1. Morning hypertension in the elderly
It is not advisable to get up immediately after waking up in the morning, and then get up after a quarter of an hour or so of slow limb movement in bed; the activity should not be too strenuous after getting up, and appropriately delay the time of the morning exercise; take antihypertensive medication for 30 minutes to one hour before the start of the morning exercise; serious morning peaks should be adjusted to the time of the exercise in the afternoon or evening; and the medication time is determined according to the rhythm of blood pressure. blood pressure rhythm to determine the time of medication. In case of nocturnal hypertension, long-acting antihypertensive drugs can be chosen to be taken before bedtime.
2. Postural hypotension in the elderly
Discontinue possible medications (nitrates, tricyclic antidepressants, nerve relaxants and ɑ-blockers, etc.); Increase salt and fluid intake moderately in those with decreased blood volume; Prevent venous stasis; Wear tight pants and elastic stockings; Sleep with a slightly elevated head position; Adhere to sports; Move slowly when shifting from a prone to seated or standing position. When changing from prone to sitting or standing position, the movement should be slow and let the body gradually adapt; patients whose basal blood pressure is not very high can consider reducing the amount of antihypertensive drugs; severe postural hypotension can be tried for a short period of time, such as fludrocortisone, midodrine, indomethacin, and so on.
3. Postprandial hypotension
First of all, we should treat the underlying diseases (hypertension, diabetes mellitus, Parkinson's disease, paralysis, and renal disease, etc.); patients with hypertension can switch to taking antihypertensive medication between meals; low-carbohydrate diets; smaller meals, avoiding overheating of food; appropriately increasing the intake of sodium salt and water; limiting or abstaining from alcohol; and taking a break from eating. 10~20 minutes before getting up and moving, move the limbs before getting up; obese or diabetic patients can try acarbose; serious cases can try Midodrine.
4. Intractable hypertension
Excluding secondary hypertension, clinic hypertension, pseudohypertension, confirm that the patient adheres to the treatment; . Intensive lifestyle interventions, especially salt restriction, alcohol restriction, weight loss, and relief of stress and anxiety; . Combination of at least 3 drugs with different mechanisms of action; patients with coronary artery disease or heart failure may prefer the combination of b-blocker ACEI/ARB and CCB; if there is no coronary artery disease or chronic heart failure, ACEI/ARB+CCB+diuretics may be preferred; when the conventional dose is not up to the standard and the patient is able to tolerate it, various drugs may be used up to the maximum dosage recommended by the instructions; diuretics and spironolactone may be a winning combination;.... Try adding BB or a blocker.
5. Benefits of weight loss
Weight loss of 10 kilograms: systolic blood pressure is reduced by 10-20 mmHg, cholesterol is reduced by 10-20%, blood glucose is lowered by 1-2 mmol, and cardiac load is reduced by 20%. The resulting benefit is a 35% reduction in cardiovascular risk over 10 years! Mild hypertension, diabetes, and hyperlipidemia can be treated through weight loss.
6. Wrong practices
High blood pressure is asymptomatic without medication; high blood pressure is asymptomatic, but the medication down to normal but dizziness, so do not use the drug; worried about the side effects of antihypertensive drugs so do not use the drug; afraid of antihypertensive drug dependence and do not use the drug; high blood pressure to eat a few days, down to normal after the discontinuation of medication; to see other people to eat what the medicine they take what the medicine; rather than eating The company's main goal is to provide the best quality products and services to its customers.
7, antihypertensive precautions
Precautions a, diet should be reasonable
Elderly patients with hypertension should pay attention to the diet of low-salt, low-fat, high protein principle. Salt intake is no more than 10 grams per day, preferably less than 5 grams. Limit the intake of animal fat and cholesterol, mainly consume vegetable oil, which is not only conducive to the prevention of atherosclerosis, but also facilitate the control of blood pressure. Intake of appropriate amount of protein, in addition to the protein provided by cereals, should be given milk, lean meat, fish and other foods. At the same time, eat more potassium-rich foods, such as vegetables and fruits, in order to replenish vitamins and regulate the electrolyte balance in the body, and to ensure smooth bowel movements. A certain amount of potassium and calcium intake can reduce the sensitivity of the cardiovascular system of the elderly to sodium, thus reducing blood pressure.
Precautions two, pay attention to upright hypotension
Elderly people are prone to produce upright hypotension. Therefore, when an elderly patient changes from lying down to upright position during antihypertensive treatment and becomes dizzy, it suggests the possibility of upright hypotension, which should be highly valued.
Elderly patients with hypertension should strictly follow the requirements of hypertension in the elderly, pay attention to self-care, reasonable diet, moderate exercise, and under the guidance of the doctor, adhere to the "lifelong medication", which is important for the prevention and delay of complications.
Precautions three, exercise in moderation, sleep to be sufficient
Elderly patients with hypertension should be able to get up and down sometimes, appropriate activities, work and rest, sleep enough. A regular scientific lifestyle can maintain stable blood pressure; overwork can raise blood pressure and aggravate the condition. Elderly people should ensure 8~9 hours of adequate sleep every day.
Precautions four, the spirit should be happy, emotional stability
Bad mood can make the heart beat faster, blood pressure rise, so the elderly patients with hypertension should maintain a calm state of mind, to avoid emotional excitement and too nervous.
Precautions five, clothing to wear loose
Elderly patients with hypertension should not be too tight, to soft and loose for good. It is best to wear cotton clothing, breathable, both easy and warm. Trouser belts and ties should not be tied too tightly, so as not to cause blood pressure fluctuations.
Precautions six, adhere to the medication, do not stop taking medication
Medication is the main treatment of hypertension in the elderly. Elderly hypertensive patients should insist on taking antihypertensive drugs according to the doctor's instructions, so that the blood pressure is gradually controlled within the normal range. During the application of antihypertensive drugs, elderly patients should move as slowly as possible when sitting up or standing up.