Prevent stroke and control high blood pressure

Stroke has become an important cause of disability and death among Chinese residents. The overall incidence of stroke is still increasing, but the mortality rate is stabilizing, with more strokes in rural areas than in cities, and strokes are occurring at a younger age. Studies have shown that among all risk factors for stroke, hypertension is still the leading cause of stroke, and antihypertensive treatment can reduce the incidence of stroke. Since the overall control rate of hypertension in my country is currently low, blood pressure management still needs to be strengthened.

Eight steps of lifestyle intervention

The latest edition of the "Guidelines for the Prevention and Treatment of Hypertension in China" points out that lifestyle interventions include reducing sodium intake, increasing potassium intake, eating a reasonable diet, controlling weight, not smoking, limiting alcohol consumption, increasing exercise, maintaining psychological balance, and managing sleep.

1. Reduce sodium intake and increase potassium intake

• Eat less salt, less than 6g per person per day

• Before using low-sodium and potassium-rich salt, renal function needs to be assessed. For patients with good renal function, it is recommended to choose low-sodium and potassium-rich salt instead of sodium salt; for patients with renal insufficiency, a doctor should be consulted before potassium supplementation.

• Potassium supplements (including medications) are not recommended to lower blood pressure;

2. Eat a healthy diet

• Control the intake of high-calorie foods (high-fat foods, sugary drinks, alcohol, etc.);

• Properly control the intake of staple food (carbohydrates);

• Increase your intake of vegetables and fruits;

• Eat less or no processed foods with high sodium content, such as pickles, ham, sausages and all kinds of fried nuts.

3. Limit alcohol intake

• Any type of alcohol is not good for the human body. It is recommended that patients with hypertension do not drink alcohol; if drinking, the daily alcohol intake of adults should not exceed 15g.

4. Control your weight

• People with high-normal blood pressure and all hypertensive patients should actively control their weight;

• Weight loss in all overweight and obese patients;

• Set a weight loss of 5% to 15% or more as a weight management goal; lose 5% to 10% of your initial body weight within 1 year;

• First, control weight through comprehensive lifestyle intervention, including self-monitoring of weight, proper diet, increased physical activity/exercise, and behavioral intervention;

• For those whose weight loss is not satisfactory with comprehensive lifestyle intervention, drug therapy or surgical treatment is recommended;

• For special populations, such as breastfeeding women and the elderly, individualized weight loss measures should be adopted depending on the specific circumstances;

• Weight loss plans should be adhered to over the long term, the speed varies from person to person, and you should not rush for quick results.

5. Exercise intervention

• Patients can adopt exercise interventions such as aerobic exercise, resistance exercise, meditation and breathing training, flexibility training and stretching training;

• For hypertensive patients with well-controlled blood pressure, a mixed training program with aerobic exercise as the main component (moderate intensity, 30 minutes per day, 5-7 days per week) supplemented by resistance exercise (2-3 times per week) is recommended; it is also recommended to combine breathing training with flexibility and stretching training;

• For those with uncontrolled blood pressure (systolic blood pressure >160mmHg), high-intensity exercise is not recommended until blood pressure is controlled.

6. Don’t smoke

• Strongly recommend and urge hypertensive smokers to quit smoking;

• If necessary, use smoking cessation medication to combat withdrawal symptoms;

• Avoid using e-cigarette alternative therapies;

• When quitting smoking, supplement it with physical exercise;

7. Maintain psychological balance

• Adjust yourself to avoid psychological imbalance;

8. Manage sleep

• Increasing effective sleep time and/or improving sleep quality can significantly increase the efficacy of antihypertensive drugs and reduce the incidence and mortality of hypertension. The main measures for managing sleep include sleep assessment, sleep cognitive behavioral therapy, and drug treatment when necessary.

Correct monitoring and standardized management

1. Correct measurement The best time to measure blood pressure is within one hour of waking up in the morning, before breakfast, after urinating, or before dinner. If you have been active before measuring blood pressure, you can rest for 5 to 10 minutes. Before measuring, the cuff should be tied 2 horizontal fingers above the elbow. The tightness should be appropriate to fit 1 to 2 fingers. When measuring, the sphygmomanometer should be at the same level as the heart. Be careful not to move or talk during measurement, and keep calm.

2. Monitoring frequency

It is recommended that patients with hypertension monitor their blood pressure twice a day if their blood pressure is well controlled, namely after getting up in the morning and before dinner. It is recommended that patients with stroke within one month after discharge or who are adjusting their antihypertensive medication monitor their blood pressure four times a day, namely after getting up in the morning, before lunch, before dinner, and before bedtime.

3. Standardize records

Blood pressure should be recorded in time after each measurement. It is recommended that patients with hypertension prepare a blood pressure record book to record the daily blood pressure and heart rate or pulse rate in a standardized manner. Bring the blood pressure record book with you every time you visit the hospital so that the doctor can adjust the antihypertensive medicine according to the patient's daily blood pressure.

Source: Beijing Tiantan Hospital