About hypertensive patients, does blood pressure really fall as low as possible?
The etiology of hypertension is "high prevalence rate", "high disability rate" and "high mortality rate", which is the main risk factor of various cardiovascular and cerebrovascular diseases. High pressure (systolic blood pressure) 140mmHg and low pressure (diastolic blood pressure) 90mmHg are a line that hypertensive patients need to remember. It is not only the dividing line of hypertension diagnosis, but also the starting line of hypertension treatment, but also the standard line of hypertension control.
Antihypertensive therapy can reduce the risk of stroke by 40% - 50%, myocardial infarction by 15% - 30% and heart failure by more than 50%. However, in our clinical work, we often encounter some patients who expect to control their blood pressure at a low level. In fact, this concept is unscientific. Especially the elderly should pay more attention to the negative effects of low blood pressure.
1. For general patients with hypertension, the antihypertensive policy is to reduce blood pressure by at least 20 / 10mmhg, preferably < 140 / 90mmHg.
2, if swallowing diabetes, slow kidney disease, coronary heart disease, heart failure, it is best to control blood pressure below 130/80mmHg.
3. For patients younger than 65 years old, if they can tolerate the policy, the blood pressure can be controlled below 130 / 80mmHg, but it is better not to be lower than 120 / 70mmhg.
4. If patients over 65 years old can tolerate, the policy blood pressure should be less than 140 / 90mmHg, but individualized blood pressure policy should be set according to weakness, independent living and tolerability.
Because patients with hypertension in their later years tend to swallow arteriosclerosis, poor vascular compliance and increased pulse pressure difference (i.e. high systolic pressure and low diastolic pressure), and too low diastolic pressure will affect the blood supply of cerebral vessels, cause dizziness, fatigue or fall, and severe will lead to cerebral infarction. At this time, it is necessary to pay attention to that the diastolic pressure should not be too low, preferably not less than 60mmhg. Therefore, for patients with hypertension in their later years, especially those over 80 years old, it is a basic policy to reduce it to 150 / 90mmHg. If it can be tolerated, it can also be reduced to 140 / 90mmHg.
In general, the blood pressure control policy varies from person to person. Generally speaking, 140 / 90mmHg is the standard line. Do not treat hypertension by feeling. Be sure to take drugs under the guidance of doctors and measure your blood pressure regularly.