The hot barbecue mode is about to start! The impact on blood pressure is far greater than you think

Recently, CCTV reported that the Central Meteorological Observatory has issued high temperature warnings in many places for 12 consecutive days and issued orange high temperature warnings many times. Some experts predict that this summer may still be "very hot!!!"

The weather is getting hotter and hotter, and the heat makes people irritable, but there is a group of people who are very happy, that is, patients with hypertension. Many patients with hypertension have this feeling that their blood pressure remains high in the cold winter, but in the summer, their blood pressure drops without medication. Then some patients think that their hypertension is "cured" and stop taking antihypertensive drugs on their own, but they don't know that there are huge dangers hidden in the high temperature!

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First of all, a person's blood pressure value is not constant. Usually, blood pressure is higher during the day than at night. Blood pressure is higher in the early morning and between 8 and 10 am, while blood pressure is lower late at night or in the early morning. This is the diurnal rhythm of blood pressure.

Secondly, blood pressure also has seasonal rhythmic changes. In winter, blood pressure is higher, while in summer, blood pressure is often lower. The reason is that in summer, the temperature is higher, and blood vessels also follow the principle of "thermal expansion and cold contraction". In a high temperature environment, blood vessels in the body are in an expanded state, and when blood flows through the blood vessel wall, the peripheral resistance decreases, and blood pressure also decreases accordingly.

In addition, people sweat more in the summer, and salt is excreted from the body with sweat. If water and electrolytes are not replenished in time, the blood will become concentrated, just like taking a diuretic antihypertensive drug, resulting in a decrease in blood volume and a subsequent decrease in blood pressure.

The answer is very definite: No!

Many patients think that they can stop taking or take less antihypertensive drugs when they see their blood pressure drop on its own. In fact, this practice is very dangerous!

This is because hypertensive patients are different from other normal people. Their blood vessel regulation ability is weakened, and the changes in blood pressure are more likely to be regulated by environmental temperature than by stopping or reducing medication on their own, which is more likely to cause a rebound increase in blood pressure. In addition, the key to blood pressure control is to "maintain stability". Irregular medication is prone to disorders in the blood pressure regulation mechanism. Hypertensive patients are prone to a sharp increase in blood pressure, which may affect the health of the patient's heart, brain, kidneys and other organs. In severe cases, it can induce cerebral stroke, myocardial infarction and other diseases. Summer is the second peak of cardiovascular and cerebrovascular diseases in the elderly. This is closely related to the high degree of vascular sclerosis, low vascular elasticity and poor blood pressure regulation ability in the elderly. Therefore, hypertensive patients, especially elderly hypertensive patients, should control their blood pressure better in hot seasons.

Warm reminder: Some elderly people believe that "long-term illness makes them doctors" and are "stubborn" enough to think they know their own bodies well, and reduce or stop taking medication on their own. At this time, family members should pay more attention to the patients, carefully observe the patients' complexion or changes in facial expressions caused by physical discomfort, etc., promptly discover abnormal conditions of the patients, and actively seek medical treatment.

1. Increase the frequency of blood pressure measurements, monitor regularly, and record accurately

During hot seasons, patients are advised to increase the frequency of blood pressure measurements, measure them regularly every day, and keep relevant records, which can be used as a reference for doctors when seeking medical treatment.

2. Home blood pressure measurement method:

The "2019 China Home Blood Pressure Monitoring Guidelines" recommends upper-arm electronic blood pressure monitors as the preferred method for home blood pressure monitoring.

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① When monitoring blood pressure at home, sit and rest on a chair with a backrest for at least 5 minutes before measuring blood pressure. When measuring blood pressure, place the forearm on the side with the cuff on the table, with the middle point of the upper arm with the cuff at the same level as the heart, and relax the legs on the ground. You can also choose a more comfortable sitting condition, such as a slightly lower seat such as a sofa, but make sure that the middle point of the upper arm with the cuff is at the same level as the heart.

② Choose a cuff and air bag of appropriate size. When purchasing a blood pressure monitor, ask the seller to provide a cuff of appropriate size that matches the upper arm circumference of the main user of the blood pressure monitor.

At present, most electronic blood pressure monitors are equipped with a standard cuff suitable for most people (upper arm circumference <32 cm) and a large cuff for people with larger upper arm circumference (upper arm circumference ≥32 cm). Children, adolescents or other people with thin upper arms should choose a small cuff when measuring blood pressure.

③Home blood pressure measurement time

The guidelines recommend measuring blood pressure 2-3 times a day, morning and evening, with a 1-minute interval between each measurement, and taking the average value. Measure blood pressure in the morning, 1 hour after waking up, before breakfast, taking antihypertensive drugs, and before strenuous activities; measure blood pressure in the evening, after dinner and before going to bed; empty the bladder before each measurement.

For patients who are undergoing initial diagnosis, early stages of treatment, or whose blood pressure has not yet reached the target despite treatment, blood pressure should be measured continuously for 5 to 7 days before seeing a doctor. When blood pressure is well controlled, blood pressure should be measured at least once a week.

It is recommended that family members who have not been diagnosed with hypertension should also measure their blood pressure regularly at home, at least once a year; if the family blood pressure does not meet the diagnostic criteria for hypertension, but the level is high, at 130-134/80-84 mmHg, the frequency of blood pressure measurements should be increased, and blood pressure should be measured at least once a month.

To ensure the quality of home blood pressure monitoring, the time of getting up, going to bed, three meals a day and the time of taking medication should be recorded during blood pressure monitoring.

④ Diagnosis and efficacy judgment criteria of home blood pressure

When the average home blood pressure is ≥135/85 mmHg, hypertension can be diagnosed, or blood pressure is not yet controlled. When the clinic blood pressure is ≥140/90 mmHg, and the home blood pressure is <135/85 mmHg, it can be diagnosed as "white coat hypertension" or "uncontrolled white coat hypertension"; and when the clinic blood pressure is <140/90 mmHg, and the home blood pressure is ≥135/85 mmHg, it can be diagnosed as "masked hypertension" or "masked uncontrolled hypertension".

3. Adjust the dosage of the medicine according to the doctor’s advice

In daily medication, antihypertensive drugs must be taken strictly according to the doctor's instructions. The dosage of the drug needs to be adjusted under the guidance of the doctor. Avoid increasing or decreasing the dosage without permission. Go to the doctor for follow-up visits on time. If there is any discomfort, seek medical treatment in time to avoid delays in the disease.

4. Maintain a healthy lifestyle

① Adjust your diet: In summer, your diet should be light and easy to digest. Reduce salt intake, eat more vegetables and fruits, and avoid oily, meaty, spicy and irritating foods.

② Drink water properly: In hot weather, you sweat a lot, so you should increase your fluid intake appropriately. It is recommended to drink light salt water, tea or light and refreshing vegetable soup. It is better to drink a small amount of water each time to avoid drinking a large amount of water that increases the burden on the kidneys.

③ Keep bowel movements unobstructed: The bathroom environment is closed and stuffy, so bowel movements should be kept unobstructed to avoid holding your breath during bowel movements, which may cause increased abdominal pressure and a sudden rise in blood pressure, leading to cardiovascular and cerebrovascular risks.

④ Reasonable heat avoidance: Avoid suddenly entering an air-conditioned room with too low a temperature, avoid excessive cold stimulation to prevent sudden contraction of blood vessels, which may cause symptoms of local ischemia and hypoxia. This is especially true for patients who already have atherosclerosis, who are more likely to suffer from insufficient blood supply to the brain.

⑤Moderate exercise: stick to moderate aerobic exercise, such as walking, swimming, etc., but avoid doing it during high temperature periods to prevent heatstroke.

⑥ Adequate sleep: Maintaining good work and rest habits and ensuring adequate sleep will help stabilize blood pressure.

⑦ Psychological adjustment: Keep a calm mind, avoid sudden emotional ups and downs, reduce stress, and help control blood pressure.

After the above introduction, I hope that patients with hypertension can effectively control their blood pressure in the hot summer and avoid the health risks caused by high temperatures. I hope that every patient can pay attention to blood pressure management, achieve scientific blood pressure reduction, and spend the summer healthily.

Planning and production

Author:

Review丨Yin Xiaolin

Department of Ophthalmology, The Second Affiliated Hospital of Naval Medical University

Producer｜Gao Liandi

Associate Professor, Nursing Department, Second Affiliated Hospital of Naval Medical University

Produced by: The Second Affiliated Hospital of the Naval Medical University of the Chinese People's Liberation Army