What is white coat hypertension? How does traditional Chinese medicine prevent and treat white coat hypertension?

What is white coat hypertension ? How does traditional Chinese medicine prevent and treat white coat hypertension?

Author: Chen Zhenchong, deputy chief physician

Unit: Department of Traditional Chinese Medicine, Dagang Town Community Health Service Center, Nansha District, Guangzhou

White coat hypertension refers to the condition in which the blood pressure measured by a doctor in the clinic is always elevated, while the blood pressure outside the clinic is not elevated during the day, and the dynamic blood pressure monitoring is normal. Some people think that it is more appropriate to call it "simple clinic hypertension".

This may be because the patient becomes nervous after seeing the doctor in a white coat or in the clinic environment, resulting in excessive catecholamines in the blood, which accelerates the heart rate, constricts blood vessels, increases peripheral resistance, and thus leads to increased blood pressure.

Current studies have shown that white coat hypertension may be an intermediate state between normal blood pressure and hypertension.

1. Western medicine treatment of white coat hypertension

White coat hypertension does not require treatment; however, if there is evidence of target organ damage or an increased risk of cardiovascular disease, patients with white coat hypertension should receive antihypertensive therapy.

The treatment cycle varies from person to person and needs to be comprehensively judged based on the patient's own health condition. If the patient has risk factors, such as damage to the heart, brain, kidneys, etc., long-term continuous treatment is usually required.

2. TCM treatment of white coat hypertension

This disease falls into the category of headache, vertigo, etc. in traditional Chinese medicine. So, what are the methods of traditional Chinese medicine for treating white coat hypertension?

1. Massage therapy.

Wipe: Wipe the forehead with the index or middle finger of both hands.

Rub: Rub the left and right sides of the head with the palms of both hands. Do not use too much force when rubbing, just feel comfortable.

Combing: bend your fingers slightly, and use your ten fingers like tiger claws, starting from the hair roots on the forehead, inch by inch towards the top of the head, and then inch by inch towards the back of the head, while combing. Of course, you can also alternate between the left and right hands and repeat the combing for about 5 to 10 minutes. On this basis, you can also use the three methods of "rolling", "kneading" and "pressing".

Rolling: Roll the waist and back. The method is to first hold the fists of the left and right hands, and roll the fists and eyes up and down on the left and right sides of the corresponding waist and back as large as possible, and massage for 3-5 minutes.

Kneading: Knead the abdomen. The method is to overlap your hands and use the hand closest to the abdomen to press the lower abdomen and knead gently. When kneading, rotate clockwise for about 3 to 5 minutes. After kneading the abdomen, blood pressure will drop significantly.

Press: It means to massage the acupoints. Commonly used acupoints include Jianjing acupoint (the midpoint between the shoulder, straight breast, Dazhui and acromion end), Neiguan acupoint (palm side of forearm, 2 inches from the transverse wrist line), and Hegu acupoint (dorsum of hand, 1st and 2nd metacarpal bones).

2. Acupuncture treatment

Traditional Chinese medicine believes that liver-kidney yin deficiency, liver yang hyperactivity, headache and dizziness; the liver likes to be smooth, depression can easily turn into fire, liver yin is consumed, wind yang is easy to move, and dizziness; spleen deficiency, or improper diet can further damage the spleen and stomach; or worry about fatigue, spleen yang deficiency, water retention, phlegm accumulation, phlegm blocking the meridians, clear yang not rising, and dizziness.

Commonly used acupuncture points:

Dazhui, Jianjing, Feishu, Liangmen, Taiyang, Fengchi, Yongquan, Taixi, Taichong, Zusanli, Quchi, Zhongyuan, Fenglong, Baihui, Qihai and other acupoints.

3. Qigong treatment

Sit or stand. Sitting means sitting on a chair, with legs apart and naturally on the ground, hands on thighs, palms down, whole body relaxed, mood happy and calm, eliminate distracting thoughts, guard Dantian, lips lightly closed, eyes slightly closed, adjust nasal breathing. Standing means standing naturally, feet at shoulder level, knees slightly bent, hands holding the ball in front of the body, whole body relaxed, guard Dantian, adjust breathing. 10-30 minutes, 1-2 times a day

Traditional Chinese medicine is effective in treating white coat hypertension and is well received by everyone. Therefore, patients who have not been effectively treated with other methods may wish to try the above method.

3. The Importance of Comprehensive Treatment of Chinese and Western Medicine

At present, the cause of white coat hypertension is not completely clear. Some studies believe that its occurrence is related to abnormal nerve regulation, psychological stress, metabolic abnormalities, etc. In addition, genetic factors, gender factors, and bad living habits can also increase the incidence rate.

Traditional Chinese medicine believes that the treatment of this type of hypertensive patients does not advocate increasing the dosage of antihypertensive drugs to reduce the increase in their blood pressure. It mainly uses non-drug therapies to guide patients to stabilize their emotions and perform self-regulation.

1. Due to large individual differences, there is no absolutely best, fastest, and most effective medication. In addition to commonly used over-the-counter drugs, you should choose the most appropriate medication under the guidance of a doctor and fully combine your personal situation.

White coat hypertension is generally not treated with drugs, but those with risk factors or target organ damage need to be treated with drugs in a timely manner. For those with a fast heart rate (resting heart rate>80 beats/min), B-receptor blockers such as metoprolol and bisoprolol are preferred. For those without a fast heart rate or impaired glucose tolerance, angiotensin receptor antagonists (ARBs) can be used for long-term treatment in low doses. In addition, for those with metabolic disorders such as blood sugar and blood lipids who have poor improvement after adjusting their lifestyle, statins, dimethoprim, gliflozin, etc. can be used at the same time to lower blood lipids and blood sugar. Note that due to large individual differences, medication should be selected under the guidance of a doctor and fully combined with personal circumstances, and should not be selected on your own.

2. Symptom relief

The first thing is to stay relaxed and happy. Doctors are also ordinary people and there is no need to feel nervous when facing the white coats.

Conduct 24-hour dynamic blood pressure testing and conduct a comprehensive analysis with reference to the electrocardiogram and other diagnostic and treatment conditions.

3. What are the possible complications?

White coat hypertension is a clinical state between normal blood pressure and persistent hypertension. Due to the volatility of blood pressure, it may cause certain damage to target organs, mainly affecting the heart, kidney structure and function, cerebrovascular and renal function.

4. What is the effect after treatment?

White coat hypertension generally does not require treatment when there are no metabolic disorders such as blood sugar and blood lipids. When these risk factors are present, standardized drug treatment generally has a good effect.

5. How should you monitor your condition in normal times?

Patients should pay attention to daily blood pressure monitoring and rest for 10-15 minutes before measuring their blood pressure to avoid affecting the results.

6. How can ordinary people prevent white coat hypertension?

Developing a good lifestyle is conducive to preventing the occurrence of diseases. Maintaining mental health, exercising more, resting more, thinking more, reading more, thinking positively and other activities that are friendly to the body and mind can maintain a good mental activity.

(1) Exercise

Scientific exercise can help us control weight, improve basal metabolism and prevent the occurrence of cardiovascular diseases.

(2) Quit smoking and drinking

Quitting smoking and drinking can reduce the damage to the cardiovascular system and prevent the disease to a certain extent.

(3) Lifestyle

Pay attention to the adjustment of lifestyle, avoid stress, correctly deal with and try to relieve various psychological pressures, and cultivate good psychological quality.

(4) What should we pay attention to in our daily diet?

Patients should eat a light diet, less oil and salt, and less greasy and spicy food.

Author: Chen Zhenchong, deputy chief physician of traditional Chinese medicine

Unit: Dagang Town Community Health Service Center, Nansha District, Guangzhou