Hypertension blood pressure goals vary from person
QuestionHypertension blood pressure goals vary from person to person only!
Answer
Almost all kinds of people can be reasonable, through a positive benefit from antihypertensive therapy. However, because different populations have different physiological and pathological basis for the goal of antihypertensive treatment is slightly different. Therefore, in clinical practice, patients should be fully taken into account the merger of other diseases and other factors to determine the ideal target blood pressure. (A) Stroke Stroke is an important complication of hypertension, one of more than 60% of stroke patients have a history of hypertension. The study found that stroke recurrence rate was as high as 3-5%, and with the level of arterial blood pressure was closely related to the positive. On the other hand, a positive step-down therapy can significantly reduce the brainThe risk of stroke recurrence. Evidence-based medical evidence showed that the antihypertensive treatment of stroke patients will be satisfied with the level of blood pressure control, the occurrence of the risk of stroke may be reduced to a history of stroke in patients with the same level. To this end, the new guidelines in the step-down treatment of the same people a higher demand, that there will be past history of cerebrovascular disease in patients with blood pressure lowered to below 140/90 mmHg or less. However, because of their special pathophysiological mechanisms and clinical features, acute phase of stroke antihypertensive therapy should be more cautious. Acute stroke, in particular the incidence within a week, plasma cortisol and catecholAmine levels were significantly higher in patients with intracranial hypertension, cerebral hypoxia, pain and mental tension, and the resulting increase in blood pressure reflex. At this point the body itself would have made this series of changes in physiological responses and adjustment. If at this stage of the lower blood pressure too much may increase the brain tissue ischemia, hypoxia, is not conducive to the disease caused by the restoration of even more serious consequences. Therefore, unless a serious increase in blood pressure (more than 180/105mmHg), antihypertensive drugs should be suspended. Is generally believed that within a week of acute cerebral infarction, the blood pressure remained at between 160-180/90-105mmHg the most appropriateDesirable. If a serious high blood pressure, should use some of the weaker the role of antihypertensive drugs to lower blood pressure in a smooth slow. Compared with ischemic stroke, hemorrhagic stroke antihypertensive treatment is more complex: high blood pressure can lead to bleeding or active bleeding, blood pressure is too low will increase the cerebral ischemia. For such patients, blood pressure is considered to be maintained at the level of cerebral hemorrhage, or slightly before the sound even more. High blood pressure can reduce intracranial pressure in the premise of the role of careful selection of some antihypertensive drugs are more peaceful, so that the slow reduction of blood pressure stable. General lowering of blood pressure within two hours of not more than 25%. Lower blood pressure too fast, too much may haveAdversely affect the condition. Blood pressure in acute intracerebral hemorrhage 150-160/90-100mmHg maintain appropriate. Whether cerebral hemorrhage or cerebral infarction, once the condition to restore stability, antihypertensive therapy should be gradually restored, and blood pressure control in the following 140/90mmHg. (B) the occurrence of hypertension in patients with diabetes mellitus 1.5-2 times in non-diabetic patients, the incidence can be as high as 50%. New guidelines in the prevention and treatment of high blood pressure to diabetes as quot;the other book,quot; The risk factors that the risk of hypertension and diabetic complications in other target organ damage equivalent. This is becauseHypertension and diabetes are major cardiovascular risk factors in the incident, both on the cardiovascular system adverse effects has multiplied. Active and effective antihypertensive treatment, not only can reduce the incidence of cardiac events, but also can avoid or delay some diabetes-related complications (such as renal glomerular and vascular lesions) from happening. Well-known British prospective study of diabetes (UKPDS) found that active antihypertensive treatment benefit more than Jiangtang treatment. While some scholars believe that the goal of using the step-down target is more stringent than Jiangtang, the results still strong in the diabetic patients in active treatment of the importance of blood pressure.At the same time, China#39;s quot;systolic blood pressure test,quot; also confirmed that satisfaction with diabetes can control blood pressure and heart rate of total cerebrovascular events over 50-60% lower. It can be seen that the diabetic patients with hypertension should be a step-down treatment of one of the most important target groups. In this context, new guidelines for the diabetic patients with hypertension has a more stringent blood pressure target of 130/80mmHg the following, or in patients with the lowest level can be tolerated. At the same time, more stringent control of blood glucose to be cardio-cerebral vascular system of the harm to a minimum. (C) renal renal failureDamage is commonly combined symptoms of high blood pressure, high blood pressure is also lethal, one of the key features disabled. Either directly or indirectly, hypertension, renal failure, kidney disease can also add to the original. And kidney disease can cause imbalance in humoral regulation and metabolism of vasoactive substances, in turn, can increase blood pressure, creating a vicious cycle. There is no sufficient evidence to confirm that antihypertensive treatment can reduce the occurrence of the risk of renal failure, but at least delay the occurrence of kidney damage. Taking into account the above factors, the new proposed guidelines do not affect renal blood perfusion, not to the deterioration of renal function under the premise of blood pressure should be reduced to 130 /Below 80mmHg. Such as already exists in patients with renal dysfunction, or urinary protein more than 1g/24 hours or even reduced blood pressure to below 125/75mmHg. Similarly, the choice of antihypertensive drugs to minimize the effect of long-acting formulations relatively slow, and pay attention to monitoring changes in renal function. (Internship Editor: Mrs Sharon)