High and low blood pressure is worrying. How to control blood pressure and avoid stroke and myocardial infarction? In fact, human blood pressure is always in a state of fluctuation, but this situation is particularly obvious in the elderly, because the blood vessels accumulate fat and harden with age, and their elasticity is less than that of young people. Blood pressure fluctuates, high and low.
However, in recent years, due to abnormal eating habits and work and rest, the symptoms of the three highs have become younger, so young people should not be ignored.
According to the statistics of the World Health Organization (WHO), the comprehensive analysis report on the global prevalence of hypertension pointed out that in the past 30 years, the number of hypertensive adults aged 30-79 has increased from 650 million to 1.28 billion. Nearly half of them did not know they had high blood pressure. The study also showed that more than half of people with high blood pressure (53% women and 62% men), a total of 720 million people, did not receive the necessary treatment. Less than a quarter of women with high blood pressure and one in five men with high blood pressure have their blood pressure under control, which is effectively controlled by medication to normal levels.
Long-term poor control of high blood pressure puts the systemic blood vessels and organs at risk of disease, and the consequent diseases include arterial occlusion, coronary heart disease, fundus retinopathy, and kidney failure.
However, high and low, unstable blood pressure is more dangerous than high blood pressure. Studies have shown that high and low blood pressure will increase the risk of stroke. Low blood pressure has almost no symptoms. People often faint, faint, and even go into shock within a few seconds. The risk is high for the elderly.
Many doctors unanimously emphasized that the most important thing is to measure blood pressure regularly and correctly, and to master the long-term fluctuation of blood pressure in order to control blood pressure well.
High blood pressure: first rule out the precipitating factors, then consider adjusting the medicine
There are many factors that cause unstable blood pressure, and the situation varies from person to person. It is very important that the doctor asks the patient’s living conditions in detail in the outpatient clinic to see if there is an emergency that makes the blood pressure soar.
Most people with high blood pressure have no symptoms. Some people experience dizziness, stiff neck, or even blurred vision. At this time, blood pressure may have soared to more than 180mmHg. It is too slow to take the medicine and need immediate medical attention.
Triggers: temperature changes, exercise, mood, lack of sleep
In general outpatient clinics, doctors will first rule out possible triggering factors. In addition to temperature changes and strenuous exercise, it is also common for patients to have high blood pressure due to anger, tension, and anxiety, which may return to normal after a while. It is recommended to exclude sudden factors first, and measure blood pressure at least half an hour later to avoid higher blood pressure due to stress.
In outpatient clinics, doctors may not prescribe drugs to lower blood pressure. Some high blood pressure is caused by insomnia and anxiety. They may prescribe sleeping pills or sedatives. Ask the patient to go home and get a good night’s sleep. After enough sleep, blood pressure will naturally drop.
Environmental factors: white coat hypertension
Some people are easily nervous when faced with medical staff when their blood pressure is measured in the hospital, and their blood pressure will rise abnormally, which is called “white coat hypertension”. Some patients always have high blood pressure when measuring blood pressure in the hospital, prescribed blood pressure lowering drugs, but found that blood pressure is too low after taking it for a few months. .
Other diseases or drug effects: taking cold medicine, stomach pain, using pain relief patches, etc.
Others, like taking cold medicine, stomach pains, or using a pain-relief patch, can briefly spike blood pressure. The ephedrine in cold medicine, and the mucosal congestion inhibitor that relieves nasal congestion, can cause vasoconstriction, while painful stimuli, such as stomach pain, can excite the sympathetic nerves, causing blood pressure to rise.
Most cold medicines will not be taken for more than 2 weeks, which has little effect, but you should remind your doctor that you are taking blood pressure lowering drugs.
If your blood pressure does not come down after taking steroids, non-steroidal anti-inflammatory drugs (NSAIDs), or female birth control pills for a long time, you may need to discuss with your doctor about switching to other drugs, or increasing your blood pressure lowering dose.
The effect of high blood pressure drugs: Everyone’s blood pressure fluctuates differently day and night. The wrong time or dose of medicine may cause blood pressure to fluctuate.
Some people take antihypertensive drugs in the morning to bring down the blood pressure that was soaring in the morning, but at noon it becomes too low, and symptoms of hypotension such as dizziness appear. Doctors suggest that these patients can take the medicine in the evening, or halve the dose of the medicine, and take it in the morning and evening.
There are patients who have been taking blood pressure lowering drugs. If the blood pressure soars, the blood pressure should be measured for 2 to 3 days. If the blood pressure has not returned to normal, return to the doctor to discuss whether the dose needs to be adjusted. Self-increasing doses may lower blood pressure too low, resulting in hypotension, which is even more dangerous.
Postural hypotension is the most common, and there is a risk of cerebral hypoxia and shock
Postural hypotension is a common low blood pressure condition, that is, when you suddenly stand up, the blood is still concentrated in the lower limbs, and there is no time to flow back to the brain, and it is easy to become dizzy and even instantly coma.
The autonomic nervous system of these patients is less sensitive, which will slow down the heartbeat and lower blood pressure. Usually, it is necessary to avoid being too tired, and when changing posture, stop for 2 to 3 minutes, and then stand up slowly. If the situation does not improve, it is necessary to Seek medical examination. If you are taking blood pressure lowering drugs, you can ask the doctor to evaluate and adjust the dose in the outpatient clinic. And irregular work and rest, staying up late, suddenly drinking too much alcohol, may also lead to low blood pressure.
If there is an instant fainting of hypotension, it means that the systolic blood pressure has been less than 80mmHg, and syncope will occur, and you should seek medical attention for a thorough examination. You can go to the outpatient department of neurology, cardiology or family medicine. Generally, electrocardiogram, cardiac ultrasound, brain wave and carotid artery ultrasound will be done to check whether there is arrhythmia, abnormal heart structure (such as myocardial hypertrophy), epilepsy or carotid artery stenosis, etc. question.
Older people have looser standards for hypertension, while younger ones need to be stricter
Blood pressure increases with age due to hardening of the arteries, but if the blood pressure is too low, the elderly are prone to brain hypoxia, even syncope and shock. Therefore, the tolerance value of high blood pressure for the general elderly is relatively loose. 110-140mmHg, diastolic blood pressure between 70-90mmHg, and fluctuations within about 10-15mmHg from the ideal blood pressure (120/80mmHg) are acceptable. The latest United States Joint Committee on the Prevention and Treatment of Hypertension (JNC8) also recommends that the goal of taking medication to control blood pressure should be changed to 150/90 mmHg for people over 60 years old, that is, older hypertensive patients.
However, the blood pressure of young people should be controlled within a strict standard range, because if the blood pressure soars at a young age, the risk of cardiovascular, stroke, and myocardial infarction will be higher in the future.
Young people’s blood pressure suddenly soars, which is often caused by abnormal work and rest, diet, or short-term emotional stress. Obesity is also prone to high blood pressure, so BMI should be controlled between 18.5 and 24.
In general, young people are less likely to have primary hypertension, and more secondary hypertension caused by other diseases. Other examinations are needed to exclude possible causes through a blanket search.
The difference between systolic and diastolic blood pressure is large, and the rate of stroke increases
It is common for older people to have low diastolic blood pressure but high and low systolic blood pressure, because with age, the elasticity of blood vessels becomes less and less, and the diastolic blood pressure also decreases. The greater the degree of arteriosclerosis, more exercise can improve the elasticity of blood vessels, slow down the speed of arteriosclerosis, and reduce the risk of stroke.
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