In the morning, friend of a policeman comes over medicine, told the story of a young hypertensive patient to me.
He just attended the memorial meeting of a colleague, the colleague just spent birthday, because cerebral hemorrhage rescue is invalid,die. Everybody knows he has high blood pressure, blood pressure is highest 200mmHg, other patient's condition is unspecified, nevertheless he never takes medicine, also do not listen to others advice to go to a hospital seeing a doctor, the result is tragic.
He is alone child, the old father and mother that keep is heartstricken. Just think, one pair is broken alone how does the old person face this reality, how should live again later?
If doctor of believe what one hears, his ending will differ completely
According to he comes on hypertensively the age and hypertensive serious degree are analysed, the likelihood with his the greatest high blood pressure is hypertension of afterwards hair sex, namely by other disease chronic kidney is ill, for instance adrenal the disease high blood pressure that cause, also not he has except cerebral hemangioma, specific illness already cannot was informed. But whatever circumstance, with medical treatment, blood pressure control amounts to mark, the happening that prevents complication of heart, head, kidney is core cure, also be the good sense of all sorts of hypertensive cure.
Regretful is, a lot of people treat hypertension to have a lot of wrong knowledge, the commonnest dare not take medicine namely, other still have: Not afflictive need not depressor; Depressor cannot be used casually, once was used,stop to be not dropped (afraid medicaments is depended on) ; Blood pressure is normal stop drug, blood pressure eats high again (by need to use drug) ; Use depressor for a long time to have side effect (give up eating for fear of choking-refrain from doing sth necessary for fear of a slight risk) ; Depressor damages a kidney (concern damages kidney and sexual function) etc, final these patients are not to destroy at the disease, destroy Yu Jiankang error and healthy rumor however.
Actually, high blood pressure produces gradually, begin a possibility some are uncomfortable, time grew to did not feel instead, this boils frog as Wen Shui. But, differ to be endangered at doing not have without the feeling, etc produced heart stalk, head stalk, cerebral hemorrhage to wait when feeling, the likelihood is already late.
Hypertension is lifelong sex disease. Hypertensive formation is heredity and environmental element the result of joint action, and it is not reversible. Of course, through reducing salt, be restricted wine, reduce weight, the blame medicaments measure such as motion, blood pressure can have the fall of certain level, but drop extent exceeds 20mmHg rarely, true step-down cure still must rely on medicaments, and depressor wants lifelong use. Depressor is not medicaments of the sex that become addiction, without dependence, can stop drug at any time, the problem is, hypertension is lifelong sex disease, need the lifelong treatment that use drug.
A few patients, blood pressure uses drug high, blood pressure is normal stop drug, this kind " by need to use drug " the practice is special mistake, often bring about blood pressure wave motion, and the complication such as heart stalk, head stalk often produces when blood pressure is flabby. Blood pressure is normal it is the result that uses drug, stopped medical blood pressure of course bounce. Should " take medicine on time " , the time that secures everyday uses fixed dose, can maintain a constant medicaments chroma in blood, in order to keep a stable blood pressure.
Undeniable, any medicine are indispensable side-effect. Nevertheless, the depressor of a gleam of that newest guideline recommends already side-effect pilot very small. Said moreover, the side-effect of depressor also does not cross hypertensive complication greatly greatly again, worry about side-effect and need not medicine controls blood pressure, is that give up eating for fear of choking-refrain from doing sth necessary for fear of a slight risk?
The view long-standing that folk damages a kidney about depressor and special bigotry, here " kidney " the desire that also implies male sex function. Above all, hypertension can cause kidney to damage and quicken kidney function aggravation, this has been medical common sense, controlling blood pressure is protective kidney function (protect kidney) the mainest measure, sha Tan kind, general benefit kind, n kind the action that defends kidney through controlling blood pressure to have, especially the first selection of disease of before two kinds of more chronic kidneys uses drug; Next, the arteriosclerosis that hypertension brings about is implement qualitative sex erects one of main reasons of the obstacle, arteriosclerosis of step-down, cure also is the main measure that treats male sexual dysfunction. Anyhow, "Kidney " be hypertensive injury, is not depressor injury.
About these hypertensive common sense, please well-known
140mmHg of ≥ of adult blood pressure and / or 90mmHg is hypertensive, no matter the age. Rate of sicken of Chinese adult hypertension is as high as 25.2% , number of countrywide hypertensive patient 270 million person, it is the chronic with sicken top rate.
Hypertension is the critical factor with bring about heart stalk, head stalk, kidney to decline the mainest. According to statistic, the whole nation has 2 million person every year to die at the disease that concerns with hypertension. And the people of 6 coronary heart disease that become above, 8 straighten into above head patient, 9 have high blood pressure into cerebral hemorrhage patient history. Can say, hypertension is human health is the mainest " killer " . So, meet high blood pressure correctly and control blood pressure strictly to have very important sense.
1, when to start step-down therapy?
① ≥ hypertensive patient of 60 years old, the contractive 150mmHg that press ≥ and / or 90mmHg of diastolic pressure ≥ can start medicaments step-down therapy;
②
2, does blood pressure fall what target?
① ≥ hypertensive patient of 60 years old, cost of step-down target target is 150mmHg of systole pressing ＜ and 90mmHg of diastolic pressure ＜ ;
②
Of course, right diabetic the target cost with nephrosis patient step-down is returned at present have different opinion, total trend is, the step-down target cost of these two kinds of patients should be a few stricter.
Hypertensive happening, concern with heredity and insalubrious lifestyle. Control is hypertensive, divide outside medicationing, still should improve way of life, but medicationing is main measure undoubtedly.
High blood pressure is initial include ACEI with medicine kind (general benefit kind) medicaments, ARB kind (Sha Tan kind) medicaments, CCB kind (n kind) , Sai Qin kind diuretic, β suffers body block to break an agent to wait.
3, hypertension uses drug 10 mistakes.
Error one: Without the feeling, do not have a problem.
Feeling of the meeting after blood pressure is elevatory has a headache, giddy, tinnitus, insomnia. But some people however feeling of it doesn't matter, this boils frog as Wen Shui, slowly elevatory not afflictive instead.
Differ to be endangered at doing not have without the feeling, wait when producing heart stalk, head stalk, cerebral hemorrhage to feel, the likelihood is already late. So, blood pressure is elevatory, no matter have,the feeling should use drug.
Error 2: Depressor cannot eat casually, once ate to be not broken
Depressor is not medicaments of the sex that become addiction, did not depend on, can stop drug at any time. The problem is to cannot stop, once stop drug, blood pressure will be new and elevatory.
Hypertension is a lifelong sex disease, need the lifelong control that use drug. Such saying, not be medicine has dependence, however hypertension has " dependence " .
Of course, inchoate without familial history hypertensive, through improving way of life, blood pressure can return to normal, need not use drug. Besides, should use medical treatment.
Error 3: Begin to cannot use good drug
Cure is affected cannot the bacteriophage of first selection high level, because once be able to bear or endure medicine, do not have medicine to be able to be used. Because the bacterium has the capacity of antagonism medicaments,this is.
The object of depressor action is not a bacterium, accept put oneself in another's position however, won't appear similar bacteriophage is able to bear or endure medical circumstance.
So called good medicine, not only step-down effect is good, side effect is little, and wait for an organ to heart, head, kidney have protective effect. Choose depressor so, which good, choose which, and begin to use good drug.
Error 4: Blood pressure is high take medicine, blood pressure stops drug normally
The blood pressure after using drug is normal, it is the result of the action of medicaments, it is the balance below medicaments control, the balance after stopping drug is broken, blood pressure will be new and elevatory;
Use drug high, stop drug normally. This kind can bring about blood pressure to always be in wave motion by the mode that needs to use drug in, and the complication such as heart stalk, head stalk produces when blood pressure is fluctuant.
Error 5: Blood pressure is lower better
Systole pressing had better be maintained between 110-140mmHg, exorbitant or too low, complication and mortality can increase, this is the J curve that famous step-down treats.
Same argument, diastolic pressure had better be maintained between 70-90mmHg.
Error 6: Discover blood pressure is elevatory, it is normal to should fall quickly
Blood pressure lifts gradually, step-down also should drop gradually. Besides the emergency such as hypertensive danger elephant, do not suggest fast substantially step-down, can cause the accident condition such as cerebral perfusion inadequacy otherwise.
To hypertensive urgent disease, inside 24~48 hour blood pressure slow fall to 160/100mmHg can, do not need vein to use drug commonly.
Clinical and general make the intention painful calm (saltpetre benzene n) contain below the tongue take urgent step-down, consider as at present improper. Pass except step-down fast outside, still can cause sympathetic excitement and cause disease of heart head blood-vessel.
Error 7: Depressor lies between a few years to be about to change
If chose depressor correctly, blood pressure pilot is very good, and without occurrence side-effect, should continue to be used, do not suggest to change medicine regularly.
Unless new breed appears on the market, and new drug has very large dominant position in curative effect and side-effect respect, can consider to change medicine.
Error 8: Depressor has side effect
Any medicine have side effect, include depressor. But what FDA approves is former grind medicine (entrance medicine) opposite very safe. If press a specification to use drug, side-effect will be very slight.
Do not want give up eating for fear of choking-refrain from doing sth necessary for fear of a slight risk, compare with hypertensive harm, the side-effect very little of depressor.
Error 9: Depressor hurts kidney
Long-standing of this kind of view and special bigotry, here " kidney " the desire that also implies male sex function.
Sha Tan kind, general benefit kind, n kind depressor has the effect that protects kidney through step-down, especially the first selection that before two kinds of medicaments are chronic kidney disease more uses drug, have perfective functional action.
The arteriosclerosis that hypertension brings about is the male erects the main reason of the obstacle, arteriosclerosis of step-down, cure also is the main measure that treats male sexual dysfunction.
Anyhow, those who hurt kidney is hypertensive, is not depressor.
Error 10: Health care is tasted also can fall blood pressure
Some closer health care tastes year of step-down increasing, for instance insole of cap of watch of step-down pillow, step-down, step-down, step-down, these health care are tasted claim to have favorable step-down effect, but the result is not such.
The step-down effect that health care tastes did not pass scientific clinical attestation at all, use this kind of health care to taste step-down, although health care is tasted,do not have a harm, also meet the cure of hypertension of incur loss through delay.
I want to say to all hypertensive patients
Clinical on I say to the patient all the time, treat hypertension as treating myopia, the eye is myopic, it is correctional and normal to match a pair of glasses with respect to OK, both neither affects the work, also do not affect the life. Once myopia forms what great majority cannot go against, do not wear glasses unalterable this is actual.
Certain disease, for instance a lot of leukaemia, medullary tumour, cancer, still do not have better remedy at present, the patient is again rich likely also cannot survival. But, hypertensive cure, both neither lacks medical service, many medicine, can still age of so much person dies at hypertensive complication gently, it is to make a person distressed mix really regretful.
Do not examine system at ordinary times, discovered hypertension need not medicine, perhaps treat finish not to amount to mark with medicine, a series of wrong way one pace sends a fresh life funeral. And final finish their not be a disease completely, know to the mistake of the disease however. Believe science please! Believe a doctor!
