huang Li: Yes. It varies from person to person. If the blood pressure is not well controlled, like Mr. Zhang just now, we should find a doctor to change his antihypertensive drugs, or add some antihypertensive drugs to him, or combine several antihypertensive drugs. To interrupt this misunderstanding, take two or three kinds of antihypertensive drugs, one kind of desperate dosage, which is not the case. Several antihypertensive drugs are comprehensively treated through different ways, which is better than using a large dose of one antihypertensive drug, and the side effects are reduced, because the side effects increase with the increase of the dose. First of all, we must control the blood pressure well, so that we can ensure that the cardiovascular and cerebrovascular problems will not occur again.
In addition to the early stage mentioned earlier, the combination of traditional Chinese medicine and western medicine can improve the symptoms of refractory hypertension and target organ damage. If we cooperate with traditional Chinese medicine, we can reduce the damage of target organs.
Compere: Generally speaking, what are the main Chinese patent medicines that we commonly use?
Huang Li: As for Chinese patent medicine, there are not many kinds of antihypertensive drugs in Chinese patent medicine. There is no such thing as western medicine. Western medicine has six categories and dozens of antihypertensive drugs. Now there are more and more complex antihypertensive drugs. There is a limitation of the antihypertensive drugs of Chinese patent medicine of traditional Chinese medicine, which is that traditional Chinese medicine is treated according to syndrome differentiation, and its development is a very complex process. At present, what we just introduced to you belongs to the type of people who fight against the rising of the liver fire, who are prone to blush and red eyes, easily lose their temper, and also have dry stools and dry mouth. People with a liver fire are suitable for using bezoar antihypertensive pills or gentian sweet pills. Of course, there is no Mutong in the current Longdan Xiegan Pill. Please note whether there are some places where the drug is used in the Longdan Xiegan Pill, because it is harmful to the kidney. The Longdan Relieving Sweet Pill we produce now does not contain Akebia. Longdan Xiegan Pill or Niuhuang Jiangya Pill are aimed at the type of resistance to liver fire, and the type of resistance to liver yang due to deficiency of yin in liver and kidney. Patients can have waist acid, fatigue, red fist and night sweat, insomnia, and five heart upset fever. In this case, Tianma Gouteng Granules are suitable, and some hospitals have and some hospitals do not have. There are also cases of blood stasis blocking collaterals. You can use Chinese patent medicines to promote blood circulation and remove stasis. There are also herbs that can be used to tonify the kidney, which belong to yin and yang deficiency.
There are not many kinds of Chinese patent medicines, but the best choice is for doctors to help you, especially Chinese doctors to help you. According to your syndrome differentiation, you can use whatever kind of Chinese patent medicine you belong to. There is another Chinese medicine and western medicine that can be used together. That is to say, there is also a need to choose which one to use. It is better to ask a doctor to help you choose.
Host: Many friends are especially afraid of taking medicine, especially western medicine. Because everyone thinks that drugs are highly toxic and that taking these drugs will definitely have side effects on the body. I also heard some other people have such a theory that we eat important, integrated traditional Chinese and western medicine, and traditional Chinese medicine can offset the side effects of western medicine. Is this statement scientific?
Huang Li: After the combination of traditional Chinese medicine and western medicine, the amount of western medicine can be reduced. Because the side effects of drugs increase with the increase of the dosage, after we add Chinese medicine, its important effects increase, such as the range of blood pressure reduction, the symptoms disappear after reaching the standard, at this time, the amount of western medicine can be reduced, and Chinese medicine cooperation, which is also what we have studied in clinical practice, not casually. We use some of our scientists and experts in clinical observation. For example, after using a certain western medicine, we cooperate with traditional Chinese medicine. Of course, according to the syndrome differentiation of traditional Chinese medicine, after cooperating with a certain traditional Chinese medicine, we can reduce the amount of western medicine. After reducing, the side effects of the western medicine will be reduced. In this way, we can achieve the goal of treatment and reduce its side effects.
Compere: This is indeed the result. Many other friends are wondering, as you just said, high blood pressure is caused by three reasons. He may have tried it for several times, and finally tried his own special antihypertensive drug. Should I take it until the end? Will there be any change in my process. It may be that this situation is more serious, but later I changed. Now I am not suitable for taking this medicine. Is it consistent?
Huang Li: Six categories of antihypertensive drugs are targeted. Just now, we introduced the target organ damage caused by hypertension, including heart, brain and kidney damage. There are six categories of antihypertensive drugs, each of which has a specific purpose for the damage of heart, brain and kidney. For example, if you have kidney function damage and urine protein, you can use drugs such as angiotensin converting enzyme inhibitors, ACEI, ARB to protect the kidney and reduce urine protein selectively.
So it is up to the doctor to decide whether to take antihypertensive drugs from beginning to end. First, your antihypertensive drug can reach our target value for reducing blood pressure. What is the target value? Generally, we are below 140/90. If we have diabetes, kidney damage or coronary heart disease, we should reduce it to 130/80. If the elderly over 65 years old are relatively old, we can try our best to control them below 150. Of course, if we can tolerate it, we can reduce it a little. This has a target value. First, we should control the blood pressure to the target value. Second, we will choose antihypertensive drugs for the degree of organ damage.
There are also different types. Some people belong to the sympathetic excitatory type. Their heart rate is very fast and they are easy to be nervous, so they can choose beta blockers. If necessary, don't make your own decisions. You'd better see a doctor.
Another thing I would like to say is that some patients will always say, doctor, you can prescribe good medicine for me, and what is more expensive. But I would like to emphasize that the more expensive the medicine is, the better it is. It does not mean that all imported drugs are good. What is good medicine? First, it is very effective for treating your disease. Second, there are no side effects for you. For you, this is a good medicine, not to say that the more expensive the imported medicine is, the better.
Compere: I found that many patients are really eager to cure their diseases. Because they don't know much about it, they must pay for everything, which is different from buying things. At this time, they choose to trust doctors.
Huang Li: Another patient has a characteristic. He heard from his neighbor that he said he was very good with this medicine, so the doctor would prescribe it for me, or my brother and sister and my daughter-in-law would take it very well. He must ask the doctor to prescribe it for him. This is wrong. The treatment of blood pressure is also different from person to person.
Compere: On the surface, they are all hypertension patients, but in fact, the reasons are completely different, so different drugs are given to them for different reasons.
Huang Li: Yes.
Host: I found that most people with high blood pressure suffer from this disease for no reason. What symptoms will they have before. Is it possible for us to prevent hypertension?
Huang Li: There are not so many hypertension patients after our college graduation. At that time, infectious diseases such as pneumonia, cough and asthma were treated frequently. But now, hypertension is increasing, with the incidence reaching 200 million and gradually increasing, which means that our living habits have changed. Now our life is actually much better than before. In the past, we could only eat fish during the Spring Festival. In the past, we scored votes and bought meat and fish. Now you are celebrating the New Year every day, so it is closely related to our diet. For example, the first thing is that we eat too salty, which means that the salt itself can cause high blood pressure.
According to the World Health Organization, our salt is 6 grams. What's the concept of 6 grams of salt? Mr. Cui, you have also eaten instant noodles. The seasoning of instant noodles is 5.6 grams. A bag of instant noodles seasoning can meet your daily salt consumption. A bottle cap is equivalent to 6 grams of salt. Now we Beijingers basically eat 12 to 13 grams a day, which is too much. After that, the blood pressure may increase.
Others are called salt sensitive. Because salt is excreted by the kidney, some people do not excrete salt well. So he is very sensitive to salt, and some people eat more salt to increase their blood pressure. Others had their blood pressure controlled very well. My classmate's mother always consulted me about high blood pressure. These days, his blood pressure suddenly became high, so he called me immediately. Later, I told him how to use medicine. Later, he told me that his aunt bought him some pickles these two days, and he ate some pickles. His blood pressure had always been good with antihypertensive drugs, but these two days it went up, so salt is very important. We should control salt and eat sodium. This is also the most effective and simple way to prevent hypertension.
How can we control it outside? When ordering food, we asked what is the taboo. You said to reduce the salt by half. And we eat foods containing potassium, which can be replaced with sodium. What is potassium? Things like beans, bananas, oranges and vegetables have a high potassium content. Eating these things can replace sodium. The first is food.
The second is to lose weight, such as obesity type hypertension. He eats too much greasy food and is overweight. Also, the spirit is too tense, so we should relax the pressure of spirit, so we have several holidays a year, don't we? I suggest that you don't work overtime during the holidays, go out to relax, travel and exercise. In this way, your mental relaxation is also good for your blood pressure. Besides, regular exercise and exercise are also advocated by the World Health Organization. You should have 20 minutes of exercise every day, and a week of vigorous exercise. Diet, exercise, salt loss, weight loss, smoking and alcohol cessation are also very important. These methods can prevent hypertension.
Moderator: All prevention starts from the details of our life.
Huang Li: Yes.
Host: And remember to make salt a part of your taboo. Everyone always says not to eat this or that. You must remember Professor Huang's words. It doesn't matter whether you eat other food or not. Remember to eat less salt.
Huang Li: We must remember that hypertension can be prevented, and it is not good for everyone to prevent it in life.
Host: Let yourself be healthy, and the problem will be solved. We answered some questions from netizens.
Netizen: I will blush at 4pm and feel my blood pressure coming up. Usually, I have never taken any antihypertensive drugs at 100/140. I am 43 years old this year. What should I do about this situation?
Huang Li: If he has high blood pressure in the early stage, I don't know his height, weight and bad habits. We can improve these bad habits to see if we can control them. Because some of our patients have lost weight, their blood pressure has dropped, and they have given up smoking and drinking, and strengthened their exercise, so their blood pressure has naturally dropped. If he is in the early stage, use this method together with traditional Chinese medicine to lower his blood pressure. You can take one to three months to observe him. If it still doesn't work, I suggest you take antihypertensive drugs.
Netizen: Five years ago, he suffered from hypertension. Now he is 43 years old. At that time, the hospital said that he had abnormal angiotensin. He had been taking telmisartan and kept it at about 83-130. Fumaric acid was prescribed before, but now it can't be prescribed. Does it affect me?
Huang Li: There should be fumaric acid. I think that the two drugs prescribed by the doctor for him are generally sympathetic excited young people, who are excited quickly and easily nervous. So we usually use beta blocker, which is what he called fumaric acid. There are domestic and imported drugs, but there is no such drug. Its corresponding beta blocker can also be used.
Netizen: Male, 57 years old, 1.8 meters tall, suffering from hypertension for 20 years. Take the initiative to lose weight. The weight is reduced from 82 kg to 72 kg, which is lower than the blood pressure before losing weight. I want to ask whether the factors affecting blood pressure have decreased after the weight recovery standard. Do you need to continue to lose weight?
Huang Li: It's better to calculate according to the body mass index. Our body mass index is 18-24. It's better to measure your height and weight to reach your BMI. If you have reached the body mass index by this time, and your blood pressure has also dropped, you can slowly reduce the amount of your antihypertensive drugs, but you must monitor your blood pressure during the reduction process, and you can't just reduce your blood pressure. In the process of subtraction, reduce it little by little and observe it carefully little by little.
Netizen: Hypertension has been more than ten years. After drug control, it can reach 135/90. Recently, the blood pressure has reached 180/110. What should we do?
Huang Li: How old are you?
Compere: He didn't say it, just said it had been more than ten years.
Huang Li: If the blood pressure suddenly increases when you are over ten years old, we should exclude renal atherosclerosis, renal artery stenosis, whether there is any problem with cardiovascular and cerebrovascular diseases, whether there is renal atherosclerosis, renal artery stenosis, whether there is emotional instability, and whether there are other problems, The blood pressure of 180 should be controlled as soon as possible.
Moderator: Due to time constraints, there is no time to answer the endless questions behind. Thank you for coming to our studio, and thank you for watching our program. Famous doctors gathered to talk about people's health. See you next time.
Huang Li: Thank you.
