Patients with hypertension need to understand these five points, the second point is very important!

Author: Zhong Jingbai, Chief Physician, Xiyuan Hospital, China Academy of Chinese Medical Sciences

Reviewer: Yang Weibin, Chief Physician, Xiyuan Hospital, China Academy of Chinese Medical Sciences

Vice President of Graduate School of China Academy of Chinese Medical Sciences

The causes of hypertension are very complex. Currently, more than 80% of the causes are unclear, which is called primary hypertension. Only 10%-20% of the causes can be found, which is called secondary hypertension.

The cause of essential hypertension cannot be found, and treatment is mainly symptomatic. If blood pressure is not controlled well, the more serious harm is cerebral hemorrhage, damage to the cardiovascular and cerebrovascular vessels, damage to the kidneys, etc. It is very important for patients with hypertension to control their blood pressure.

In addition, patients with hypertension should pay more attention to blood sugar and blood lipids than the general population. Although blood lipids and blood sugar are not high now, the risk of high blood lipids and high blood sugar is higher than that of people without hypertension, so attention should also be paid to screening blood sugar and blood lipids.

In addition to the above precautions, patients with hypertension should also pay attention to the following five points.

1. When is the best time to take antihypertensive drugs during the day?

The time to take antihypertensive drugs is determined according to blood pressure fluctuations.

For example, by monitoring your blood pressure at home or based on dynamic blood pressure monitoring data, you will find that most people have dipper-type blood pressure, that is, high blood pressure in the morning and better blood pressure at night. Therefore, most patients with hypertension take antihypertensive drugs in the morning, and it is best to take them on an empty stomach in the morning.

Some hypertensive patients have two blood pressure peaks a day. If they take antihypertensive drugs once in the morning, their blood pressure cannot be controlled and will still be high in the afternoon, so they need to take them both in the morning and evening.

Some hypertensive patients have reverse dipping blood pressure, that is, their blood pressure is not very high in the morning, but very high in the evening and at night. At this time, they should take strong antihypertensive drugs, or the only antihypertensive drug, at night.

Therefore, the time to take antihypertensive drugs varies from person to person.

Figure 1 Original copyright image, no permission to reprint

2. Is the blood pressure lowering effect of antihypertensive drugs better the faster it is?

Currently, both abroad and at home, the guidelines for the treatment of hypertension advocate that for ordinary hypertensive patients, blood pressure reduction is a slow process and there is no need for a sharp drop in blood pressure.

Figure 2 Original copyright image, no permission to reprint

It is generally believed that if blood pressure does not drop or even rises after taking antihypertensive drugs for about 2 weeks, then the antihypertensive regimen should be adjusted. It is currently considered to be relatively appropriate if blood pressure drops to the normal range 2-4 weeks after taking antihypertensive drugs, and is less likely to cause cardiovascular and cerebrovascular reactions.

Therefore, do not pursue lowering blood pressure too quickly. Lowering it too quickly, especially for some elderly hypertensive patients, may cause symptoms such as cerebral ischemia.

3. Is it better to take the same antihypertensive drug continuously or to change the drug frequently?

Antihypertensive drugs must be safe first. If a certain antihypertensive drug is safe to take and has no side effects, there is no need to change it. If you choose a certain antihypertensive drug, your blood pressure can be controlled. If you change antihypertensive drugs, your blood pressure will have to adapt to the new drug again, which can easily cause blood pressure fluctuations and be detrimental to the target organs. Therefore, it is strongly recommended that patients with hypertension do not develop the habit of changing drugs regularly.

When do you need to change the medicine? If some adverse reactions related to the medicine appear or are found during examination, you can change the medicine under the guidance of a doctor. For example, about 10% of patients who take antihypertensive drugs such as pril will have a cough. Everyone's situation is different. Some people cough as soon as they take the medicine, while others start coughing after taking it for a period of time, and the dry cough is particularly severe. If it is determined that this adverse reaction is related to the antihypertensive drug, then it is recommended to change the medicine.

4. Can Chinese medicine replace Western antihypertensive drugs to treat hypertension?

In the outpatient clinic, patients with newly diagnosed hypertension can first improve their lifestyle and use some Chinese medicine for observation if they can have an observation period. Indeed, many patients, especially those with newly diagnosed hypertension, can control their blood pressure in about 30%, and they do not need to take antihypertensive drugs for a long time in the later stage.

When blood pressure cannot be controlled, especially when it reaches level 2 or 3, the higher the danger level, you should use antihypertensive drugs to lower your blood pressure first.

There are many Chinese patent medicines for lowering blood pressure now, such as Niuhuang Antihypertensive Pills, Zhenju Antihypertensive Tablets, Qinggan Antihypertensive Capsules, Songling Xuemaikang Capsules, etc. They all have the efficacy of treating hypertension and have a certain antihypertensive effect, which can help some patients control their blood pressure well.

Whether Chinese patent medicine can be used to lower blood pressure needs to be analyzed according to each person's specific situation. Chinese medicine is called syndrome differentiation and treatment, which is safer and more effective, so it is not recommended to buy and take it yourself. Of course, if the doctor prescribes a certain Chinese patent medicine and the effect is significant after taking it, you can continue to buy and use it according to the doctor's instructions.

5. Is it good for patients with hypertension to take paste prescriptions in winter?

Hypertensive patients, especially elderly patients with hypertension, have aging organs, atherosclerosis of the arteries, lacunar cerebral infarction, decreased renal function, etc., taking paste prescriptions for nourishment and conditioning is one of the best choices. Some patients take paste prescriptions in winter, and after taking them, their blood pressure will be more stable in the summer, reducing blood pressure fluctuations.

One thing that needs special reminder is that you should not expect that taking paste prescriptions is like taking antihypertensive drugs, which will be effective tomorrow after taking them today. Paste prescription conditioning is a chronic process. The ingredients of paste prescriptions are very complex, just like the principles of taking decoctions. They need to be tailored and processed according to the prescription, and then made into paste prescriptions to ensure safety, deliciousness and effectiveness.

Hypertension is a chronic disease. Chinese medicine believes that chronic diseases are generally mixed with deficiency and excess. Hypertensive patients with deficiency syndrome can take paste prescriptions for conditioning. In some special cases, such as when blood pressure stability is particularly poor, it is necessary to use drugs to adjust and control blood pressure at any time. At this time, it is generally not recommended to take paste prescriptions; in addition, when hypertension is combined with other acute diseases, such as acute heart failure in the late stage of hypertension, it is not suitable to take paste prescriptions when heart failure cannot be controlled.